Cervical Neck Instability

@slw18 I would advise a consult with a spine specialist and a current MRI to determine your status. An X-ray does not show the discs, but it can show if the spaces the discs occupy between vertebrae are abnormal. In general, you can go to a physical therapist, but the PT should be asking you for a report of imaging if there is any question of spinal instability. If you have instability and the vertebrae can slide forward or back, you are at serious risk of injury or paralysis if someone works on your neck. It sounds like your orthopedic doctor does not want to take your case for any further treatment. Surgeons pick and choose cases, and they may avoid difficult cases because a poor surgical outcome can hurt their statistics of success. They are rated by insurance companies and don't want to harm their careers, so they refuse to help patients. They also refuse to help patients who they don't think they can please because they don't want bad reviews posted online. Sometimes they don't help people if they perceive a mental issue also because that patient will never be happy with the outcome. These are things I have heard a surgeon say when presenting cases at a conference for other surgeons and discussing patient selection. Do everything you can to be a good patient that surgeons will want to help.

You do need to find another doctor for another opinion. Spine surgeons like to refer patients to specific neurologists if testing is required, so it makes sense to start with a spine specialist. You do have an old injury, and spine problems from that can sneak up on you. You mentioned "electrical stimulation throughout the body". You might be describing the same symptom I had that was caused by spinal cord compression. When I bent my neck forward, I got an electric shock down my entire body. If that is what you have, You should see a spine surgeon ASAP. Choose your spine surgeon carefully. Some are gifted; some are not, so do your research and find the best you can. Check your insurance coverage and make sure they are in network. Spine surgery is very expensive. If you do make another appeal to get into Mayo, do that with current imaging of your spine issues directed to a spine surgeon or to the neurosurgery department. Your primary care doctor could order MRI imaging based on your symptoms for a referral to a spine specialist. There are orthopedic and neurosurgery spine experts and either can operate on the spine. I chose my spine surgeon because his areas of interest matched my case, and because when I read his papers, I knew he would understand my symptoms because it referenced leg pain caused by cervical stenosis (cord compression in the neck). Here is my patient story. Let me know if I can be of further assistance. I was turned down 5 times before I came to Mayo.
https://sharing.mayoclinic.org/2019/01/09/using-the-art-of-medicine-to-overcome-fear-of-surgery/

Jump to this post

Thanks Jennifer. The electric feeling is like when you have an anxiety attack. it never goes away. its feels like vibrations in my legs and sometimes my neck. I've been to so many doc I dont know what it is anymore. It makes it also feel like my heart is racing. I did a MRI of the cervical and the neurologist said there was no concern. He is having another MRI of the pituitary gland bc he saw something of question. Could a muscle in the neck cause this? would that show on a MRI of the cervical?

Jump to this post

@slw18 What comes to my mind is thyroid function. If your thyroid is overactive, or if you take thyroid meds and you are on an overdose, that produces anxiety type symptoms and a racing heart beat. Hopefully your doctors have checked this, if not, it would be something to ask about. Another thing to think about would be a deficiency like Magnesium. Most people are deficient and don't know it. I have been deficient myself and have felt like I had bugs crawling on my skin and little tingles and zaps. Taking magnesium supplements and soaking in epsom salt baths does help. Another cause could be symptoms of menopause which also causes anxiety type symptoms for some women. I don't know if that applies to you at all, but I mention it for those who may benefit. I know my heart rate can be affected and that taking bio-identical hormone replacement helps smooth things out and I have less aches and pains and sleep better. If you don't get good sleep regularly, that can certainly add to anxiety type symptoms. How about breathing issues? I also have asthma and I do have a faster heart beat when I'm getting clogged with phlegm. I check this along with my oxygen levels when I don't feel that great and it helps me know when to use my inhaler. I also know when I may have a chest infection when my heart races just with walking around. I have some physical issues that cause trapped phlegm that can easily become bronchitis, so I try to be aware of changes and treat them right away and stretch when I feel a chest spasm coming on. Keeping allergies under control goes a long way toward good breathing and a lower heart rate and I just feel better.

As for your question of if a neck muscle can cause anxiety and a racing heart, the answer is yes. That has also happened to me. If you have tight neck muscles, it can compress the nerves next to the spine that go to the heart and lungs. I have thoracic outlet syndrome which causes tightness between my neck and chest and a few times, it has caused a spasms in a chest muscle and sped up my heart, or when I tucked my head bending my neck it could bring on the spasm. I am also a spine surgery patient and a time that this happened was right after my surgery to fuse C5/C6 that caused throat swelling from the surgery. I knew it was a neck spasm that started it because the pain started in my throat (which hurts right after ACDF surgery) and it migrated into my chest. I was able to take my hands and massage the chest and stop the pain. It happened a few other times too, and I have been working with a physical therapist on this for several years treating the TOS, and there have also been times that I went to the ER with a racing heart rate because of the trapped phlegm causing a chest infection. (This was all prior to COVID) My dad was a heart patient, and that was all ruled out for me. Extreme stress and harassment can also cause chest pain which I experienced several years ago and consulted a cardiologist. He found no issues whatsoever, so changing my diet when my dad because a heart patient many years ago made a big difference for me since I was in my early twenties at the time.

