Do you have neck pain and frequent severe headaches? Does your headache not respond to conservative treatments, like physical therapy?
You may need to see a neurosurgeon.
Many people think neurosurgeons only focus on conditions affecting the brain. However, the specialty is broader than that. Neurosurgeons also treat conditions of the nervous system, which includes the brain, spine, and spinal cord.
Headaches caused by referred pain from the cervical spine in the neck are referred to as cervicogenic headaches. These headaches are often triggered by certain neck movements. Pain typically begins in the base of the neck and progressively moves into the head.
When to Consult with a Neurosurgeon
Most neck pain with headaches is caused by muscle strain and can be treated through conservative, nonsurgical treatments, such as physical therapy, pain medication, or applying heat or cold packs.
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However, if your headache pain radiates from the neck – and you are experiencing pain, numbness, tingling and muscle weakness – your nervous system could be involved.
The following symptoms are signs that you may need to see a neurosurgeon:
- Severe pain or discomfort that radiates from the neck
- Pain caused by trauma, such as a fall
- Pain on one side of the head
- Same-sided shoulder or neck pain
- Nausea and/or vomiting
- Sensitivity to light or sound
- Difficulty swallowing or breathing
- Loss of bladder control
- Slurred speech
- Blurry vision
Your First Appointment: What to Expect
On your first visit with a neurosurgeon, your doctor will ask you to describe the symptoms you are experiencing. Your doctor will perform an assessment and order one or several of the following diagnostic imaging tests:
An x-ray provides an overall assessment of the health of the bones in the spine and neck. Your doctor will look for signs of abnormal alignment, dislocation, or slippage of vertebra or spinal discs. Abnormalities such as bone spurs, stenosis (disc space narrowing), fracture, or misalignment can be identified on x-ray.
A CT scan (computed tomography scan) is an imaging test that produces more detail than an x-ray. CT scans provide cross-sectional images of the affected area and can help doctors spot abnormalities that do not show up on x-ray, such as blood clots, internal bleeding, and small tumors.
An MRI (magnetic resonance imaging) test uses a magnetic field that creates radio waves to produce detailed, 3D, high-resolution images of structures in the body, including bones and the surrounding soft tissues. This test is frequently used to detect conditions of the brain and spinal cord.
After Your Diagnostic Exam
After your diagnostic exam, your doctor will pinpoint the specific cause of your symptoms and let you know whether surgical intervention is required. Generally, surgery will be considered if other treatments have not helped.
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If your condition is caused by a compressed nerve in the cervical spine, your doctor may perform a nerve decompression surgery. The goal of nerve decompression surgery is to relieve the pressure on the nerves in your cervical spine, usually by decompressing the area, increasing spinal canal space and removing the nerve impingement.
The procedure is minimally invasive. It is performed through a small incision and guided by video from a miniature camera. The bony plate on the back of the vertebra (the lamina) is removed, which creates more space for the spinal nerves.
Sometimes spinal fusion may be needed. In this procedure, the surgeon removes the lamina as well as the discs. The vertebra is then linked to adjoining vertebrae with metal hardware and a bone graft (spinal fusion) to maintain the spine's strength.
Pain Prevention Post-Surgery
Your doctor may prescribe pain-relieving and anti-inflammatory medications. Additionally, you can do the following self-care at home to prevent pain:
Avoid movements that strain the neck.
Your doctor may provide you with a neck brace or cervical collar to immobilize your neck. In your daily activities, be mindful not to put unnecessary stress on your neck.
Apply hot or cold packs.
If you are experiencing pain, apply heat or ice to your back or neck. Heat will relax the muscles in the neck. Cold will help to reduce inflammation.
Watch your posture.
Avoid slouching, which puts unnecessary pressure on the neck. Keep your spine erect when sitting or standing. If you work at a computer, sit up straight and set the height of the chair so you are keeping your spine in a neutral position and not straining your back or neck.
After your recovery, your doctor may refer you to a physical therapist to help you learn gentle exercises to strengthen muscles in your neck and shoulders, correct any muscle imbalances putting unnecessary pressure on the neck, and to increase spinal flexibility and mobility.
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