Head and Neck Pain


 

HEAD AND NECK PAIN

 

Head and neck pain may inflict severe discomfort limiting your daily activities.  The cervical spine is composed of seven vertebrae held together and supported by a complex system of ligaments, tendons and muscles.  The vertebrae and discs allow the neck a full range of motion. Neck pain may result from any disruption of its vertebrae, discs, muscles, tendons or ligaments.  Poor posture, osteoarthritis, muscle spasms, nerve entrapment, degenerative disc disease as well as age and occupation can factor into neck pain. At the Center for Integrated Pain Management personalized treatment plans are designed to give the patient optimal health and pain relief from minor to major neck pain and injuries.  Below is a list of Neck and Head conditions that are treated:

 

  • Cervical Radiculopathy
  • Degenerative Disc Disease
  • Whiplash Facet Joint Syndrome
  • Cervical Sprains, Strains and Tears Neck Spinal Osteoarthritis
  • Migraine Headache Neck Spinal Stenosis
  • Tensions Headache Neck Spondylolisthesis
  • Occipital Neuralgia Muscle Spasms
  • Intercostal Neuralgia
  • Nerve Entrapment/Radiculopathy


A diagnosis will be made once Dr. Kulick reviews your family history, completes a thorough physical examination and conducts an in-office ultrasound. If necessary, Dr. Kulick may request that you obtain an MRI, a CT Scan or additional X-rays in order to determine the diagnosis and treatment plan. 

To learn more about the treatment and relief of neck injuries please contact our office at 212-867-1777.

 

Cervical Radiculopathy

 

What is Cervical Radiculopathy?

Cervical radiculopathy is neck pain that radiates to the upper arm, forearm, hand, or all of the above.  It is caused by compression in the neck of one of the nerve roots that exit bilaterally from every level of the cervical vertebrae.  Spinal stenosis, a herniated disc or degenerative disc disease, and muscle spasms (all forms of cervical radiculopathy), are often an unfortunate effect of aging and may cause this nerve impingement.

 

Seek Treatment for these Symptoms:

  • Neck, chest or upper back pain
  • Numbness or tingling in the neck, upper back, arms or hands
  • Radiating pain through shoulders, arms, or fingers

 

Next Steps 

Consult the Center for a diagnosis and for treatment options.  Depending on the diagnosis, treatment options may include ultrasound-guided corticosteroid injections, ultrasound guided injections of platelet rich plasma (PRP), ultrasound, prolotherapy injections, stem cell therapy, physical therapy and anti-inflammatory medication. If nerve entrapment is diagnosed then a hydrodissection is performed under ultrasound to release the nerve.

 

Peripheral Neuralgia

 

What is Peripheral Neuralgia?

Peripheral Neuralgia is a condition related to the damage of the peripheral nervous system.  This is a network of nerves that carry signals or information to and from the brain and spinal cord (the central nervous system) to all parts of the body. Damage impairs the transmission of signals to and from the brain, like a bad connection on the telephone. This condition can cause pain, sensitivity, tingling or numbness in the body’s extremities (the legs, arms, hands, fingers, feet and toes). Cramps and muscle spasms, low blood pressure may affect motor coordination and the functions of the digestive and urinary systems. Causes include traumatic injuries, repetitive activities that damage muscles, ligaments or tendons producing nerve compression, vitamin deficiency, diabetes, alcoholism, liver and kidney disease.  Viral and bacterial infections such as shingles or Lyme disease can lead to nerve damage as can a variety of autoimmune diseases. The pain can interfere with sleep patterns and your daily activities.

 

Seek Treatment for these Symptoms:

  • Numbness or tingling in the legs, arms, hands or feet
  • Sharp pain in the legs, arms, hands or feet
  • Chronic cramps or muscle spasms
  • Sensitivity to touch, heat or light
  • Pain in response to something typically painless
  • Decrease in reflexes and motor coordination
  • Dizziness
  • Sleep disruption

 

Next Steps

Consult the Center for a diagnosis and for treatment options. Treatment options will depend on the cause of the neuropathy.  Ultrasound-guided corticosteroid injections, anti-inflammatory medication, trigger point therapy and physical therapy may be suggested.  If there is a nerve entrapment then a hydrodissection to relieve nerve compression or a series of ultrasound-guided nerve block injections may be indicated.

To learn more about cervical radiculopathy and its treatment please call our office at 212-867-1777.



Whiplash

 

What is Whiplash?

