Question
I have been experiencing undiagnosed perioral tingling for about 5 years and it frightens me.  It came about when I was doing a lot of lifting in preparation for a hurricane. I experienced a tingling/numbness feeling around my mouth. I say numbness but it is not actually numb as I do not lose feeling. It feels like it should be but there is no loss of sensation or movement. My tongue and lips have no deficit and can make every facial and tongue movement. I get this sensation and it is intermittent and may last for a couple days and go away and I can go for months without it. On a scale of one to ten being the most intense it is about a 2 to a 4.  It is not specific to the site, I can have it on top of the upper lip, lower corner just beneath the lip on either side not specific to right or left. I have seen two neurologists one who thought it was MS. The other migraines, which it does increase or precede headaches occasionally. The Cat scan of my brain revealed two tiny spots who one doctor said it was a dymylinating disease and it was reread by two other physicians and they found nothing abnormal including then neuro specialist at Shands in Gainesville. I have seen an oral surgeon who told me that the cat scan may have missed a brain tumor, but that was ruled out. I lost 10lbs in two weeks from that fright. Its more frightening than uncomfortable. It has not gotten worse in the last 5 years and still remains intermittent. I have a long history of spinal issues including 3 degenerative discs in my neck and nerve damage on C - 4or or 5 that radiates down my right arm. I do suffer neck discomfort frequently. I also have 2 herniated discs in my lumbar spine. I am 52 years old, relatively fit shape, 5ft and 118 lbs.  I was told that my neck issues would not affect my facial nerves and they could not be related but I don't see how they cannot be related.  I feel strain in my anterior neck muscles when lifting and I can feel that up into my facial muscles. Do you have any insite into this. I also clinch my teeth at night on occasion. Thank you Lynn

Answer
facial pain, facial tingling, peri-oral tingling, numbness, DDD, degenerative disc disease, degenerative joint disease

Dear Lynn,

Sorry to hear of your complaints.

It sounds like you have been having a good thorough workup.  Obviously a thorough examination with Xray, MRI, CT, EMG, EEG, blood tests, etc. is the first step.

Facial nerve, trigeminal nerve, TMJ are all areas to be evaluate.

I also agree with you, and not the doctors,  that perhaps (even indirectly) the cervical spine can be contributing to this problem.

I recommend a Doctor of Chiropractic with additional credentials.  Chiropractors have additional education in sport injuries, nutrition, orthopedics, rehabilitation, radiology (and others); and the specialty I would recommend to you- neurology.

Among the tests I would recommend include a neurometer or a neural scan ( http://www.nervepathology.com/ ).  These sensory nerve conduction tests could be helpful in determining the source of the sensory problem.

Some information I utilize in my Staten Island Chiropractic office:

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Degenerative    Disk     Disease
DDD = Degenerative Disc Disease; DJD = Degenerative Joint Disease; = similar/ same OsteoArthritis.
Degenerative Disc Disease  (old term =  DJD) is  actually  a  quite  common  condition.   However,  the course of the condition is highly variable.   Some patients with DJD literally cannot walk, yet other patients with similar X-ray/ MRI findings may be able to run marathons or lift heavy weights.   Some people suffer for only a few days with pain and symptoms, some people suffer for months. Although the course is highly variable, there are certain steps that are always helpful to follow:  Ice the area when painful-  10/ 15minutes on, 30/ 45 minutes off;  avoid certain postures and movements;  bend the knees when coughing or sneezing;  bend the knees when lifting anything;  do not extend legs straight out when sitting, laying down, lifting, or driving.   Avoiding certain movements and postures will prevent aggravation of the condition.   Practicing good postures and movement patterns will help the condition heal and be less painful.  DDD, DJD,  OsteoArthritis, -  deteriorating discs (disk)   is/ are  often caused by,  or often  concurrent with the Vertebral Subluxation Complex.  VSC is a misalignment which hastens deterioration of the joints involved.

         Vertebral   Subluxation   Complex    (a.k.a.  憇ubluxation?
The vertebral subluxation complex is the underlying cause of many healthcare problems.

A subluxation interferes with the proper functioning of joints, and can cause osteo-arthritic degeneration, Degenerative Disk Disease, degenerative joint disease, etc.
A subluxation interferes with the proper functioning of the nervous system (the master system which controls and coordinates all function within the body) and may cause various other conditions, symptoms and problems.

Subluxation  is  a  serious  condition  identified  by  its  five  parts:

    Spinal Kinesiopathology:
         This is fancy way of saying the bones of the spine have lost their normal motion and position. It restricts your ability to turn and bend. It sets in motion the other four components.

    Neuropathophysiology:
         Improper spinal function can choke, stretch, or irritate delicate nerve tissue. The resulting nerve  system  dysfunction  can  cause  symptoms  elsewhere  in  the  body.

    Myopathology:
          Muscles supporting the spine can weaken, atrophy, or become tight and go into spasm. The  resulting  scar  tissue  changes  muscle  tone,  requiring  repeated  spinal  adjustments.

    Histopathology:
         A rise in temperature from an increase in blood and lymph supplies result in swelling and inflammation.   Inflammed  Discs can easily bulge,  herniate,  tear,  or  degenerate.   Other  soft tissues  may  also  suffer  permanent  damage.

    Pathophysiology:
         The VSC contributes to  OsteoArthritic  degeneration.  Bone spurs and other abnormal bony growths attempt to fuse malfunctioning spinal joints. This spinal decay, scar tissue, and long-term  nerve  dysfunction  can  cause  other  systems  of  the  body  to  malfunction.