On MRIs, usually a spasm is noted because of where the shortened muscle will move the bones. For example on a cervical spine MRI, they may note the loss of the lordotic curve (or lordosis) which straightens the spine by taking away the normal curve. My spine was like that before my spine surgery due to spasms. You may also see that vertebrae may be twisted or tilted and not aligned properly. You may want a physical therapy evaluation, and I would recommend looking for one who also does myofascial release. You can have tight tissue anywhere in the body that can compress nerves and we develop patterns of tightness from injuries, infections, inflammation, surgeries, and bad habits. Nerves pass through some pretty small spaces. Here is the link to our MFR discussion.
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/
There is a provider search on the MFR website for therapists. There is a lot to read with most of the information links on the first pages of the discussion. MFR therapy help a a lot of issues and a good therapist can feel the tightness wit there hands and where that might wrap around in your body, for example around the heart or lungs. The tightness of the respiratory diaphragm also affects breathing. One side of my body is to tight, so I work on this all the time too.

Jump to this post

Jennifer, they did a test of my thyroid and hormones and everything was fine. i just went to the hospital again for heart rate of 140 just by standing up and they said I was fine. Im running out of hope.

Jump to this post

@slw18 It might be time for an opinion somewhere else, and not from an emergency room. They pretty much treat whatever is an acute problem and tell you to follow up with another doctor. They won't be looking deeper for causes of issues. Has anyone checked how your blood pressure changes between sitting, standing and laying down? Your body is supposed to compensate for changing position, and blood pressure and dehydration do affect heart rate. Make sure you get enough water. Do you think this is anxiety because of not knowing what is wrong? I re-read your first post and you have reported a lot of symptoms that can be spine injury related in your discussion about your chiropractor. Do you want to consider seeing a spine specialist? I know it is easy to get overwhelmed when you are seeing a lot of doctors and no one is figuring things out and you don't feel like they are listening to you.

Don't loose hope. I went through 2 years of this of having a cervical stenosis with cord compression and being refused surgery and doctors making up excuses like perhaps I had MS (no I didn't), the central nervous system doesn't feel pain (yes it does feel funicular pain), go to a rehab specialist and fix that problem in your legs, and then you can come back to me for spine surgery ( and the leg problem was caused by the compression of the cervical spinal cord). I know your neurologist doesn't see an issue, but is this neurologist one who specializes in spine problems? That is why I recommend starting with a spine specialist who then refers to the neurologist who they like to work with in a spine center. That is really why you should come to a place like Mayo or Clevland Clinic where they have a lot more experience with difficult spine cases and an interdisciplinary team that works efficiently to figure it out.

The beginning of your symptoms from the chiropractor session is a big clue to what may be wrong now which you need to tell your specialist. It helps to have family support, and if you don't have that, you may need to reach out to your friends. It's a lot to go through when you have spine issues and recovery from spine surgery takes awhile. Everything involves ruling out other possible causes of overlapping symptoms. I had overlapping nerve pain symptoms being generated from carpal tunnel syndrome, thoracic outlet syndrome, in addition to an old spine injury with cord compression. That made me a complex case that was misunderstood, and that surgeons didn't want to mess with. You have to advocate for yourself and keep looking until you find a good specialist who will look for the causes of your symptoms. I know this is hard, but you are the only one who can advocate for yourself. Keep a chart of dates, times and when you have symptoms and what you were doing at the time, for example body positions, etc. Keep records of heart rate and blood pressure and time of day, etc. You can also try sinking your palm into your chest below the collar bone and pushing toward the arm pit and holding it. Use a ball in your hand or something to help if you need it or someone else can do that for you. That will help open up chest tightness and that is how myofascial release works. You might have to hold that 15 minutes before is starts to release. Do both sides. Start working on the anxiety with relaxing music and slow deep breathing in time to the music. I did a lot of that and it really helps. I could lower my blood pressure 15 points on the top number by doing that, and lower my heart rate. Make that a daily habit. Set a goal, measure your blood pressure and heart rate before you start and after you have listened to music for an hour doing deep breathing. When you make progress, celebrate that small victory. That might be enough to build confidence as you navigate among doctors, and you will build a habit and a safe place you can return to any time you need it.

