Pain in the Neck | Auburn Medical Group


That is the absolute worst. stinging we definitely want
to hit that area that hurts because we want to numb up where the pain is no pain no gain thanks for joining us poor Jane
has been having this pain in the back of her head that you say it’s not a
headache and you’ve had migraine before and it’s not that but it just it hurts feels like someone hit me in the back of the head with a shovel okay and this happened a year ago and it
resolved eventually and testing was done right no testing was not done at that
time okay so if it doesn’t resolve with this simple procedure we’re going to do
some further testing probably MRI imaging but if we can get it to go away
with just breaking the spasm of the muscles from treating the pain and get
you pain relief then we’ll be good so we’ll use a treatment called the greater
occipital nerve block because your tenderness is right over those nerves on
the back when we press on it and we’ll show that a little bit later and if we
can get this taken care of just by doing this shot or these two shots we don’t
have to do anything further because we took care of it that’s nice as long as it doesn’t come back and there won’t be
anything to f… I don’t want it to come back no no so I’ll draw up the medicine and
I’ll come back in and give you the shot okay and you’re gonna hold my hand right I’m gonna hold your
head okay so for this we will use bupivacaine 0.5% we’re putting three milliliters in
each injection there we go and take the sharp off with the sharps
remover just need three milliliters or three
cc’s of 0.5% bupivacaine and then we get the smallest needle we have we have 30
gauge this is the spray this is nice How are you going to get through all my hair that’s the tricky part yeah
it’s not straightforward I just cut 5 inches off I don’t know if it’ll matter that much where I’m working okay and what we do is we rub the skin
with alcohol wipes and the hair you want me just flip it all up all flipped over the whole thing there you go how’s that that’s gonna get
much closer to where we’re going let me wind it up here a little bit like bamm-bamm and pebbles we’ll just put a
bone through it okay so this am I in the midline yep so the occipital
prominence oh that hurts it actually you know when it hurts so bad it feels good and that’s what it feels like when I push on your occipital
prominence yeah that feels sore we do we do notice the tremor and then I come over and see where the
tragus of the ear is and I’m going halfway between them is that the spot no there a little up just touch right yeah right in there somewhere it might have been down towards the ear that hurts sorry no that’s good that’s the right spot holy moly that hurt okay and I’m gonna confirm
the spot again before I spray it with the ethyl chloride so again the spot is owe
right there yep and that’s cold right no no no it’s a little cool yeah it is running down my neck I know I’m sorry it’s
all gonna get frosty here as I give you a shot so I’m aiming upward putting in
some medicine it stings as it goes in no I just feel like there’s so much
pressure and this feels like pressure too okay ya momma redirect uh sorry
draw back I’m sorry that my head’s shaken no no no it’s fine I hould have said more prayers draw back
redirect put in some more medicine we’re putting in a lot of medicine were put in
three ml cool it back off again maybe it wouldn’t hurt so bad pull it off again no cool it you
know with that spray yeah moly still feeling it oh it’s crunching I know that
that’s what you feel when you have muscles that are really really tight but
kind of massage it in now I’m gonna need a break for a minute because oh yeah we’re done with the injection on this side the almost gettin’ that muscle spasm on my left any
improvement yet I don’t know it hurts too bad are you certain to notice numbness going up your scalp okay
now it’s just starting I can’t feel you doing it as much yeah isn’t that a nice change I feel it there but I can’t feel it there well as I go up this way
okay that’s numb hey that’s pretty nice There’s a sore spot right there there up half a finger and to
the middle there about right in there there was a sore spot right there that’s
where we injected you well maybe it’ll go away well let’s rub it around a little bit more see it felt like when you were doing it you were down farther I may have been
I can actually see but there’s a little bit of just blood that comes out where
the shot was given so yeah if this is tender It’s not so much now I think this is where the shot
was given now let’s give it a little more time rub it in that crinkling crunching that’s weird isn’t
that was weird and I feel it on my end too do you because I’m
holding on to the syringe oh do you so what is that just the that’s the it’s the muscles that are tight oh wait till you get to the other side the if you think those were tight oh the left is
the worse huh well my neck says it right now certainly after we give you the shot on
the right you’re gonna have it worse on the left because this will start feeling
better relative to that so just given what we’ve what you’ve experienced so
far do you think you want to go through with the shot on the other side well I’m here
I might as well what you need practice practice I just want to make you feel better oh I
know hey I will do anything at this point to feel better and yeah I I can say that I can feel some
relief here yeah is that weird no you can you can have that even though I didn’t directly get
something that innervates this you can still get some relief in places that
didn’t get the shot just because the way these networks operate cause I can feel it sometimes you get here
good very good so that’s a good thing oh yeah so if you do the other side maybe I won’t I wouldn’t be surprised if we
