Dizziness and Trapezius Pain: When to See a Neurologist?

Q: Dizziness and Trapezius Pain: When to See a Neurologist?

Hello： Based on your description, it may be necessary to consider cervical spine disorders, specifically cervical spondylosis, which can cause neck pain and stiffness. <br>This condition may compress nearby nerve roots, leading to pain that can extend to the shoulders, arms, and

Dizziness and trapezius muscle pain?

Hello, Dr.
Jiang.
Recently, I've been experiencing neck pain and discomfort in my trapezius muscles, and I've also had some pain in my forehead and head.
Whenever I sit and use the computer (due to work), the discomfort worsens.
Sometimes I feel dizzy, and while lying in bed, I occasionally feel my body shaking (a few days ago it was side to side, and in the last couple of days it has been up and down).
When I look at my finger moving with my right eye, I feel a bit dizzy, but my left eye seems to be fine.
I wake up naturally very early every day (not getting more than five hours of sleep).
I've taken muscle relaxants, but they haven't had a noticeable effect.
I would like to ask Dr.
Jiang if this is simply a muscle strain or if I should see a neurologist? What could be the possible causes?

RR, 30~39 year old female. Ask Date: 2021/05/08

Dr. Jiang Junyi reply Neurology

Hello: Based on your description, it may be necessary to consider cervical spine disorders, specifically cervical spondylosis, which can cause neck pain and stiffness.
This condition may compress nearby nerve roots, leading to pain that can extend to the shoulders, arms, and hands, causing discomfort.
The fascia around the cervical spine contains small muscles that connect to the head, while the larger superficial muscles of the neck and shoulders are engaged during significant movements.
It is possible to experience occipital headaches that are more pronounced than neck and shoulder pain.

Treatment can be divided into pharmacological and physical therapy approaches:
1.
Pharmacological treatment: When nerves are compressed, an inflammatory response occurs, resulting in symptoms such as pain, numbness, and weakness.
Non-steroidal anti-inflammatory drugs (NSAIDs) can be used for treatment, as they have both anti-inflammatory and analgesic properties, which can reduce inflammation and alleviate pain.
2.
Physical therapy:
- Heat therapy: Primarily increases local blood circulation and improves muscle ischemia.
- Shortwave and ultrasound therapy: Mainly promotes blood circulation in deeper tissues.
- Transcutaneous electrical nerve stimulation (TENS) and medium-frequency vector interference current: These can provide localized pain relief and alleviate tension and discomfort in the neck and shoulders.
I recommend consulting with a neurologist or a rehabilitation physician to discuss examination and treatment options.
Wishing you good health and peace of mind.

Dr.
Jiang Junyi, Neurology, Taoyuan Medical Center
Please remember to implement self-protection measures and maintain cleanliness and disinfection before and after seeking medical care, especially given the recent tight COVID-19 situation.

Reply Date: 2021/05/08

More Info

Dizziness and trapezius pain can be concerning symptoms, especially when they interfere with daily activities and work. Based on your description, it seems that you are experiencing a combination of neck pain, trapezius discomfort, headaches, and dizziness, particularly when using a computer for extended periods. These symptoms can arise from various causes, and it’s essential to consider both musculoskeletal and neurological factors.

Firstly, the trapezius muscle is a large muscle that extends from the back of the neck down to the middle of the back and across to the shoulders. It plays a crucial role in neck and shoulder movement. Prolonged periods of sitting, especially with poor posture while using a computer, can lead to muscle strain and tension in the trapezius, resulting in pain and discomfort. This muscle tension can also contribute to headaches and dizziness, as tight muscles can affect blood flow and nerve function in the area.

The dizziness you are experiencing, particularly the sensation of your body shaking while lying down, could be related to several factors. It may be a result of muscle tension affecting the cervical spine, which can irritate the nerves and lead to dizziness. Alternatively, it could be a sign of vestibular dysfunction or other neurological issues. The fact that you notice a difference in how your eyes respond to movement (with one eye experiencing more dizziness than the other) could indicate a neurological component that warrants further investigation.

Given that you have tried muscle relaxants without significant improvement, it may be time to consult a neurologist. A neurologist can perform a thorough evaluation, including a physical examination and possibly imaging studies, to rule out any underlying neurological conditions. Conditions such as cervical radiculopathy, which occurs when a nerve in the neck is compressed or irritated, could explain your symptoms. Additionally, other neurological disorders, such as migraines or vestibular disorders, could also be contributing to your dizziness and discomfort.

In summary, while your symptoms may initially suggest a simple case of muscle strain or tension, the combination of dizziness, trapezius pain, and the specific nature of your symptoms indicates that a more comprehensive evaluation is warranted. It is advisable to see a neurologist who can assess your condition in detail and determine whether further tests or treatments are necessary. Early intervention can help prevent the progression of symptoms and improve your quality of life.
In the meantime, consider implementing ergonomic adjustments to your workspace, such as ensuring your computer screen is at eye level, taking regular breaks to stretch and move, and practicing good posture. These changes may help alleviate some of the muscle tension and discomfort you are experiencing. However, do not hesitate to seek professional medical advice to address your concerns thoroughly.

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