Unexplained Neck and Throat Discomfort: Seeking Answers and Solutions

It seems that there is tissue displacement at the junction of the neck and chin?

Hello, Doctor.
First, I would like to thank you for your patience in reading this message to understand my condition.
I have been experiencing a foreign body sensation in the area where my right jaw connects to my neck for the past two years.
Initially, it felt like something was stuck in my throat, and I constantly felt the urge to burp.
Later, it progressed to difficulty turning my neck to the right; when I attempt to do so, it feels like it gets stuck, and when I turn back, my throat makes a popping sound (like a "pop").
There is no pain, but if it gets too tight, it can be painful when I turn back.
I also feel a pulling sensation under my right tongue, as if my tongue is being held in a tense position and cannot relax.
Over the past two years, I have sought medical attention, but so far, no one has been able to identify the problem or provide a treatment plan.
I consulted an endocrinologist, who performed an ultrasound and confirmed that my lymph nodes are normal and there are no tumors, only a thyroid nodule measuring about 0.7 cm, which the doctor said should be monitored.
I later underwent a CT scan, but the cause remained undetermined.
Traditional Chinese medicine practitioners suggested that there might be a muscle issue in my neck, and while acupuncture provided temporary relief for half a day to a day, sometimes discomfort returned within an hour.
An ENT specialist examined my throat with an endoscope and found nothing abnormal, advising me to relax and prescribing muscle relaxants.
I then visited a rehabilitation specialist who arranged an MRI; the report only mentioned the thyroid nodule and stated that everything else was normal.
The rehabilitation doctor recommended that I see an orthopedic specialist.
After examining me, the orthopedic doctor indicated that the issue is near the trachea and referred me to a pulmonologist.
The pulmonologist then stated that this falls under the ENT specialty and referred me back to the ENT.
Finally, the ENT doctor (the same one I initially saw) insisted that my symptoms were due to anxiety and advised me to relax.
After prescribing muscle relaxants, I was sent home.
However, after finishing the muscle relaxants, I saw no improvement.
I eventually consulted a neurologist (since the ENT doctor suggested that my nerves might be tense), but the neurologist said I should not be seeing him and referred me back to the ENT, even scheduling an appointment for me.
He mentioned that I might have laryngospasm, but after researching online, I found that the symptoms of laryngospasm do not match mine.
Currently, I am unsure which specialty to consult, as all the doctors I have seen have been unable to identify the cause.
I now experience a sensation of something moving back and forth in my neck, whether I turn left or right.
When I feel uncomfortable, I need to apply pressure with my hand at the junction of my jaw and neck; only with significant pressure can I find relief, but if I press too long, my throat starts to hurt.
It feels like something is out of place, as if a muscle is not in the correct position.
If I keep my neck still for too long or do not open my mouth, it becomes very tight, and opening my mouth produces a popping sound, making neck movements uncomfortable.
This issue has troubled me for a long time; I cannot turn my head to the right, and at night, I struggle to find a comfortable sleeping position.
My right sublingual area feels constantly pulled, and sometimes my right nostril gets congested due to neck issues, while my right ear also feels tense.
It seems that the lower triangular area of my right face is affected by the neck problem.
I have communicated all these issues to every doctor I have seen.
The foreign body sensation feels like it is within the superficial layer of the pharynx, possibly in the muscle layer.
Therefore, I would like to ask if you could assist in evaluating how I should proceed.
Thank you very much for your response.

Doris, 30~39 year old female. Ask Date: 2018/11/20

Dr. Ji Zhaoyun reply Otolaryngology

Hello, the situation you described may be indicative of chronic pharyngitis.
It is recommended to undergo laryngoscopy to rule out any masses, as well as to consider pharmacological treatment.
In addition to medication, please pay attention to the following daily living tips: avoid lying down for two hours after eating, and refrain from coffee, tea, cigarettes, alcohol, fried foods, and spicy foods, as these can help improve symptoms.
Wishing you safety and health.
Sincerely, Chi Chao-Yun, Taichung Hospital, Ministry of Health and Welfare.

Reply Date: 2018/11/20

More Info

Hello! Thank you for sharing your concerns regarding the discomfort you’ve been experiencing in your neck and throat area. It sounds like you’ve been through quite a journey in seeking answers and treatment for your symptoms, and I commend you for your persistence in trying to find relief.

From your description, it appears that you have been experiencing a sensation of something being stuck in your throat, along with restricted movement in your neck, particularly when turning to the right. The popping sound you hear when you turn your neck, along with the pulling sensation under your tongue, can indeed be quite distressing. It’s understandable that after consulting multiple specialists, you would feel frustrated and uncertain about the next steps.

Given that you have undergone various imaging studies, including ultrasound and CT scans, which have not revealed any significant abnormalities, it may be worthwhile to consider a few possibilities that could explain your symptoms. One potential cause could be muscle tension or spasms in the neck area, which can lead to discomfort and restricted movement. This is often exacerbated by stress or anxiety, which can create a cycle of tension and discomfort. The fact that muscle relaxants were prescribed suggests that your healthcare providers are considering this possibility.

Another consideration is the presence of myofascial pain syndrome, where trigger points in the muscles can refer pain or discomfort to other areas, including the throat and jaw. This could explain the sensation of tightness and the need to apply pressure to relieve discomfort. Physical therapy, particularly focusing on myofascial release techniques, may be beneficial in addressing these muscle-related issues.

Additionally, you mentioned that you have been advised to relax and manage your stress levels. While this may seem simplistic, stress can significantly impact muscle tension and overall physical well-being. Incorporating relaxation techniques such as deep breathing exercises, yoga, or mindfulness meditation may help alleviate some of the tension you are experiencing.

If you haven’t already, it might be beneficial to seek out a multidisciplinary approach. This could involve working with a physical therapist who specializes in neck and jaw issues, as well as a psychologist or counselor to address any underlying anxiety or stress that may be contributing to your symptoms. Sometimes, addressing the psychological aspect can lead to significant improvements in physical symptoms.

In terms of your next steps, I would recommend the following:
1. Consult a Physical Therapist: Look for a therapist who specializes in neck and jaw pain. They can assess your posture, muscle tension, and movement patterns to develop a tailored treatment plan.

2. Consider Stress Management Techniques: Engage in activities that promote relaxation and reduce stress. This could include yoga, meditation, or even gentle exercises that promote neck mobility.

3. Follow Up with an ENT Specialist: If you feel that your symptoms are not improving, consider seeking a second opinion from an ear, nose, and throat (ENT) specialist who may have a different perspective on your condition.

4. Explore Myofascial Release Therapy: This therapy focuses on relieving tension in the fascia, which could help with the discomfort you are experiencing.

5. Keep a Symptom Diary: Documenting when your symptoms worsen or improve can provide valuable information to your healthcare providers and help identify potential triggers.

It’s essential to continue advocating for your health and seeking the support you need. While it can be disheartening to feel like you’re not getting answers, remember that persistence is key in finding the right treatment for your condition. I hope this information provides you with some clarity and direction as you navigate your health journey. Please take care, and I wish you the best in finding relief from your symptoms.

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