got improvement and I’ll tell you that is strange yeah now you’re a numbskull right are you sure that’s my head hey I resemble that remark I resemble that remark oh that is good that is REALLY good you like that I don’t know if I can say that I like feeling numb oh okay but that’s
good well I’ll take good it’s good awesome I mean so you were saying before it felt like a shovel hit
you back here and now would you say it’s half yeah it only hit me over here now do you want to go through with the
shot I think so all right I mean I’m a big chicken big chicken the only hing that felt really bad was when you were moving oh I know pulling and going back in and pulling
and going back in That is way weird it’s just unbelievable alright but here it’s just so on the verge given what we got on the right side I’m very hopeful for the
neck spasm to be improved over here with injecting the greater occipital nerve up
here okay alright so now moving the hair to the other side I’m going to grab on this alright so we’re
gonna localize the greeter not the greater occipital
yeah the greater occipital nerve by first finding the occipital prominence
which should be in the midline is that your midline there no
you need to go to my right go to the right a little bit there ya go that yeah that feels like or there
there yeah okay that feels middle to me so okay I don’t really have a part in the hair that’s in the
midline to go by I’m trying to see where your spine is alright so if I
check the tragus on the ear and check this spot here I’m going roughly a
third of the way to halfway because that’s where we found it last time
there there right there that hurt more than the first one anyway
this area yeah oh yeah I’m rubbing it with the rubbing alcohol yeah I’m getting the
surrounding area makes my toes wanna curl it’s it’s not a true sterile prep like we do when we’re
opening up the body and doing some i should of went to the bathroom first sorry okay I do need to confirm the exact spot there oh man alright let me get a hold here cause my head’s on my watch and that isn’t very oh go ahead comfortable I’ll start spraying while you do that ooh that’s cold on my neck I know I’m sorry yahoo you can see the
skin start to frost up because that’s cold alright I’m gonna go up and
inject the reason we go upward is cuz we don’t want to go straight into the
spinal canal which is a low risk but oh crinkly yeah and back off and go in another
direction this is the worst part of it right that is the absolute worst
stinging we definitely want to hit that area that hurts because we want to numb
up where the pain is no pain no gain I can’t believe I’m doing this I can’t
believe I’m doing this with nobody here holding my hand I’m sorry okay it’s
already numb it’s starting to get numb oh that felt that I’m sorry I try to
go slowly because that’s what works best and fanning out in all the directions
but going upward so as to avoid the spinal canal and I’ll show why we do
that ooh holy moly and we got the whole thing in the reason we do is because even though it
looks solid like this the skull comes in right here
and there’s lots of muscles that hide that from you but when you feel it with
your fingers you can feel it goes down and we want to hit where the skull is
not where it’s just muscle between us I have a lot of muscle spinal canal although you do have you do
have the vertebrae there but you can get between the vertebrae in this and the
skull so now I rub it in just like before it doesn’t hurt do you feel like you’re better
than when you came in well so that’s pretty numb far yeah you should have complete numbness from from here to
here I mean it’s numb to here pretty close to and this one’s not there yet it it’s working its way up yeah how’s your pain well I think
the head part’s gone is it just neck now and if it’s like this side this side
feels totally relaxed nice so this side the left side there that you’re working
on still feels a little tight and tense like it hasn’t quite relaxed yet it
doesn’t know how that is so strange I can feel that why you can tell him touching you yeah it’s because
there’s two nerves greater occipital nerve from this area and lesser
occipital nerve is over here and we didn’t hit it okay and the reason we did
hit it is because when we were pushing on your scalp earlier it really wasn’t
all that tender there is it tender now when I push there no you just feel it
okay and these were the super tender spots right or the greater occipital
nerve where it came out and it’s still right there right there oh right
there yeah keep it pushing in the medicine that’s probably right where the like this side over here
right right where the injection site was and then are the muscles relaxing at all
feel softer yeah they feel softer they’re starting
to okay good find their way back do you feel light-headed at all put your hair
back now that really does work it’s pretty good huh yeah you glad I talked you into it yeah I think
so now that it’s done Chief Joseph Trail Ride Chief Joseph trail ride did you do the
Chief Joseph trail ride I’ve done it for 33 years how long is it it’s a
hundred miles every year and it’s thirteen hundred and fifty miles to
complete it oh my goodness so they do a hundred mile segment each year and it
traces the track of Chief Joseph and his flight from the cavalry and with the Nez
Perce Indians oh my goodness and you’ve done the whole thing I’ve done the whole
thing working on three times my goodness you also do Tevis no don’t do Tevis but you do
this one yeah I do this one okay well thank you okay thank you
and special thanks to Meg lightbown Petra Rosenberg Lindsey Antwine and boo
boo kitty thank you for helping make this possible until next time dr. Mark
Vaughan telling you to stay in good health

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