YIKES! That’s horrible! If Dr. Milligan is an hour further away than Dr. Rothman, they obviously aren’t in the same office so who cares that they happen to be in the same practice. That is an absurd rule!!! I’m glad you’ve been proactive in filing complaints. If all else fails, there are a couple of other doctors on the list for AZ. You could try contacting one or both of them to see about moving forward.
I’m hoping my appointment at the end of November with the Mayo Clinic goes well. I am pretty happy with how quickly they can see me, however there isn’t much information on Dr. Neal online or on this forum so I can only have my fingers crossed at this point.
I spend a few hours today attempting to create a 3D image of my CT, however I couldn’t get it to do what I would like. I was doing great for most of the steps and then towards the end it just turned into a disaster 
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As a reminder to anyone who would like to comment on my CT, I have been diagnosed with bilateral calcification of the styloid ligaments (1.6 CM on the left side that is causing me pain)
I will try again tomorrow. Hopefully I can find a YouTube video to follow. Thank you for any comments or suggestions!
I thought I’d chime in… (not a doctor though). The styloids aren’t long per se, and they are very thin indeed, though might be a bit sharp at the ends (it’s hard to judge though, as in many “normal” ct scans I have seen they are sharp too). But what you have in my opinion is quite significant loss of cervical lordosis, aka military neck along all the C region.
Just a question… when you shrug the shoulders (or even better, say when you try to lift your shoulders towards the ears), do you feel some very uncomfortable restriction/tension in the inner side of the shoulder blades as if the shoulders were kind of tied to the spine? Or do they glide as free as if they were totally detached and well lubricated between the shoulder blades and the rib cage?..
Also I attached the image with the styloids marked in blue.
Hi @vdm ! Thank you for your response.
My styloid bones are not an issue. A doctor has diagnosed me with bilateral calcification of the styloid process ligament. 1.6 CM on the left side that is causing me pain. I don’t feel it on the right side.
However, to answer your question: when I lift my shoulders to my ears, the shoulder blades do move somewhat freely but with a lot of pain and grinding noises, especially on the left side. I also have grinding pain on the left side of my neck when I roll my neck.
I’m hoping when I try the 3D model again today that I can get the ligaments to show.
Also I’ve never heard of military neck, but wow after googling it I’m shocked at how straight my neck is. No one has mentioned this to me before.
Hey @Mnfarr37,
Sorry about not being specific about the ligaments and mentioning the styloids, and thanks for your answer re shoulders!
Now I probably should explain why I asked that…
See, I have been searching a lot about the Eagle’s syndrome wherever I could and analysing CTs/Xrays (again - I’m not a doctor, just a “hobbyist” who has Eagle’s myself). Eventually I noticed that so many affected people with elongated styloid (who have Eagle’s syndrome symptoms) also have “military neck”.
It’s hard to tell if one causes the other, or both are caused by some third thing, or it’s just a massive coincidence, but I started developing a theory that styloid elongation, ligament calcification etc. might be the body’s self-guarding or just stress-related response to the overflexed neck. Maybe as a way to support deep neck muscles and stabilize the head, maybe as a result of constant over-tension, maybe lack of nutrition or excess of lactic acid around spasmed muscles, maybe something else.
It’s well known that body can produce calcium deposits in shoulder tendons (google for “calcific tendonitis”), and I speculate that calcifications in stylohyoid ligament/overgrown styloids also might be (partially) developed in a similar fashion. The good and amazing thing that in shoulder the calcium deposits often are eventually reabsorbed back by the body, and perhaps it’s because shoulders naturally get more physical activity than the neck. Meanwhile the neck might be under constant tension depending on profession/stress levels/postural habits.
In your case it is especially interesting, as you have quite normal styloids but only some calcification in the ligaments. I wonder if that might be something reversible too, in case the hypothesis about military neck being related to the Eagle’s syndrome turns out to be true (at least to some extent).
Have you ever tried to discuss your neck pain with a good physio therapist? If you have a chance, I guess based on your age range, it should be possible to give the body needed physical exercises and slowly bring the spine back into the “normal” alignment (though of course everyone has their own “normal” which might be very different from person to person). Maybe it would be enough to make those calcifications disappear… 
From my own experience, I am trying to fix my “military neck” by observing my posture and re-learning basic things like walking, sitting, standing. There are moments when my whole spine suddenly relaxes and I get short-lasting but significant improvements on neck and shoulder pain, and I clearly start feeling that my whole spine temporary becomes flexible like a snake before stiffness comes back again. On the other hand, I am beyond that age when the body is very easy to “shape”, so it takes a little longer now…
UPD: I suspect military neck also might make the trapezius and levator scapulae muscles pull the shoulder blades closer to the rib cage, and that might contribute to the grinding noises - more friction between the rib cage and the scapulae, but again - these are just “educated speculations”.
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It’s worth ringing the Mayo Clinic beforehand to check that Dr Neal is treating ES patients- he must have done a successful surgery for his name to be put on the list, but if his name’s not been mentioned much on the forum it may be he’s not treating ES any more, we have heard that some of the Mayo clinics don’t treat ES.
