Pain and tingling sensation on the back of the neck

Dear Ask The Doctor: I suffer from spondylysis and have a dull ache at the nape of my neck on and off which goes away when i apply ointment. Of late I am experiencing dull tingling sensation at the back of my head what could be this due to. I feel the sensation more when I am lying horizontal or when I am resting my head in a tilted position. It is bearable and I tend to ignore it most of the times. I am 47 years old and am going thru menopausal symptoms.

Dear Sumita: The pain and tingling sensation on the back of the neck as you described most likely is due to a cervical nerve compression. In the younger patients, cervical radiculopathy may be a result of a disc herniation or an acute injury causing impingement of an existing nerve. In the older patient, cervical radiculopathy is often a result of spinal canal narrowing from bone (osteophyte) formation, decreased disc height and degenerative changes due to aging process (spondylosis). The same described for the cervical spine applies to the lower back in terms of cause of pain and numbness in the legs, same causes, different spinal level. The treatment strategy usually includes: physical therapy program aimed to reduce pain and inflammation, and the use of anti-inflammatory drugs (as ibuprofen), also a re-education of habits and posture to improve quality of life. You should be independent in a stretching and strengthening program and continue with these exercises under the periodic supervision of a physical therapist initially and then completely on your own. Patients whose conditionfails to improve with a comprehensive rehabilitation program and selective injections should be presented with a surgical evaluation. Often, patients should show progressive improvement over the first 6-8 weeks with conservative treatment. If there is no significant improvement in this time frame, consider a surgical evaluation.