Yes you read correctly, this is a case involving a patients tongue causing her chronic neck pain and headaches. I’ve mentioned Canadian doctor of Chiropractic, Anthony Lombardi before on this blog. He is the creator of the EXSTORE system of analyses. Anthony dropped me an email letting me know of an interesting case that had come through his clinic. He knows people here love to know what causes neck pain.
I won’t tell the whole story. I’ll let Anthony tell you in his words exactly what happened and how he discovered the source of this women’s long-term neck pain and headaches. I must admit who would have thought of linking the tongue to neck pain like this. This is the first time I have ever come across a case like this. Enjoy the story and thanks Anthony for sharing.
Rare Case of Chronic Neck Pain and Headaches
by Dr Anthony Lombardi
A 32 year old female presented to me with chronic neck pain & tightness from the sternocleidomastoids to the posterior neck extensors with daily tension headaches going on for the past 7-8 years and getting worse. She saw numerous medical specialists, she had several diagnostic imaging studies (MRI, CT, ultrasound etc), and even went through a clinical trial of psychotherapy.
On the alternative side she tried several chiropractors, massage therapists and acupuncturists with no change in her condition.
She was referred to me and I followed my EXSTORE assessment system, which included a patient history and I discovered some things that were not recognized or addressed by anyone else. Of course she presented with what anyone with 8 years of neck pain would expect to have: joint restrictions, muscle inhibitions, trophic muscle changes etc…
However, I asked her to simply open her mouth and touch the roof of her mouth with her tongue. No one asked her to do this before and by following the assessment system I made the observation that she was unable to do so and I could clearly see why, ankyloglossia.
That’s right, most of us have never heard of this, but we have all likely seen it before. It’s the decreased mobility of the tongue due to the presence of a short or thick frenulum which attaches the bottom of the tongue to the floor of the mouth.
Mechanically, I thought it could play a significant role in her condition for a couple of reasons. First, the muscles of the tongue specifically the stylohyoid, styloglossus, genioglossus, and geniohyoid all have muscular attachments to the hyoid bone and to either the mandible or the styloid process of the temporal bone. Therefore a thick frenulum (also know as “tongue-tied” to the lay-person) can engage more strain on those and surrounding cervical (neck) tissues.
Secondly, she told me her job requires her to speak both English and Russian and that she started learning to speak Russian back in 2004. The significance of learning a new language infers that her tongue is forced to adapt into different directions to formulate and pronounce words foreign to the English language. This transition from English to Russian on a regular basis over an extended period of time can create the equivalent of repetitive strain injury in someone with a restriction of their tongue.
Based on my EXSTORE assessment and her history, I recommended she see an oral surgeon for a consultation. Due to longer wait times in Canada she chose to see a doctor in the United States. Three weeks after she saw me she had a lingual frenectomy. This loosened the tension on her tongue and the aforementioned surrounding muscles.
An example of lingual frenectomy surgery:
She returned to me for some soft tissue work and joint manipulation and within 4 weeks of the surgery her neck pain and headaches were totally gone. I followed up with her this past week and its been 8 months since the frenectomy and she has not had any neck pain or headaches since.Image Credit: Some rights reserved by diveofficer
Dr. Anthony J. Lombardi is a chiropractor in Hamilton, Ontario, Canada who uses manual techniques and medical acupuncture to improve performance and reduce pain in patients with neuro-musculoskeletal disorders is the creator of EXSTORE. For more information on the ESTORE system email him here.