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vdm -
The therapy you’re giving yourself sounds like a form of somatic therapy. There is a book you would probably enjoy reading - Somatics - reawakening the mind’s control of movement, flexibility, and health by Thomas Hanna. It deals almost precisely with the type of body observation & retraining you’re talking about in your situation. It may be available on Amazon. I have a copy but have never read it cover to cover, but the bit I have read has certainly given me “food for thought.”
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Im not sure what insurance you have but the “practice” itself sounds like it has a policy in place to avoid pitting their doctors within the group against each other. It could also be you need to take your complain higher up the food chain at the medical practice. Unfortunately there are alot of low level admin people working in these offices that interpret the rules wrongly. Insurance companies are a whole nother realm. I would suggest you call Dr. Milligan’s office and ask to speak to the office manager and explain your situation. Maybe dont even explain anything and just get the appointment with Milligan. If you hit a brick wall, move on to find another practice that doesn’t have stupid internal policies that are not in the best interest of the patients. Might be a sign, its not the right place.
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A little update since I’ve last posted. Due to my complaints, Dr. Milligan reviewed my CT and consulted with Dr. Rothman and they have decided together that I do not have ES because the calcification is only 1.6 CM on each side. This information was passed onto me through a nurse and I did not meet with Dr. Milligan or speak with him even once. I am truly unhappy with AOC physicians group. They did not invite me back for an appointment to look further into it and they did not offer any suggestions to help me manage the discomfort I am in.
Dr. Bartell says it is ES and Dr. Milligan (a doctor I never met or spoke with) says I do not have ES. At this point, I am waiting patiently for my appointment with Dr. Neal at the Mayo Clinic on November 30.
Sorry to hear this…I would give any weight to what the nurse passed on although I know it has to be upsetting. It’s not the right practice to be in given the way you have been treated. Hang in there and dont give up. Keep banging on doors. You will get to the bottom of all this. 
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I hope Dr. Neal is supportive & helpful. I’m really sorry for the way you were passed over by Drs. Rothman & Milligan.
Please let us know how your appt goes w/ Dr. Neal.
I feel for you, that’s so frustrating… hopefully a better appt with Dr Neal. Keep strong, you have to keep pushing to get answers…
Just got a call and Dr. Neal at the Mayo Clinic canceled my appointment. He is only taking spine patients moving forward. Now I have to wait until January to see a different doctor, in a different department. 
I’m so sorry, Mnfarr37! I hear your frustration!! Did Dr. Neal’s office refer you to another doctor? Are you able to try to get an appointment for a video conference w/ Dr. Samji or Dr. Cognetti prior to Jan. just for an opinion & to give you some peace of mind that you’re on the right track? Health insurance will often help pay at least part of this type of appt.You can check to see if yours does.
I will say, that Dr. Samji most likely won’t be very helpful if you have a calcified stylohyoid ligament but not an elongated styloid so you might want to contact Dr. Cognetti’s ofc. I think Dr. Hackman in NC is willing to work on calcified ligaments alone, but I also recall he requires the first appt. to be in person which probably isn’t possible for you. Another option is Dr. Nuss in Louisiana. Just wanted to give you some options incase all your local docs don’t end up being helpful.
Please let us know how we can support you in the meantime.
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Well that sucks! 
Hang in there and keep pushing for someone else, perhaps elsewhere. Do you know much about this different doctor in another department? Level of expertise in Eagles? Views on surgery?
It may be a dead end and you will still need to find someone with the expertise you need. I would find out more about the new doc and start working on others outside Mayo as a back up. You can always make appointments elsewhere and cancel them if you dont need them in the end but at least you are in the que to be seen. We all know it can take months to get into see some of these docs.
I’m so sorry you’re being passed around to different doctors when you are just needing help. How frustrating. If you are wanting other opinions, I would second/third the recs to perhaps get a consult with other doctors from this forum. You might also consider Dr Hepworth in Denver as Denver is closer to Arizona if you were to travel for surgery. He takes into account your symptoms and imaging not just the length of your styloid. I can’t speak highly enough of him and his staff only issue is his schedule is very full so may not be much sooner to get in with him. Good luck and hang in there!
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That is so frustrating, I hope you can get an appt sooner with someone on the list…
Hi everyone!
A little update since my last post. There was a cancellation at the Mayo Clinic and I was able to see a neurosurgeon, Dr. Bendok. He treated me for occipital neuralgia with a nerve block in both nerves in my skull, and the results have been great. My symptoms have been gone for 2 weeks and I am off all pain medication. I am also seeing a physical therapist for my neck and shoulder to ensure the pain doesn’t come back when the nerve block wears off.
Even though my symptoms leaned towards calcification ES, based off how well the nerve block worked, I do not have ES. We are hoping the calcification fixes itself with physical therapy.
Thank you EVERYONE for your input, support, and encouragement! You are all amazing individuals for giving your time to this site.
Mnfarr37 signing off. 
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I’m really glad for you that the nerve block has worked so well! Hopefully it’ll stay that way, but if symptoms ever return you might want to explore the calcification…best wishes!
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Mnfarr37 - That’s great news! Thx for the update.
I also hope you get long-term relief from the nerve block & PT. Sometimes nerve blocks are used to diagnose ES, as in, if they stop the pain then that confirms ES. Not saying you have ES, but if, as Jules mentioned, your pain comes back at some point in the future, we will be here for you. 
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