Whiplash is a neck sprain or strain that injures the cervical spine and causes acute neck pain. It occurs when the neck is rapidly thrown from its normal alignment. This is often the result of a contact sports incident or a car accident.  

 

Seek Treatment for these Symptoms:

  • Neck pain and stiffness
  • Loss of range of motion in neck, shoulders or arms
  • Headaches
  • Dizziness and fatigue
  • Numbness in the arms

 

Next Steps

Consult Dr. Kulick for a diagnosis and treatment choices.  Depending on the diagnosis, customized treatment options may include ultrasound-guided joint injections, pain medication, a cervical collar, trigger point therapy, ultrasound guided prolotherapy injections, physical therapy and anti-inflammatory medication.

To learn more about the treatment and relief of Whiplash please call us at 212-867-1777.



Cervical Sprains, Strains and Tears

 

What Is a Cervical Sprain, Strain and Tear?

A cervical sprain or strain is damage to the soft tissue in the neck.  A strain affects muscles and tendons and a sprain affect the ligaments. A tendon attaches muscle to bone while a ligament attaches bone to bone.  A neck sprain or strain can be caused by poor posture, contact sports, moving the wrong way, heavy lifting or a car accident.

 

Seek treatment for these symptoms:

  • Stiffness, pain or weakness in the neck, shoulders or arms
  • Loss of full range of neck motion

 

Next Steps

Consult the Center for a diagnosis and for treatment possibilities.  If tendinosis is indicated then treatment options are ultrasound-guided tenotomy injections to destroy damaged tissue followed by ultrasound-guided injections of platelet rich plasma (PRP) to accelerate the growth of healthy replacement tissue. Additional options include a cervical collar, trigger point therapy, physical therapy and anti-inflammatory medication.

To learn more about the state-of–the-art treatment for the relief of cervical sprains, strains or tears please call our office at 212-867-1777.

 

Migraine Headache

 

What is a Migraine Headache?

Migraine headaches may begin in childhood or adolescence but more typically occur between the ages of 25 and 55. Women are three times more likely to develop chronic migraines. These headaches can be so debilitating that it is impossible to function on a daily basis and you may be unable to attend work or school. They can last from four hours to three days. Pounding pain, nausea, sensitivity to light, air conditioning or noise can incapacitate an individual. Often the onset of a migraine is preceded mood changes or auras. An aura is a visual change during which the sufferer sees flashes of light or shapes. Triggers may include stress, certain foods, alcohol, hormonal changes, medications and even weather variation. Many migraines are triggered by muscle spasms and can be released with trigger point injections.

 

Seek Treatment for these Symptoms:

  • Incapacitating head pain
  • Throbbing on one or both sides of the head
  • Sensitivity to light, sound, touch or smell
  • Nausea or dizziness
  • Vomiting
  • Double vision

 

Next Steps

Consult the Center for a diagnosis and for treatment options.  These include trigger point therapy, ultrasound-guided prolotherapy injections, ultrasound injections of platelet rich plasma (PRP). If nerve entrapment is indicated then an ultrasound-guided non-steroid hydrodissection or nerve block injections will be advised.

To learn more about the treatment and relief of migraine headaches please call our office at 212-867-1777.                                                                                       

 

Tension Headache

 

What is a Tension Headache?

The daily grind, stress, fatigue, poor posture and eye strain can cause tension headaches. This common complaint can also be caused by musculoskeletal issues in the neck or shoulder or because of a nerve impingement. Holding your head in a single position for a long time while working at a desk or computer may also cause a tension headache to develop. They can last a few minutes, several hours, or a few days. If they occur more than fifteen days out of a month they are considered to be chronic. A tension headache often starts as a dull throb in the head or neck and then may feel like a tight band across the forehead.

 

Seek Treatment for these Symptoms

  • Recurring headaches
  • Fatigue and inability to sleep
  • Stiff neck
  • Fever
  • Impairs daily activities

 

Next Steps

Consult the Center for a diagnosis and for treatment options.  These include trigger point therapy, ultrasound-guided prolotherapy injections, ultrasound injections of platelet rich plasma (PRP). If nerve entrapment is indicated then an ultrasound-guided non-steroid hydrodissection or nerve block injections will be advised.

To learn more about the treatment and relief of tension headaches please call our office at 212-867-1777.

 

Occipital Neuralgia

 

What is Occipital Neuralgia?

