Question
Hello,

I am a 20 year old female.  Just as recently as Saturday morning, I noticed then when I would tap on the right side of my face on 2 particular spots, it would produce a tingling sensation that would only last for about 1 second.  I am able to produce this whenever tapping.  1 of the spots is just in front of my ear and the other is closer to my jawline but straight downwards from the other spot.

I was worried about this, so I went to the ER that night.  I was given a CT scan, but said it was negative and everything looked good.  They said to watch out for any changes in symptoms.  They suggested the possibility of bells palsy, but didn't think that was it.  They said it was probably from some inflammation in possibly my sinuses or somewhere else that could cause pressure on some nerve.  

On Sunday afternoon, I started to have neck pain.  The pain is located in the back.  It is at about the place where my hair starts.  I feel as thought the pain is more on the left side, but not so one sided.  Now today is Monday, and I am still having neck pain.

I can not recall doing anything abnormal that would cause any neck pain or anything else.

I was just wondering if there is anything you can suggest might be going wrong, or what it could be.  I know it is difficult to give solutions without an examination, but anything would be greatly appreciated.  

Answer
Dear Kate,

First of all I agree with the possibility that you caould have Bell's Palsy, but there is no confirmed treatment for that condition other than stimulating the nerves on the face with an electrical current to keep the muscles stimulated, and it is considered to be a self limiting condition.

Interestingly enough you have mentioned the neck pain at the base of the hairline.  this is the level in the spine of the second vertebra in the neck.  The associated nerves close to that area supply information to the back of the head, back of the neck, directly behind and above the ears, and there is an important ganglion (nerve cell cluster outside of the spinal cord) in that immediate area.  The gangion is called the trigeminal ganglion and it supplies alot of information to the face, it is like a train station with multiple tracks comming and going.

The immediate good news is that the CT scan was negative which helps to rule out pathological causes of your dysfunction.  This leaves less problematic causes such as inflammation of nerve roots, and biomechanical dysfunction of the spine.  Specifically, the biomechanical dysfunction can actually casue increased inflammation as well.

What I would recommend in your case is that you seek out the care of a local chiropractic physician to specifically analyse the neck and the articulations of the upper spine.  I see patients with problems similar to your case in the office quite frequently, and they respond to chiropractic care.  Ask your friends and family for a referral to a chiropractor they see.  If you need any help finding a qualified local docotr, feel free to get back in touch with me and I would be happy to help you.  

WHAT TO EXPECT:  The chiropractor should perform abroad family history, and a detailed current history of your complaint.  A physical examination should be performed including vital signs, orthopedic tests, neurologicqal tests, posture exam,  and range of motion.  The chiropractor should take x-rays as well-a two view series of the neck should be sufficient.

TREATMENT:  Depending on what the exam and x-rays find, spinal adjusting is the main treatment for any spinal dysfunction when biomechanics are the problem.  Adjsutments are very safe and are applied in a contolled manner.  You may here a loud pop/cracking noise with the adjustment, but sometimes you don't.  This POP has nothing to do with the actuall bones of the neck, it is just the noise of gasses leaving the joint space of the spine very quickly...just like opening a champagne bottle or coke can.
this helped to alleviate the pressure within the joints and allow the spine to move more freely.

Additionally, you may have massage therapy/myofascial work prescribed by the doctor or exercises and physical therapy to aid in the resolution and stabilization of your problem.
The doctor may also query you about your nutritional status and recommend some supplements as the lack of nutrients such as B vitamins can easily give rise to neurological symptoms.  This may be simple or multifaceted depending on the severity of what was found on examination as well as the doctors philosophy on active treatment.  

The bottom line is that I think you are a great candidate for chiropractic care, and that you will see changes for the better in a few weeks.  Generally patients see improvements with care in two weeks unless thay have been in a serious trauma such as a car crash or sports injury, which take longer to treat.

Let me know what happens Kate, and feel free to ask any additional questions about any diagnoses as well as any treatment recommendations.

Respectfully,
Dr. J. Shawn Leatherman