Category: Headaches

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Diagnosing pain.

Did you know that there is a diagnosis code for virtually every part of your body plus the word “pain.”

Low back pain M54.5
Pain in the Thoracic Spine M54.6
Pain in the left foot M76.672
Chronic Bladder Pain R39.82

There are also diagnosis codes for significantly more detailed problems. This is often the reason for the “pain” diagnosis. I can diagnose right facet joint arthritis, or cervical degeneration that causes radiculopathy. There is value in both forms of diagnosis.

When you, the patient, comes in, you usually tell me about how you’re feeling. This discussion revolves, most commonly, around your pain. I will dig around and ask some questions and let you tell me your story. At this point, I can easily diagnose you with your specific pain diagnosis. You come in with neck pain, and I can diagnose neck pain in about 3 minutes of meeting you.

In the next step, I get to dig around and find out if there is an even more specific diagnosis that explains the “pain” diagnosis. This is the part where I rule out the really serious diagnoses, like a broken bone or a torn ligament. It is the part that takes a lot longer, occasionally more than one visit sort of longer. This is the part where we will usually throw out the fancy words. “Hip Impingement” or “Arthritis.” (And occasionally these fancy words come with an even fancier test.)

Now here is the really tricky part. Getting rid of pain can be really easy. (Tylenol, Gabapentin, Codeine) But getting rid of the fancier word part, the actual cause… now that is a lot harder. Just like diagnosing it requires a deeper understanding by your doctor to name it, it also requires a deeper understanding by you, for you to heal it.

Notice I said “You” to heal it. I can help you get rid of the pain and understand what needs to be done to heal, but the longer term changes, that is going to take more than just coming to see me a few times and taking tylenol for a couple weeks. There is a good chance you’ll need to support your body with movement, nutrition, rest and time.

This is a process. I hope to teach you everything you need to learn to heal, but it takes time. It takes time for us to peel away the layers that got you into pain in the first place and it takes time to explain each new healing step as we reach it. It will take time for you to make the changes you need to stay out of pain.

As Always,
Keep Moving.

Dr Cate

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The Dull Thud of Headache Pain

headacheIts 2:30 pm and you’ve been spending hours working diligently on your computer. You’re feeling great about what you’ve accomplished when suddenly you start to feel that dull thud into the back and sides of your head. Headache pain! UGH! Horrible timing for a headache! (But then again, is there ever good timing for a headache?!)

With just a few questions to rule out anything more serious, those 2 sentences will put almost any practitioner onto the right path for diagnosis and treatment of your cervicogenic headache and once you can recognize the signs of headache pain, you can likely stop the headache in its tracks right now as well!

Did you know that women are 4 times more likely than men to suffer from cervicogenic headache pain than men and that the average age is 43 years old?  (Cited Here) As we increase computer use, time spent driving, and the steady increase in electronics, as well as holding our stress in ‘our neck’ its easy to see that the the mechanics of our necks have been changing.

What is a “Cervicogenic Headache”? Essentially, Cervicogenic means that the pain in your head is originating in your neck, or your ‘cervical spine’. Often times, you will instinctively start rubbing your neck once the head pain starts. That is a great indicator of what is causing your symptoms.  As our knowledge of neurology changes, we are now able to more accurately describe how the nervous system in your neck causes the pain in your head. Understanding how your brain confuses neck signals is a complicated discussion, and one that you probably don’t want to try to think about as you currently have a headache. To simplify – The brain is attached to the spinal cord, which supplies signals to the rest of your body. Some of these nerves exit through the upper neck and innervate the muscles and joints of your neck. In reverse, the muscles of your neck tell your nerves how they are feeling, which then gets intermingled with a few areas in the brain. When your neck gets compressed and stressed from poor position and stress, the muscles and joint tell your brain that something is not happy. Because of the way these nerves are set up, sometimes your brain gets confused, and you feel the pain in your head. (Like I said, simplified discussion!)

So what do you do?

  1. Drink a full 8 ounce glass of water, refill the cup, and plan to drink another one over the the next hour or so. Hydration will make sure the joints and muscles in your neck can heal and move freely.
  2. Get up, walk away from the computer, and focus your eyes on things over 20 feet away.
  3. MOVE your neck. Stretch it, roll it and do some distraction.
  4. Get your neck checked by a chiropractor. We specialize in normalizing movement into the joints. If you’re noticing an increased frequency of headaches, lets make sure its not something more serious and then get that neck moving better!

As always, Thanks for reading, I hope you enjoyed learning and don’t hesitate to call if you have any questions or schedule an appointment here!