Neck and Head Pain: When to Seek Further Medical Help

Head and neck issues?

Hello doctor, a few days ago I suddenly experienced sharp pain in my neck along with stiffness, which was accompanied by headaches.
However, after trying stretching and applying heat at night, the headache subsided, but my neck remains very stiff.
Sometimes, when I turn my head, I can hear sounds, and my entire head feels slightly numb, though not severely.
When I furrow my brow, it feels tight and somewhat tingly, with a sensation of numbness located slightly to the right at the back of my head, near the occipital nerve.
Occasionally, I also experience a feeling of fullness in my left ear.
I have seen a physical therapist, and it may be due to the stiffness.
Should I consult another specialist for further examination? I am quite worried.

Ji, 20~29 year old female. Ask Date: 2019/11/03

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 muscles in the back of the neck, resulting in neck and shoulder discomfort.
Initially, resting may alleviate the pain, but it can progressively worsen and affect daily activities.
Some patients experience severe neck pain upon waking, accompanied by stiffness, tightness, and intolerable pain levels.

I recommend the following:
1.
Change your posture regularly: Shift your position every 15 minutes to allow the neck tissues to rest.
Maintaining any posture (including a normal one) for an extended period can lead to tissue fatigue and inflammation, so brief movements can reduce the risk of muscle inflammation.
2.
Rest: Allowing the muscles to utilize their self-repair capabilities is essential, and vigorous exercise should be avoided during this time.
3.
Apply heat to the neck: Use a heating pad for 15 to 20 minutes, ensuring the temperature is safe to avoid burns.
4.
Non-steroidal 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 as needed.
5.
Neck muscle stretching exercises: After the acute pain phase, develop a habit of performing slow, gentle neck stretches every 15 to 20 minutes, ensuring the angles do not cause discomfort.
Regarding your concerns about brain issues, I recommend consulting a neurologist for cervical ultrasound or other neurological examinations to help rule out vertebral artery disease or muscular problems.
It would be beneficial to discuss examinations and treatments with a neurologist or a rehabilitation physician.
Wishing you good health and peace.
Dr.
Jiang, Neurology Department, Taoyuan Hospital, cares about you.

Reply Date: 2019/11/03

More Info

When experiencing neck and head pain, especially when accompanied by symptoms such as stiffness, numbness, and occasional ear fullness, it is essential to understand the potential underlying causes and when to seek further medical help. Based on your description, it seems you are dealing with a combination of neck stiffness and headaches, which can often be related to muscular tension, cervical spine issues, or even neurological concerns.

Understanding Your Symptoms
1. Neck Stiffness and Pain: This can often result from poor posture, especially if you spend long hours in front of a computer. Muscular tension in the neck can lead to referred pain in the head, resulting in tension-type headaches. The stiffness you describe, along with the popping sounds when turning your neck, may indicate muscle tightness or joint dysfunction.

2. Head Pain: The pain you experience in your head, particularly around the forehead and the back of the head, could be tension-related. However, if the pain is severe or persistent, it could also suggest other conditions, such as migraines or cervicogenic headaches, which originate from the cervical spine.

3. Numbness and Tingling: The sensation of numbness or tingling in the head and neck area, particularly if it is localized, could indicate nerve involvement. This might be due to nerve compression from muscle tightness or cervical spine issues, such as herniated discs or degenerative changes.

4. Ear Fullness: The occasional feeling of fullness in the ear can be related to Eustachian tube dysfunction, which can occur with neck tension or sinus issues. However, it could also be a sign of referred pain from the neck.

When to Seek Further Medical Help
Given your symptoms, it is advisable to monitor your condition closely. Here are some guidelines on when to seek further medical evaluation:
- Persistent Symptoms: If your neck stiffness and headaches persist for more than a few days despite home treatment (like stretching and heat application), it would be wise to consult a healthcare professional.

- Worsening Symptoms: If you notice an increase in the severity or frequency of your headaches, or if the numbness and tingling worsen, you should seek medical attention promptly.

- Neurological Symptoms: If you experience any additional neurological symptoms, such as weakness in the arms or legs, changes in vision, or difficulty speaking, you should seek emergency medical care.

- Physical Therapy: Since you have already seen a physical therapist, it may be beneficial to continue with physical therapy, as they can provide targeted exercises and treatments to alleviate muscle tightness and improve neck mobility.

Recommended Specialists
1. Neurologist: If your symptoms persist or worsen, a neurologist can evaluate for any underlying neurological conditions that may be contributing to your symptoms.

2. Orthopedic Specialist: An orthopedic doctor specializing in the spine can assess for any structural issues in the cervical spine that may be causing your symptoms.

3. Physical Medicine and Rehabilitation (PM&R): A PM&R specialist can help with non-surgical management of musculoskeletal pain and may provide additional therapies to improve function.

4. Chiropractor: If you are open to it, a chiropractor may help with spinal alignment and muscle tension, but ensure they are licensed and have a good reputation.

Conclusion
In summary, while your symptoms may initially seem manageable with home care, it is crucial to remain vigilant. If your condition does not improve or worsens, seeking further medical evaluation is essential. Early intervention can prevent complications and lead to more effective treatment. Always prioritize your health and well-being, and do not hesitate to reach out to healthcare professionals for guidance.

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