Neck and Shoulder Pain: Causes and Solutions

Headache and neck and shoulder pain?

Hello, doctor...
I often have trouble sleeping and experience a lot of stress, which causes me to toss and turn at night and adopt poor sleeping positions.
This has led to frequent shoulder and neck pain.
A week ago, I woke up with severe soreness in my shoulders, neck, and arms.
When I tilt my head back, the pain in my neck becomes unbearable, and when I stretch my arms back, the soreness in my shoulders and scapula is also intolerable.
After three days, I started experiencing intermittent sharp pain above my right eyebrow, which is particularly tender to the touch.
This headache has persisted for three days; while it’s not extremely painful, it lasts all day.
I don’t feel pain while sleeping, but my shoulders, neck, and arms remain extremely sore.
Doctor, what could be the issue? How can I resolve this? Thank you for your help.

Niming, 30~39 year old female. Ask Date: 2019/05/10

Dr. Jiang Junyi reply Neurology

Hello, based on your description, the most common cause of neck pain is cervical myofascial pain.
Prolonged periods of looking down can lead to overuse of the trapezius muscle in the back of the neck, resulting in neck and shoulder discomfort.
Sometimes, headaches may extend to the forehead.
Initially, resting may alleviate the pain, but over time, it can worsen and affect daily activities.
Some patients experience severe neck pain upon waking, accompanied by stiffness, tightness, and unbearable pain levels.

I recommend the following strategies:
1.
Change positions: Alter your posture every 15 minutes to allow the neck tissues to rest.
Any sustained posture (including normal ones) can lead to tissue fatigue and inflammation, so moving around briefly can reduce the risk of muscle inflammation.

2.
Rest: Resting allows the muscles to utilize their self-repair capabilities; avoid vigorous exercise during this time.

3.
Neck heat therapy: Apply heat for 15 to 20 minutes, ensuring the temperature is safe to prevent burns.

4.
Nonsteroidal anti-inflammatory drugs (NSAIDs): If you do not have a history of gastric ulcers, allergies to NSAIDs, or normal kidney function, consider using NSAIDs to reduce inflammation and alleviate pain when necessary.

5.
Neck muscle stretching exercises: After the acute pain phase, develop a habit of performing slow and gentle neck stretches every 15 to 20 minutes, avoiding any positions that cause discomfort.

I suggest consulting a neurologist or a rehabilitation specialist for further evaluation and treatment.
Wishing you good health and peace.
Dr.
Jiang from the Department of Neurology cares about you.

Reply Date: 2019/05/10

More Info

Hello! Thank you for sharing your concerns regarding your neck and shoulder pain. Based on your description, it seems that you are experiencing a combination of muscle tension, potential nerve irritation, and possibly some postural issues that could be contributing to your discomfort.

Causes of Neck and Shoulder Pain
1. Muscle Strain and Tension: Poor sleeping positions and stress can lead to muscle strain in the neck and shoulders. When you sleep in awkward positions or frequently change positions, the muscles can become tight and fatigued, leading to pain and discomfort.

2. Cervical Spine Issues: Your symptoms, including pain radiating to the arms and the sensation of pain above your eyebrow, could indicate issues with the cervical spine. Conditions such as cervical spondylosis or herniated discs can cause nerve compression, leading to pain that radiates down the arms or into the head.

3. Nerve Irritation: The sensation of throbbing pain above your eyebrow may suggest irritation of the nerves that originate from the cervical spine. This can happen due to muscle tightness or structural issues in the neck.

4. Posture: If you spend long hours in front of a computer or in a position that strains your neck, this can exacerbate muscle tension and lead to pain. Poor posture can also contribute to the development of tension headaches.

Solutions and Recommendations
1. Ergonomic Adjustments: Ensure that your workspace is ergonomically friendly. Your computer screen should be at eye level, and your chair should support your lower back. This can help reduce strain on your neck and shoulders.

2. Stretching and Strengthening Exercises: Incorporate gentle stretching exercises for your neck and shoulders into your daily routine. This can help alleviate muscle tension. Strengthening exercises for the upper back can also improve posture and reduce strain on the neck.

3. Heat and Cold Therapy: Applying heat to the affected areas can help relax tight muscles, while cold therapy can reduce inflammation. You can alternate between the two for optimal relief.

4. Mindfulness and Stress Management: Since stress can exacerbate muscle tension, consider incorporating relaxation techniques such as deep breathing, meditation, or yoga into your routine. This can help reduce overall tension in your body.

5. Physical Therapy: If your symptoms persist, consider consulting a physical therapist. They can provide tailored exercises and treatments to address your specific issues and help improve your range of motion and strength.

6. Medical Evaluation: Given the duration and nature of your symptoms, it may be wise to consult a healthcare professional for a thorough evaluation. They may recommend imaging studies, such as an MRI, to rule out any serious underlying conditions.

7. Medication: Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can help manage pain and inflammation. However, it’s important to use these as directed and consult with a healthcare provider if you have any concerns.

Conclusion
In summary, your symptoms likely stem from a combination of muscle tension, potential nerve irritation, and possibly poor posture. By making ergonomic adjustments, incorporating stretching and strengthening exercises, and managing stress, you can alleviate some of the discomfort. However, if your symptoms persist or worsen, seeking medical advice is crucial to rule out any serious conditions and receive appropriate treatment. Remember to listen to your body and take breaks when needed to prevent further strain. I hope you find relief soon!

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