The Vertebral Subluxation Complex describes what happens when spinal bones lose their normal movement patterns and position.  When subluxated, joints are in a stressed, vulnerable, compromised condition.  Subluxation may cause Arthritis, Disk Herniation, Disk Degeneration,  or aggravate such conditions.   

          Vertebral  Subluxation  cannot be corrected through chemicals (medicine), stretching, yoga, vitamins or physical therapy alone.     Subluxation- a neuro/skeletal/muscular-   mechanical-   problem  requires  a   mechanical correction-  -  -    a manipulation,     best performed with the chiropractic adjustment.

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How It Works - Neural-Scan Physiology

Referred pain results in 30% of patients misdirecting doctors away from the source of pain, and physical exams have even less sensitivity. This explains why the Massachusetts General Hospital Handbook of Pain Management states; "In MOST cases (over 50%) of neck and back pain the anatomic and physiologic diagnosis remains unclear."


The mechanism causing this is explained by Guyton's Textbook of Medical Physiology: Over 90% of A-delta fibers reach the sensory cortex allowing exact localization of the source of pain, but C fibers do not reach the cortex. C fibers are so poor at localizing pain that it can seem to be coming from the opposite side. Following injury C fibers continue firing, but A-deltas fibers down-regulate, so localization is poor. Guyton states; "This explains why so many patients have serious difficulty localizing the source of pain."

The Neural-Scan detects down-regulated A-delta function to locate injured nerve(s) with 95% sensitivity. Its patented modulated electrical signal selectively stimulates A-delta fibers. The higher the amplitude causing an action potential is above the normal range the more indicative of pathology. The Neural-Scan potentiometer verifies firing by detecting the amplitude of the action potential. The patient is his own control, so the test is independent of age, gender and population variables. High potentiometer amplitudes have been reported to have a close correlation with high VAS ratings. The Neural-Scan can also test C and A-beta fibers, which is useful when RSD or sympathetically mediated pain syndrome is suspected.

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Vertebral  Subluxation           (  慥SC?,    憇ubluxation?  )
Vertebral Subluxation  is  actually  a  quite  common  condition.   Doctors of Chiropractic look for pathological conditions which may require referral to other specialties, and also look for 慡ubluxation? Other disciplines look for pathology, but overlook the importance of alignment and movement in the spine which affects our nervous system  (the master control system- ALL health disciplines learn this).   Only a Doctor of Chiropractic will evaluate and treat for VSC.   The course of VSC is highly variable.   Some patients with VSC literally cannot walk, yet other patients with similar test findings may be able to run marathons or lift heavy weights.    Some patients immediately develop symptoms related to the VSC,  some patients take years to develop symptoms.  Some people suffer for only a few days with pain and symptoms, some people suffer for months.  Some people recover in days, some take months or years, depending upon severity of the condition.
         Vertebral   Subluxation   Complex    (a.k.a.  憇ubluxation?
The vertebral subluxation complex is the underlying cause of many healthcare problems.
A subluxation interferes with the proper functioning of the nervous system (the master system which controls and coordinates all function within the body) and may cause various other conditions, symptoms and problems.

Subluxation  is  a  serious  condition  identified  by  its  five  parts:
    Spinal Kinesiopathology:
         This is fancy way of saying the bones of the spine have lost their normal motion and position. It restricts your ability to turn and bend. It sets in motion the other four components.
    Neuropathophysiology:
         Improper spinal function can choke, stretch, or irritate delicate nerve tissue. The resulting nerve system dysfunction can cause symptoms elsewhere in the body.
    Myopathology:
          Muscles supporting the spine can weaken, atrophy, or become tight and go into spasm. The resulting scar tissue changes muscle tone, requiring repeated spinal adjustments.
    Histopathology:
         A rise in temperature from an increase in blood and lymph supplies result in swelling and inflammation. Discs can bulge, herniate, tear, or degenerate. Other soft tissues may suffer permanent damage.
    Pathophysiology:
         The VSC contributes to OsteoArthritic degeneration.  Bone spurs and other abnormal bony growths attempt to fuse malfunctioning spinal joints. This spinal decay, scar tissue, and long-term nerve dysfunction can cause other systems of the body to malfunction.

The Vertebral Subluxation Complex describes what happens when spinal bones lose their normal movement patterns and position.  When subluxated, joints are in a stressed, vulnerable, compromised condition.  Subluxation may cause Arthritis, Disk Herniation, or aggravate such conditions.   
         Vertebral  Subluxation   cannot   be corrected through chemicals (medicine), stretching,  yoga,  vitamins  or  physical  therapy  alone.       Subluxation- a neuro/skeletal/muscular-    mechanical-    problem  requires  a    mechanical correction-  -  -    a manipulation,     best performed with the chiropractic adjustment.

Dr. Victor E. Dolan,   Doctor of Chiropractic;   Diplomat, American Chiropractic Board of Sport Physicians; Diplomat, American Academy of Pain Management;  Certified Clinical Nutritionist (IAACN); FIRST  Chief of Chiropractic  in  a  Hospital  in  New York State (DHSI);  As  Seen  in  PREVENTION  Magazine

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You nay be able to find a neuro based chiropractor near you at
http://www.LifeChangingCare.com .

I hope this information is helpful.  I recommend a DC, and the thorough examination above.  

I wish you good luck and Good Health Naturally, your Staten Island Chiropractor siging off,

Dr. Victor Dolan, DC
http://drvictordolan.chiroweb.com     (email newsletter)
http://www.DocDolan.net
http://www.GoodHealthNaturally.info