Neck Pain and Numbness: When to Seek Medical Help

Q: Neck Pain and Numbness: When to Seek Medical Help

Hello： Your symptoms may suggest headaches caused by intracranial hypotension. <br>The primary symptom of this type of headache is "postural headache," which worsens when the patient is standing or sitting and significantly improves or disappears when lying down. <br>The most com

Neck pain and numbness?

Last Thursday afternoon, I experienced severe headaches, and after taking painkillers, I felt slightly better.
However, on Friday morning, I began to feel soreness and numbness in the back of my neck.
After that, whenever I sat or stood, the soreness and numbness in my neck would start again, and it would also occur while riding a bike.
Eventually, the pain extended to the back of my head.
Leaning forward or squatting slightly alleviated the pain, and I only felt no pain when lying down.
In the morning, right after waking up, I did not experience any pain, but about 30 minutes later, the soreness and numbness in my neck would return.
I initially visited a clinic, and they mentioned that I have migraine symptoms, but the migraine medication did not help.
I would like to ask the doctor what might be going on.
Should I go to the hospital to check my cervical spine?

Hsin, 30~39 year old female. Ask Date: 2018/07/30

Dr. Jiang Junyi reply Neurology

Hello: Your symptoms may suggest headaches caused by intracranial hypotension.
The primary symptom of this type of headache is "postural headache," which worsens when the patient is standing or sitting and significantly improves or disappears when lying down.
The most common pattern is bilateral, non-pulsating headaches.
In addition to postural headaches, some patients may experience: neck pain or stiffness, commonly located in the neck but possibly extending downwards, even causing lower back pain; nausea and vomiting, which often accompany the headaches and are usually related to changes in posture; diplopia, commonly due to unilateral or bilateral abducens nerve palsy, with occasional cases of oculomotor or trochlear nerve palsy; auditory symptoms, including echo, sounds becoming distant or unclear, tinnitus, or even hearing loss; visual symptoms, primarily characterized by blurred vision and photophobia.
It is recommended that you consult a neurologist to discuss examination and treatment options.
Wishing you good health and peace.
Dr.
Jiang, Department of Neurology, Taoyuan Hospital, cares about you.

Reply Date: 2018/07/30

More Info

Based on your description, it sounds like you are experiencing a complex set of symptoms that could be related to several underlying issues. The combination of severe headaches, neck pain, numbness, and the specific patterns of your discomfort suggests that it would be prudent to seek further medical evaluation, particularly concerning your cervical spine (neck) and neurological function.

Understanding Your Symptoms
1. Headaches and Neck Pain: The onset of severe headaches followed by neck pain can indicate a few possibilities. One common cause is tension-type headaches or migraines, which can lead to muscle tension in the neck. However, the fact that your neck pain is accompanied by numbness raises the concern for potential nerve involvement, possibly due to cervical spine issues.

2. Numbness and Pain Patterns: The numbness and pain radiating from your neck to the back of your head, along with the relief you feel when bending forward or squatting, may suggest that certain positions are alleviating pressure on nerves or muscles. This could indicate cervical radiculopathy, where nerve roots in the neck are compressed or irritated, leading to pain and numbness.

3. Symptoms Worsening with Position: The fact that your symptoms worsen with sitting or standing and improve when lying down could suggest that your posture or the position of your cervical spine is contributing to your discomfort. This is often seen in conditions like cervical spondylosis or herniated discs, where certain positions exacerbate nerve compression.

When to Seek Medical Help
Given the complexity of your symptoms, it is advisable to seek further medical evaluation. Here are some steps you should consider:
1. Consult a Specialist: Since you have already seen a clinic and received a diagnosis of migraine, it would be beneficial to consult a neurologist or an orthopedic specialist who focuses on spinal issues. They can provide a more comprehensive evaluation of your symptoms.

2. Imaging Studies: Requesting imaging studies such as an MRI of the cervical spine may be warranted. This can help identify any structural issues such as herniated discs, degenerative changes, or other abnormalities that may be contributing to your symptoms.

3. Physical Examination: A thorough physical examination, including neurological assessments, can help determine if there are any signs of nerve involvement. This may include testing reflexes, muscle strength, and sensory responses.

4. Consider Physical Therapy: If structural issues are identified, physical therapy may be recommended to strengthen the neck muscles, improve posture, and alleviate pressure on the nerves. A physical therapist can provide targeted exercises and techniques to help manage your symptoms.

5. Monitor Symptoms: Keep a detailed record of your symptoms, including when they occur, their intensity, and any factors that alleviate or worsen them. This information can be invaluable for your healthcare provider in diagnosing and managing your condition.

Conclusion
In summary, your symptoms warrant further investigation, particularly concerning your cervical spine and potential nerve involvement. Seeking a specialist's opinion, possibly undergoing imaging studies, and considering physical therapy are all steps that can help you find relief and address the underlying issues. It’s essential to act promptly, especially if your symptoms worsen or new symptoms arise. Your health and well-being are paramount, and addressing these concerns early can lead to better outcomes.

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