Chronic Neck Stiffness and Swelling: Seeking Solutions for Persistent Pain

Unilateral neck swelling and tightness, with stiffness in the shoulders and upper back for many years?

Hello, doctor.
I have been experiencing stiffness and swelling in my right neck for many years.
When I turn my head to the right, I feel tightness, and my right eyelid and eyebrow feel weak, which often leads me to raise my eyebrows involuntarily, making it look quite unattractive.
Many years ago, I underwent tests including an electrocardiogram and an EEG, both of which were normal, but my symptoms have not changed.
Certain angles of neck movement give me a sensation similar to joint locking, especially at night when I cannot lie flat or sleep on my right side, which causes me to feel like my throat is blocked, leading to coughing and significant distress.
My right shoulder and back are also very tense, and when I stretch my right arm upward, I experience a similar locking sensation in my back, as if I'm pulling the joints apart.
Additionally, I sometimes have pain and tightness in the muscles along my spine, which has been troubling me for years.
The entire right side of my back, shoulder, and neck feels interconnected, and my face is also uncomfortable.
Could you please advise me on which specialty I should consult and what examinations would be appropriate? I really want to resolve this issue.

John, 30~39 year old female. Ask Date: 2020/05/23

Dr. Jiang Junyi reply Neurology

Hello, based on your description, I believe it is essential to first clarify whether there is cervical nerve root compression or cervical myofascial pain.
Prolonged periods of looking down can lead to overuse of the trapezius muscle in 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 strategies for daily management:
1.
Change Positions: Alter your posture every 15 minutes to allow the neck tissues to rest.
Maintaining any position (including a neutral one) for an extended period can lead to tissue fatigue and inflammation, so moving around briefly can reduce the risk of muscle inflammation.
2.
Rest: Rest is crucial for allowing muscles to utilize their self-repair capabilities.
During this time, avoid vigorous activities.
3.
Neck Heat Therapy: Apply a warm compress for 15 to 20 minutes, ensuring the temperature is safe to prevent burns.
4.
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): For individuals without a history of peptic ulcers, allergies to NSAIDs, or normal kidney function, consider using NSAIDs as needed to reduce inflammation and alleviate pain.
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 provoke discomfort.

I suggest consulting with a neurologist or a rehabilitation physician for further evaluation and treatment.
Wishing you good health and peace of mind.

Dr.
Jiang, Taoyuan Medical Center, cares about your well-being.

Reply Date: 2020/05/23

More Info

Chronic neck stiffness and swelling, especially when accompanied by discomfort in the shoulders and face, can be quite debilitating. Based on your description, it sounds like you are experiencing a combination of musculoskeletal issues, possibly related to cervical spine problems, muscle tension, or even nerve involvement. Here’s a comprehensive approach to understanding your symptoms and potential next steps.

Understanding Your Symptoms
1. Neck Stiffness and Pain: Chronic neck stiffness can result from various factors, including poor posture, muscle strain, or degenerative changes in the cervical spine. The sensation of tightness when turning your head, particularly to the right, suggests that there may be muscle tension or joint dysfunction in the cervical region.

2. Facial Weakness: The feeling of weakness in your right eyelid and eyebrow could indicate nerve involvement, possibly related to the cervical spine or even a condition affecting the facial nerve. It’s essential to evaluate this further, as it may not be directly related to the neck stiffness.

3. Joint Sounds: The "clicking" or "catching" sensation when moving your neck could be due to joint dysfunction or the presence of osteophytes (bone spurs) in the cervical spine, which can occur with degenerative changes.

4. Breathing Difficulties: The sensation of your throat feeling blocked when lying down or turning your head is concerning. It could indicate muscle tension affecting your airway or even a more complex issue related to the cervical spine.

5. Shoulder and Back Pain: The tightness in your right shoulder and back, along with the pain when extending your arm, suggests that there may be a broader issue involving the muscles and joints in that area.

Recommended Next Steps
1. Consult a Specialist: Given the complexity of your symptoms, it would be advisable to start with a visit to a neurologist or an orthopedic specialist who focuses on the spine. They can evaluate your neurological function and assess any potential structural issues in your cervical spine.

2. Imaging Studies: Depending on the initial evaluation, your doctor may recommend imaging studies such as an MRI or CT scan of the cervical spine. These tests can help identify any herniated discs, spinal stenosis, or other structural abnormalities that may be contributing to your symptoms.

3. Physical Therapy: Engaging in physical therapy can be beneficial for chronic neck stiffness. A physical therapist can design a program tailored to your needs, focusing on strengthening the neck and shoulder muscles, improving flexibility, and teaching proper posture and ergonomics.

4. Pain Management: If your pain is significant, discussing pain management options with your healthcare provider may be necessary. This could include medications, injections, or alternative therapies such as acupuncture or chiropractic care.

5. Lifestyle Modifications: Consider making lifestyle changes that may alleviate your symptoms. This includes ergonomic adjustments at your workstation, regular breaks to stretch, and exercises that promote neck and shoulder mobility.

6. Follow-Up: Regular follow-up appointments with your healthcare provider will be essential to monitor your progress and make any necessary adjustments to your treatment plan.

Conclusion
Chronic neck stiffness and associated symptoms can significantly impact your quality of life. By seeking the appropriate medical evaluation and treatment, you can work towards alleviating your discomfort and improving your overall well-being. Don’t hesitate to reach out to a healthcare professional who can guide you through this process. Your health is paramount, and addressing these issues early can lead to better outcomes.

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