Have you ever felt this way? When you bend your head to pick up something that fell on the floor, or when you just bend your neck forward, you feel a sharp pain that feels like a jolt of electricity running down your spine. It's like an electric shock. Although it goes away in a few seconds, the feeling is a bit scary. That's what we're going to talk about today. In medical terms, this symptom is called Lhermitte's Sign.
What exactly is Lhermitte's Sign?
Simply put, Lhermitte's Sign is a sharp, electric-like pain that suddenly shoots down your spine, sometimes into your arms and legs, when you bend your neck forward. This can happen when you cough or sneeze. The pain comes on suddenly and goes away within seconds. But it can happen several times a day.
Sometimes your doctor will call this the ``barber chair phenomenon.'' The reason for this is that in the past, some people experienced this type of pain when they had their heads tilted forward in barber chairs while having their hair washed.
But remember, this symptom called Lhermitte's Sign is not dangerous or life-threatening. However, it is an important signal that gives us about something going wrong inside our body.
Why do we feel this way? What is the reason?
The main reason for this is that there is some damage to the nerves in our spinal cord. In medicine, we call this damage a ``lesion'' or a ``scar''. A doctor can find out if you have such a scar in your cervical spine with an ``MRI'' scan.
Think of our nerves as electrical wires. These wires are protected by a protective sheath (insulation). This protective sheath around our nerves is called myelin. This myelin sheath is what allows messages from the brain to travel quickly and accurately to other parts of the body.
If for some reason this myelin sheath is damaged, a condition called ``demyelination,'' the nerve becomes exposed. At that time, when you bend an area like your neck, the damaged nerve gets stimulated and sends false pain signals to the brain. That's what makes us feel like we're being electrocuted.
What medical conditions can cause Lhermitte's Sign?
The most common and leading cause of this symptom is multiple sclerosis (MS). Studies have found that about one in three people with MS will experience Lhermitte's sign at least once in their lives.
Apart from that, there are several other reasons that could affect this. The table below will clarify this further.
| Condition/Cause | A simple explanation |
|---|---|
| Multiple Sclerosis (MS) | This is a disease that affects the nervous system. In this case, the body's own immune system damages the myelin sheath around the nerves. This is the most common cause. |
| Vitamin B12 deficiency | Vitamin B12 is essential for a healthy nervous system. When B12 levels in the body are too low, nerve damage can occur. |
| Herniated disk | A jelly-like disc between the vertebrae (bones) of the spine bulges out, pressing on the spinal cord or nerves. We usually say "herniated disc." |
| Cervical spondylitis | Nerve compression due to wear and tear of the vertebrae and joints in the neck with age. |
| Spinal cord compression | Pressure on the spinal cord due to a tumor, accident, or other cause. |
| Chickenpox virus (Shingles) | In some cases, the virus that causes chickenpox can reactivate and affect the nerves. |
| Radiation or chemotherapy (Radiation/Chemotherapy) | This can occur as a side effect of radiation therapy for cancer, especially to the neck area. |
What are the triggers for this pain?
This pain can suddenly appear due to certain activities and situations.
- Bending the neck forward: This is the main trigger.
- Cough
- Crocodile hunting
- Yawning
Also, the likelihood of this symptom occurring is higher in the following cases:
- When you are tired (Tired)
- When you are stressed
- When exercising
- When in a hot environment
How does a doctor diagnose this and what are the treatments?
There is no specific test to check for Lhermitte's sign. The doctor will recognize it as soon as you mention it. The doctor's main goal is to find the cause of the symptom, that is, the underlying medical condition.
For that,
- The doctor will ask you carefully about your symptoms.
- A physical examination will be performed. A test such as the Spurling test may be performed to check for nerve compression that may be causing the neck pain.
- You may be referred for an imaging test, such as an MRI scan . This can clearly show whether there are lesions, a herniated disc, or other damage to the spinal cord.
When it comes to treatment, this pain, which only lasts a few seconds, may not require any special treatment. The most important thing is to treat the underlying cause.
For example:
- If the cause is MS, treatment for it will reduce the occurrence of Lhermitte's Sign.
- If the cause is vitamin B12 deficiency, administering vitamin B12 can completely cure this condition.
- If a disc is herniated, physical therapy or possibly surgery may be necessary.
In addition, your doctor may recommend the following to help manage this pain:
- Medications for nerve pain, for example `(Gabapentin)`.
- A neck brace is worn to limit neck movement.
- Referral to a physical therapist for muscle relaxation exercises and stretching.
When should I see a doctor?
If you feel the electric shock-like pain described above, especially when you bend your neck, don't ignore it.
- If this is the first time you've felt something like this in your life , definitely see a doctor.
- If you already have a condition like MS, and these symptoms appear new or worsen, inform your doctor.
- If this pain is accompanied by other symptoms (e.g. numbness in the limbs, difficulty walking, changes in vision), seek medical advice immediately.
Although this is not life-threatening, it is an important signal from your body. So don't ignore it and let the underlying cause become serious.
Take-Home Message
- Lhermitte's Sign is a brief, electric-like pain felt down the spine when the neck is bent forward.
- Although this symptom is not dangerous, it is an important sign of damage to the nerves in the spinal cord.
- Although the main cause of this is Multiple Sclerosis (MS), other causes such as vitamin B12 deficiency and spinal disc herniation can also play a role.
- If you have any of these symptoms, do not ignore them and see your doctor immediately to find out the real cause and get proper treatment.
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