Neuralgia refers to nerves. In this case, two pairs of nerves called the occipital nerves - located in the back of the neck and skull - are inflamed. This causes severe pain to originate at the back of the skull and the nape of the neck and to sometimes radiate to the eyes. This headache may be caused by a pinched nerve in the neck as a result of a head trauma, arthritis of the cervical spine or a muscle spasm.

 

Seek Treatment for these Symptoms:

  • Stabbing pain in the back of the neck or the scalp
  • Throbbing pain on one or both sides of neck and head
  • Pain may radiate to one or both eyes
  • Scalp may be sensitive to touch

 

Next Steps

Consult the Center for a diagnosis and for treatment options.  If there is a nerve entrapment then a hydrodissection to relieve nerve compression or a series of ultrasound-guided nerve block injections may be indicated. 

To learn more about the treatment and relief of Occipital Neuralgia please call our office at 212-867-1777.



Degenerative Disc Disease

 

What is Degenerative Disc Disease?

The spinal column allows you to twist and bend.  It is made up of bones (vertebrae) between which are jelly-like cushions called discs, that act as shock absorbers. These discs may degenerate as a result of aging, back injuries and daily wear and tear. In addition, the outer wall of the disc may sustain minute tears that are replaced with scar tissue. The disc wall can become progressively weaker and the jelly-like center of the disc containing water and proteins may begin to dry out.  If the disc completely ruptures or cracks it is called a herniated disc. As the disc loses water it compresses and the joints in the vertebrae begin to rub against each other causing osteoarthritis pain and stiffness. The compressed disc may also put pressure on nerves as they exit the spine through its openings and cause further pain, numbness or tingling in the arms or legs bepending on the location.

Seek Treatment for these Symptoms:

  • Neck, chest or upper back pain
  • Numbness or tingling in the neck, upper back, arms or hands
  • Radiating pain through shoulders, arms, or fingers


Next Steps

Consult the Center for a diagnosis and for treatment options.  Depending upon the diagnosis, treatment options may include ultrasound-guided corticosteroid injections, ultrasound guided injections of platelet rich plasma (PRP), ultrasound guided prolotherapy injections, stem cell therapy, physical therapy and anti-inflammatory medication. If nerve entrapment is indicated then a steroid-free hydrodissection to release the nerve or ultrasound guided nerve block injections may be recommended.

To learn more about the treatment and relief of Degenerative Disc Disease please call our office at 212-867-1777.

 

Facet Joint Syndrome

 

What Is Facet Joint Syndrome?

Facet Joint Syndrome is pain in the joints of the vertebrae, the bones that comprise the spine. Each vertebra has 2 facet joints that connect it to the next vertebra. The joints both stabilize the spine so that it does not move too far forwards or backwards and they allow you to bend and twist.  Soft tissue called cartilage, as well as a lubricating fluid, cushion the joints. An injury to the back or neck, daily wear and tear or osteoarthritis can cause the cartilage to deteriorate and the joints to rub against each other causing stiffness and pain. This may in turn cause bone spurs or an overgrowth of bone that results in increased inflammation. If the joints swell too much then the openings in the spine through which nerves travel may narrow and cause nerve compression and even greater discomfort.

 

Seek Treatment for these Symptoms:

  • Need to turn entire body to look left or right
  • Unable to bend or twist neck
  • Back or neck pain
  • Pain that extends into your buttocks and upper thighs
  • Muscle weakness in the arm, shoulder, or leg

 

Next Steps

Consult the Center for a diagnosis and for treatment choices.  Depending upon the diagnosis, treatment options may include ultrasound-guided corticosteroid injections, physical therapy, ultrasound guided injections of platelet rich plasma (PRP), ultrasound-guided prolotherapy injections, stem cell therapy, physical therapy and anti-inflammatory medication. If nerve entrapment is indicated then a steroid-free hydrodissection to release the nerve or ultrasound-guided nerve block injections may be recommended.

To learn more about the treatment and relief of Facet Joint Syndrome please call our office at 212-867-1777.

 

Neck Spinal Osteoarthritis

 

What is Osteoarthritis?

Osteoarthritis afflicts millions of people and can curtail physical activities and disrupt daily routines. Known as the wear and tear disease, it causes the gradual weakening of the cartilage. Cartilage is connective tissue that protects the ends of the bones and allows the bones to glide smoothly in the joint. When cartilage deteriorates, bones rub against one another creating inflammation, stiffness and pain. Bone spurs, an overgrowth of the bone, often develop and intensify the pain. Aging and daily attrition accelerates the degeneration of the joint.

