Chronic Neck Pain: Seeking Solutions for Persistent Discomfort

This issue is really troubling me?

I would like to ask the doctor for some guidance.
For the past year or two, I have been experiencing a sensation of heaviness and dizziness in the back of my head and neck.
I used to spend a lot of time on the computer, and I wondered if I had a neck issue.
I consulted a doctor who performed an X-ray and an electromyography, and he diagnosed me with cervical scoliosis.
He also mentioned that my facial asymmetry might be contributing to the problem.
He referred to my condition as a type of headache and suggested that if it persisted, I could see a rehabilitation specialist.
At that time, I decided to minimize computer use and avoid straining my neck.
However, after a year, I noticed that my symptoms had worsened.
As I work in sales, I realized that even slightly tilting my head to the left while chatting would lead to a heavy sensation in my neck, and if I spoke loudly or strained my neck, I would quickly feel heaviness in the back of my head, followed by facial numbness and warmth.
Sometimes, I even experienced difficulty speaking, which made me fear I might be having a stroke.
However, I found that taking a walk or resting would alleviate the symptoms, and I would feel completely normal after a nap.
Recently, I noticed that when I wake up in the morning, I feel fine, but within 2-4 hours, I experience heaviness in the area between my neck and the back of my head again.
Sometimes, I also feel nauseous and dizzy, and this occurs every 2-3 days, which is very distressing and affects my work.
I decided to see a neurologist again, but this time the doctor reviewed my X-ray and said he didn't see significant scoliosis.
He believed my main issue was facial asymmetry and also diagnosed it as a type of headache, prescribing pain relievers and muscle relaxants.
I asked the doctor if I should see a rehabilitation specialist or a neurologist, but he felt it wasn't necessary and advised me to try the medication first.
Unfortunately, my symptoms did not improve at all.
Now, I am at a loss about what to do.
Recently, in addition to the issues I've mentioned, I feel like my neck is always tense.
Whenever I do some neck exercises, I experience pain in the left side of my neck, and I can only sleep on my back comfortably; side sleeping is uncomfortable, particularly on the left side.
Additionally, if my neck sweats and I am exposed to air conditioning, I immediately feel very heavy and uncomfortable.
I would like to ask the doctor what direction I should take now, as this has caused serious problems in my work and family life.
I am 31 years old and currently run 3-4 times a week, covering about 6 kilometers each time.
I measure my blood pressure every morning and before bed, and it is always normal.
Doctor, what should I do? This is really troubling me.

Ya Hao, 30~39 year old female. Ask Date: 2016/09/07

Dr. Gao Chunde reply Neurology

If the neurological examination shows no significant issues, you may consider a rehabilitation assessment to evaluate your shoulder and neck muscle condition and receive recommendations for some lifestyle maintenance strategies.
Additionally, it is important to consider stress management, such as seeking assistance from a psychiatrist or psychologist.

Reply Date: 2016/09/07

More Info

Chronic neck pain can be a debilitating condition that significantly impacts daily life, work, and overall well-being. Based on your description, it seems that your symptoms are multifaceted, involving neck discomfort, headaches, and even sensations of dizziness and nausea. These symptoms can be exacerbated by prolonged computer use, poor posture, and possibly underlying musculoskeletal issues. Here’s a comprehensive approach to understanding and addressing your chronic neck pain.

Understanding Your Symptoms
1. Musculoskeletal Factors: Your history of neck pain, especially after using a computer for extended periods, suggests that you may be experiencing muscle strain or tension. Poor posture while sitting at a desk can lead to muscle imbalances and strain in the neck and upper back, which can contribute to headaches and discomfort.

2. Cervical Spine Issues: The mention of cervical spine curvature (scoliosis) and facial asymmetry could indicate that your neck structure is contributing to your symptoms. While your recent X-rays did not show significant issues, it’s important to consider that subtle changes in the cervical spine can lead to chronic pain.

3. Nerve Compression: The symptoms of facial numbness and difficulty speaking may suggest nerve involvement, possibly due to muscle tension or cervical spine issues. This could lead to irritation of the nerves that exit the cervical spine, causing referred pain or discomfort.

4. Psychosomatic Factors: Chronic pain can also be influenced by psychological factors such as stress and anxiety. If you find that your symptoms worsen with stress or emotional strain, this could be a contributing factor.

Recommended Steps for Management
1. Physical Therapy: Since your symptoms have persisted despite medication, consider seeking a physical therapist who specializes in neck and spine issues. They can provide tailored exercises to strengthen the neck muscles, improve posture, and enhance flexibility. Techniques such as manual therapy, ultrasound, or electrical stimulation may also be beneficial.

2. Ergonomic Adjustments: Evaluate your workspace ergonomics. Ensure that your computer screen is at eye level, your chair supports your lower back, and your feet are flat on the ground. Taking regular breaks to stretch and move can help alleviate tension.

3. Mindfulness and Relaxation Techniques: Incorporating stress-reduction techniques such as mindfulness meditation, yoga, or tai chi can help manage both physical and psychological aspects of pain. These practices can promote relaxation and reduce muscle tension.

4. Medication Review: If the current medications are not providing relief, it may be worth discussing alternative options with your healthcare provider. Sometimes, a combination of medications, including muscle relaxants or anti-inflammatory drugs, can be more effective.

5. Consultation with Specialists: If your symptoms continue to be severe or if new symptoms arise, consider consulting with a neurologist or a pain specialist. They can perform further evaluations, such as MRI scans, to rule out any underlying conditions that may not have been detected in previous assessments.

6. Lifestyle Modifications: Regular physical activity, such as your running routine, is excellent for overall health. However, incorporating specific neck and shoulder stretches can help target the areas of discomfort. Additionally, maintaining a healthy sleep posture and ensuring your pillow supports your neck properly can improve your symptoms.

Conclusion
Chronic neck pain is often multifactorial, and addressing it requires a comprehensive approach that includes physical therapy, ergonomic adjustments, stress management, and possibly further medical evaluation. It’s essential to communicate openly with your healthcare providers about your symptoms and concerns, as this will help them tailor a treatment plan that best suits your needs. Remember, managing chronic pain is a journey, and it may take time to find the right combination of strategies that work for you.

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