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You are here: Experts > Health/Fitness > Back and Neck Injury/Chronic Pain > Chiropractors > Neck Injury
Expert: Gerald Anzalone, D.C. - 10/30/2009
Question
The Injury and Context:
Five weeks ago I was injured at a mixed martial arts class when I was put into a Guillotine choke hold (http://en.wikipedia.org/wiki/Guillotine_choke - the air choke variety) and there was a pop sound in the front of my neck. There was no immediate (or lasting pain), just discomfort as my neck inflamed. Besides the discomfort due to inflammation (guessing it was inflammation), which lasted about two to three weeks, there has been no pain, no difficulty breathing or swallowing, and no perceived reduction in mobility for my neck.
However, its been about six weeks now, and my neck muscles have been increasingly getting sore (The ones in the back of my neck, and the front right). I cannot do any form of exercise that forces my neck to support my heads weight without the muscles becomming severely sore afterwards, like pushups. I have not tried situps. Even driving for long periods of time causes soreness. I generally keep very good body posture while sitting and standing.
My front left neck muscles also seem numb/week, and I cannot get them to stand out when I flex them, like they normally do. These front left muscles (B in picture) do not seem to be getting any better. When I flex the front of my neck, this muscle (B) typically stands out, just like the one that it mirrors in the picture. The right one stands out prominantly (as you can see), but the left one does not appear at all. In fact, I cannot feel the muscle at all; it is as if the muscle is not there at all. This is not normal for me. Before the injury, I could both feel and see the muscle (when flexing face to loosen up the muscles for acting, or what not).
In addition, whenever I flex my neck like this, the muscle on the left side of my neck (A in picture) quivers, as if it is either very weak, or trying to support do more weight/pressure than it is used to.
As a final issue, about 30-50% of the time I swallow now, there is some sort of dull clicking in my neck. I cannot tell if this is made by two bones scraping against each other, or muscles rolling off each other strangely, or some other cause. When I am swallowing food or water this does not occur - typically it only occurs when I am swallowing saliva.
I have been to the emergency room a week after the injury occured, and they said that as long as the situation does not get worse to just wait. It has been long enough that I believe I need to see a specialist.
Questions:
1) What type of specialist should I see for this type of injury?
2) Do you have an idea about what type of injury this is, and what is my best course of action to treat it?
3) If there is a serious injury, as there appears to be, why is there no pain?
Answer
Thanks for your question.
First, I would recommend seeing a musculoskeletal-based doctor of chiropractic (D.C.), or see your family physician for initial evaluation and referral.
Secondly, based on the mechanism of the injury and the symptoms you described, I would be concerned about the possibility of a cervical disc herniation, and minimally, a cervical sprain-strain injury. A musculoskeletal-based chiropractor can easily assess this. An MRI would really be required to definitely rule out a disc lesion exerting pressure against a neural structure (spinal nerve root or the spinal cord). See this article for additional information:
http://www.aafp.org/afp/20010815/631.html
Thirdly, if there is a serious injury (such as a herniated disc in the neck compressing the spinal cord or spinal nerve roots), you may require more than conservative treatment.
And you'll need to not engage in these kinds of martial arts activities until you're properly diagnosed and treated appropriately to avoid exacerbation of an injured area.
I hope that this answers your question.
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