I’ve already been diagnosed. Why do I need to be diagnosed again?
Chronic pain can be very difficult to diagnose. Approximately eight hundred new headache patients per year are examined at our clinic. An estimated eighty percent of these patients are diagnosed with cervicogenic headache. Of these patients almost none are referred with this diagnosis. They are usually referred with diagnoses such as tension type headache, migraine headache or no diagnosis at all.
I’ve had x-ray, CT scans, and MRIs and they did not show the source of the pain.
The problem with imaging tests is that pathology can exist and not show up on the test. Postmortem studies have shown small fractures of the zygapophyseal joints or other bony structures that were not picked up by x-ray. CT and MRI scans have also missed pathology that was discovered postmortem.
This situation is further complicated by the fact that the damage seen on an x-ray or MRI could have preceded the current injury. The only way to confirm this would be by viewing the results of tests performed prior to the injury that caused the chronic pain.
We use diagnostic blocks to determine the source of the pain. A small amount of local anesthetic is injected into the location that is suspected to be the source of the chronic pain. If this injection relieves the chronic pain symptoms for an appropriate amount of time one can conclude that the source of the pain has been located.