Jump to this post

im suppose to get a ultrasou d of the heart and a heart monitor to wear but its just a long drawn out process. ive just had a mri of the cervical spine and they didnt find anything. i dont know what else to do. the more i try drs the more i get ocd and anxious.

Jump to this post

Where do I begin…. I feel lost and scared because I cant find the right doc or a doc I need that will see me.

I have always had neck and back issues, which I can usually control with a visit to the Chiropractor. I have also had this gaging feeling or choking feeling in my throat for about a year. It wasn’t till the first of 2020 I started to notice a trend in my symptom.

I started to get really fatigued and had a burning in my throat with the gaging feeling at time when I would turn my head a certain way, or try to do crunches at the gym, a whooshing sound in my ear when I would lay down. Still all manageable,. I even got test for COVID-19 thinking that was the case, but negative.
I went to my OBGYN thinking it was hormone related, all checked out normal. Then I went to a Endocrinologist and thought maybe it was my Thyroid or Adrenals. I thought maybe my Cortisol was off too, because certain sounds, like a smoke detector would send me into a panic. Those tests came back fine. So I took a break and tried to overlook the symptoms. I started to need to drink a coffee in the morning and an energy drink in the afternoon to just get by, but then I couldn’t sleep in the evenings.

It wasn’t till the end of 2020 I started to notice more symptoms. By February 2021 I looked into a ENT doc and told them about my symptoms. They check the throat and they thought it was GERD, so I went on a strike diet, but it didn’t work. They checked my earing due to the whooshing sound in my ear and the neck pain. That is also when I also notice a small bump under my ear sticking out. The doc said it was the Transverse process of the upper cervical and that its completely normal. “Normal!” I didn’t have it before. During this time, I started to research my symptoms and came across CCI. I mentioned it to him, but he said he could only test for the certain things. So I got a MRA brain without contract, MRA of neck without contract, and a MRI IACS with and without contract. All that came back was a 4mm pineal cyst in the brain. They didn’t see anything alarming, so they said they couldn’t do much else to help. So I requested for a referral. Once I found out about the transverse process, I went to my Chiropractor who said he could adjust the neck( which I have never done), reluctantly I agreed. After two sessions the bump went away, but that when things got worse. Not sure if there is any relation to the adjustment or not, just stating the facts. The Chiropractor also suggested I try to do some neck stretching exercises to help with my posture and that it could help the neck pain. So I did a couple of them and that’s when I notice major changes.

While this was all happening, I started to notice new symptoms:
• stiffness in neck, Tension headaches everyday
• head shakes when upright too long
• heart palpations and chest pain
• sensitivity at base of skull and upper neck
• pressure on top, lower skull, upper neck when upright too long- once pressure has increased it hurts to lay head down
• stiffness in neck
• tenderness at base of skull
• blurred vision
• brain fog- have hard time finishing sentence or completing a verbal thought
• pulsating in varies body parts
• ear issues- pulsatile tinnitus, fizzy sound, and ears fill full, sensitivity to sounds
• cold and sweaty hand and feet- comes and goes
• dizzy and off balance after upright
• electric stimulation throughout body daily
• chronic fatigue
• cognitive and memory decline
• difficulty swallowing or sensation of being choked

The ENT gave me a referral to an Orthopedic doc, but that didn’t do much help, because they went by the ENT notes and only wanted to examine one thing. I got a couple xrays and they said maybe try a Neurologist. Really? No further test? You won’t look into more based on my symptoms? He couldn’t tell me if the adjustment to my neck could have started this, nothing about the transverse process either. Frustrated, So I have currently took the referral and I’m hoping to get into a Neurologist, but it’s a waiting game to see if they will even take me based on previous doc notes, which could be a misdiagnosis. I tried to get into the Neurology group at Mayo but got denied. Orlando doesn’t have the best rating of Neurologist in the area, which is depressing.

I think based on my research it is CCI, but not sure at this point. I feel I need a upright MRI of the neck and brain with/ and without contrast. I need to know there is no tumors in the brain and need to rule out if this is CCI.

I’m so scared. I see so many people on here who can’t get to the right docs. I was laid off due to Covid in 2020 and just starting to get some freelance work, but I can barely work. No job is going to hire me, if I can only work a couple hours a day. Being bounced around from doc to doc, I’m starting to getting a lot of bills. My family is frustrated at the situation, and I think my husband almost thinks it’s in my head. I deal with anxiety and OCD on top of this so most doc sum it up to that and it just makes me obsess about it more.

Can anyone give me suggestions? I cant seem to find the right docs or get the right referral.
I want to rule out brain tumor, so it’s that a MRI with contrast of the brain? Is the 4mm cyst in the brain adding to this?
I want to do a test for CCI and maybe CSF- do I do a upright MRI of the upper cervical spine?

Jump to this post