Question
I am a 36-year-old male, 200#, 6'1" and non-smoker.  In April 2006, I was in a vehicle accident, where I was driving a dumptruck, making a left turn and struck on the drivers side by a S10 pickup...pushing me thru the ditch & hitting a fence on the other side.  I sustained trauma to my head, neck, hand & knee.  I have had chronic neck pain since the accident.  I feel I have an extremely high pain level and my daily pain is now a 5-6 and can be as high as a 9.  I have had MRI, CT Scan, Bone Scan & X-rays...which none of show any disc herniation or tears.  C5-C6 disc is desiccated, associated with a minimal circumferential disc bulge.  I have tried chiropractic adjustments, medication, trigger point injections, ultrasound, PT, hot packs/ice & exercises...none of which have solved the problem.  The chiropractic adjustments and PT/exercises seemed to help some at first, but only as a temporary "fix".  Going to PT has gotten my neck to loosen up some, but it is now locking.  If I look up, my neck locks and I am then unable to flex my neck past neutral.  My neck will not turn to the right or left either.  This can become extremely painful and cause horrible headaches.  I am able to unlock my neck from this position by applying manual posterior-anterior pressure to C2 to glide C1-C2 forward to C0.  I try most of the time not to even look up anymore to help my neck not to lock...but even this has not made a difference with the constant pain.  When I had an FCE done a couple of months ago, my strength is 5/5, but shows the above locking problem.  Some days, my neck creeks, pops and grinds alot.  One these days, it seems like I am more likely to get a bad headache. (Sometimes I am getting a headache even if my neck hasn't locked first.)  These headaches start back in the top of my neck, C1, and go over the top of my head to my forehead. These headaches usually last for days and usually causing pain levels to rise to 9.  Since the accident my shoulders have also been aching badly, almost like someone has a knife turning/stabbing between my shoulder joints where my arms connect to my shoulders.  If I raise my arms above my head, this seems to help relieve some of the pain temporarily but my arms will fall asleep and ache worse after bringing them down.  I have also been having some lower back pain since the accident.  Unfortunately, all of this pain is causing me not to sleep well either.  Sometimes my pain is worse in the morning right away when I get up, otherwise my pain is pretty much the same day & night, no matter what I'm doing.  I have seen multiple doctors/PT and they are unable to come up with any explanations/cure for what I am going thru.  Before the accident, I was a very healthy, happy male with little to complain about, including never even getting headaches.  Now I am in constant pain that nothing seems to relieve...The neck pain is the worse and the hardest to live with.  I am sure hoping with all your medical knowledge, maybe you have seen/heard of this neck locking problem with someone else and you will be able to give me some advise...something I can take to my doctors and say "What about this...Let try this"...I just want to feel well again and have some hope that this is not the way I'm going to have to feel the rest of my life.  I really do appreciate all your time in this matter-It really does mean alot!! Thank you, George

Answer
Dear George,

The first question I have for you is what is your diagnosis?  Have any of the doctors you have seen given you a straight forward diagnosis?  This is the first step in figuring out what to do next.

I understand that chiropractic and functional rehab was helping to control your symptoms, but the pain returned.  How long did you go to the chiropractor, and physical therapist?  What did they do?

The reason I ask these questions is because physicians and clinicians form all field are often confused with the pain that results from acceleration injuries in car crashes.  This is because they cannot seem to get an accurate diagnosis, and they miss the all common ligamentous, joint capsule and facet joint injuries, because they have not been adequately trained to assess the spine is that manner, or how to rehabilitate it.

The pain you describe sounds like sclerotogenous pain or referred pain, and again this is poorly understood by most clinicians even though the original research on this type of pain dates back to 1939.

Listen George, give me some more information if you can, and we will work on some options.  If you would like a detailed explanation of sclerotogenous pain and where it goes on the body, please send me a personal e-mail through my website, and I will send you information that I cannot send through all-experts as the files are too large.

Hope to hear from you soon.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net