Question
I am a PT with a patient who presented as TMD w/ severe HA and facial pain since root canal 5 years ago.  In the past 4 months S/S progressed to include bilat hand coldness and paraesthesias, burning tops both feet. He has normal TMJ mobility but no mandibular protrusion. He has some improvement from PT but only with facial S/S. Clonepin helps slightly. He has had brain and cervical MRIs (but reports start at C2-3). (+) slump test. Could they have missed a C1 or 2 fracture caused by hyperextension during the dental procedure - could this cause these symptoms?

Answer
Therese;

IMHO it's highly doubtful that there is a fracture at c1 c2 from a dental procedure. (easy way to check is a 5 v cervical series, including flexion and extension)

For the lumbar disc we do the SLR, and slump test, have the pt put their leg out fully. Sounds like a separate problem, though.

I hate to "push my product" but think this may actually be a chiropractic candidate with cervicogenic headache?   Spending a number of hours in a dental chair is far more likely to change the alignment of the cervicals than dislocate or fracture them.

Find a good DC, refer them out, and see what happens.  I'd recommend a Palmer graduate to start with.   It's no guarantee, but it's a start.

Hope this answer helps,

Dr. Peter Carr
Dynamic Chiropractic Clinic
Seattle Washington
www.dynamicclinic.com