Osteoarthritis can occur in any joint – neck, shoulder, elbow, wrist, fingers, hips, spine, knees, ankles or toes.

 

Seek Treatment for these Symptoms:

  • Pain and tenderness in the neck
  • Loss of range of motion
  • Stiffness in the joint after a period of inactivity
  • Inability to participate in former activities
  • Difficulty moving any and all joints

 

Next Steps

Seek a diagnosis and treatment choices. Dr. Kulick will design a customized treatment plan designed to alleviate the symptoms suffered.  Options include anti-inflammatory medication, ultrasound-guided corticosteroid injections, ultrasound-guided injections of a hyaluronic injection acid such as Synvisc and Supartz to help cushion the joint, ultrasound-guided prolotherapy injections and physical therapy, cutting edge therapy such as ultrasound-guided stem cell injections that may stimulate the growth of new cartilage.

To learn more about the treatment of Neck/Spinal Osteoarthritis please contact our office at 212-867-1777.

 

Spondylolisthesis

 

What is Spondylolisthesis?

Spondylolisthesis is weakening of the ligaments allowing partial dislocation of the vertebrae allowing in an anterior or posterior direction.  If allows small movements creating further osteoarthritis and cartilage degeneration. Signs of osteoarthritis, like bone spurs, an overgrowth of bone, may result in increased inflammation. If the joints swell too much then the openings in the spine through which nerves travel may narrow and cause nerve compression and even greater discomfort. Spondylolisthesis may be caused by a traumatic injury, a fracture or the degeneration of bones, ligaments or discs due to the wear and tear of aging.

 

Seek Treatment for these Symptoms

  • Neck pain
  • Neck stiffness
  • Tingling or weakness in arms, legs, hands or feet

 

Next Steps

Consult the Center for a diagnosis and for treatment options.  A steroid-free hydrodissection will release the nerve and ultrasound-guided nerve block injections will provide relief if there is nerve compression.  Depending upon the cause of the spondylolisthesis, additional treatment options may include ultrasound-guided corticosteroid injections, ultrasound-guided injections of platelet rich plasma (PRP), ultrasound-guided prolotherapy injections, stem cell therapy, physical therapy and anti-inflammatory medication.

To learn more about the treatment and of Neck Spondylolisthesis please call our office at 212-867-1777.

Muscle Spasms

 

What Are Muscle Spasms?

Muscle spasms are very common and can happen without warning. Perhaps you reach for an item, turn your neck to face a friend or even sleep in an awkward position. This suddenly triggers a muscle spasm in your neck and you cannot turn or move it without pain. Muscle spasms are the involuntary contraction or tensing of one or more muscles. They may anywhere in the body.  Muscle spasms may be caused by turning suddenly, heavy lifting, muscle overuse, weak muscles, nerve compression, spinal conditions such as degenerative disc disease or a herniated disc, and many sports injuries. Some sports including tennis, golf, football, weightlifting and basketball that require the constant twisting of the spine may lead to back spasms. Spasms may seem to appear out of nowhere however; typically small tears in the muscle may have developed over time. These tears may lead to swelling that compresses the nerves surrounding the muscle. This in turn sparks a muscle spasm that can cause pain, cramping or twitching.


Seek Treatment for these Symptoms:

  • Muscle pain that does not dissipate on its own
  • Constant muscle cramps
  • Difficulty walking or moving
  • Muscle appears hard or distorted

 

Next Steps

If the muscle spasm does not resolve by itself after a few days of rest, icing the area for short periods of 10 to 20 minutes every two hours or using a heated pad, and taking non-steroidal anti-inflammatory medication, then seek treatment. Consult the Center for a diagnosis and for options.  The spasm may be the result of an underlying condition that can be treated. Once identified, treatment options may include ultrasound-guided corticosteroid injections, trigger point therapy, ultrasound guided prolotherapy injections or anti-inflammatory or muscle relaxant medication. Ultrasound guided injections of platelet rich plasma (PRP), or stem cell therapy may be advised. If nerve entrapment is indicated then a steroid-free hydrodissection to release the nerve or ultrasound-guided nerve block injections will be recommended.

To learn more about the treatment and relief of Muscle Spasms please call our office at 212-867-1777.

 

Location
Alexander Kulick, MD
112 East 61st Street
Upper East Side

New York, NY 10065
Phone: 917-810-4139
Fax: (646) 585-0042
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917-810-4139