Neck and Shoulder Pain: When to Seek MRI for Diagnosis

Q: Neck and Shoulder Pain: When to Seek MRI for Diagnosis

Hello： The symptoms you mentioned are more indicative of cervical spine issues. <br>In addition to an MRI, I recommend consulting a rehabilitation specialist for physical therapy and electromyography (EMG) testing. <br>Wishing you good health and peace. <br>Dr. <br>Jiang, Neurolo

Head trauma and shoulder-neck issues!

Hello, doctor.
I've loved using computers since I was young and often stayed up late with poor posture, which has led to frequent sharp pain in my right neck and shoulder.
Over time, the pain has subsided, but my right neck and shoulder have become very tight, and a small area of skin on my right side has lost sensation.
My right neck is also somewhat swollen, and my right face feels uncomfortable.
Additionally, my eyes feel strained when looking at things, and the ophthalmologist mentioned that my eye muscles are overly tense.
Furthermore, I have had a head injury decades ago, and the lump from that injury is still present.
Could this be related to the issues I've described? If I were to pay out of pocket for an MRI, should I focus on my head or neck? This issue has been troubling me for a long time and is affecting my work and social life.

ROU, 30~39 year old female. Ask Date: 2020/01/04

Dr. Jiang Junyi reply Neurology

Hello: The symptoms you mentioned are more indicative of cervical spine issues.
In addition to an MRI, I recommend consulting a rehabilitation specialist for physical therapy and electromyography (EMG) testing.
Wishing you good health and peace.
Dr.
Jiang, Neurology, Taoyuan Hospital, cares about you.

Reply Date: 2020/01/04

More Info

Neck and shoulder pain can be debilitating, especially when it affects daily activities and quality of life. Based on your description, it seems that you have been experiencing a range of symptoms, including pain, tightness, and numbness in the right neck and shoulder area, along with discomfort in your right face and issues with your eyesight. Given your history of poor posture while using the computer and the long-standing nature of your symptoms, it is essential to understand the potential underlying causes and when to seek further diagnostic imaging, such as an MRI.

Understanding Your Symptoms
1. Muscle Tightness and Numbness: The tightness in your neck and shoulder could be attributed to muscle strain or tension, often resulting from prolonged poor posture, especially during computer use. This can lead to muscle fatigue and discomfort. The numbness in the skin over your right shoulder may indicate nerve involvement, possibly due to compression or irritation of the nerves that exit the cervical spine.

2. Facial Discomfort and Eye Strain: The discomfort in your right face and the sensation of tightness in your eye muscles could be related to referred pain from the neck or shoulder area. The cervical spine houses nerves that can affect various regions, including the face. Additionally, prolonged screen time can lead to eye strain, which may exacerbate your symptoms.

3. History of Head Trauma: You mentioned a history of head trauma with a persistent lump. Depending on the nature of the injury, this could be related to your current symptoms. If the lump is associated with nerve damage or if there was a concussion, it could potentially lead to ongoing issues.

When to Consider MRI
MRI is a valuable diagnostic tool that provides detailed images of soft tissues, including muscles, nerves, and discs in the cervical spine. Here are some considerations for when to seek an MRI:
1. Persistent Symptoms: If your symptoms have been persistent and are affecting your daily life, it is reasonable to consider imaging. MRI can help identify any structural issues, such as herniated discs, spinal stenosis, or nerve compression.

2. Neurological Symptoms: The presence of numbness, tingling, or weakness in your arm or shoulder suggests possible nerve involvement. An MRI can help determine if there is a pinched nerve or other neurological issues.

3. Facial Pain and Eye Discomfort: Given your facial symptoms, it may be beneficial to investigate whether there is a connection to cervical spine issues. An MRI of the cervical spine could provide insights into any nerve root compression that might be causing referred pain to the face.

4. History of Trauma: Since you have a history of head trauma, it is essential to rule out any complications that may have arisen from the injury. An MRI of the head may be warranted if there are concerns about structural changes or if you experience headaches that are unusual for you.

Recommendations
1. Consultation with a Specialist: Before proceeding with an MRI, it is advisable to consult with a healthcare provider, such as a neurologist or orthopedic specialist. They can perform a thorough clinical evaluation and determine the necessity of imaging based on your symptoms and medical history.

2. Consider Both Areas: Depending on the findings from your clinical evaluation, your doctor may recommend an MRI of both the cervical spine and the head. This approach ensures that all potential sources of your symptoms are investigated.

3. Physical Therapy: In addition to imaging, physical therapy may be beneficial in addressing muscle tightness and improving posture. A physical therapist can provide exercises and strategies to alleviate pain and prevent future issues.

4. Lifestyle Modifications: Implementing ergonomic adjustments to your workspace, taking regular breaks, and practicing good posture can significantly reduce strain on your neck and shoulders.

In conclusion, your symptoms warrant further investigation, and an MRI could be a valuable tool in diagnosing the underlying issues. It is essential to work closely with your healthcare provider to determine the most appropriate course of action based on your specific situation.

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