Neck and Occipital Pain: When to Seek Medical Attention

Pain in the neck at the base of the skull?

Hello doctor, I have been experiencing pain in the area where my neck meets the back of my head for almost a week now.
The frequency of the pain varies: it hurts every night for one day, occasionally for two days, persists in the evening for two days, intermittently throughout the day for three days, at night for four days, and I wake up with continuous pain on the fifth day.
My head feels heavy, and I also have a stiff sensation in my shoulders and neck.
Occasionally, I see shadows with my eyes.
Due to the current severe pandemic situation, I'm unsure if I should go to the hospital for a consultation, so I'm asking online to alleviate my anxiety.
Thank you, doctor.

AZ, 30~39 year old female. Ask Date: 2021/05/28

Dr. Jiang Junyi reply Neurology

Hello,
Based on your description, the most common cause of your right neck pain is likely 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.
Initially, resting may alleviate the pain, but over time it can worsen and affect your daily activities.
Some patients report waking up in the morning with severe neck pain, stiffness, tightness, and intolerable levels of pain.

I recommend the following:
1.
Change Positions: Change your position every 15 minutes to allow the neck tissues to rest.
Maintaining any position (including a normal 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 essential for allowing 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 avoid burns.
4.
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): If you do not have a history of gastric ulcers, allergies to NSAIDs, or impaired kidney function, you may 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 and gentle neck stretches every 15 to 20 minutes, ensuring the angles do not cause discomfort.
Thank you for your inquiry, and feel free to discuss any related questions! Wishing you good health and happiness.
Dr.
Jiang Junyi, Taoyuan Medical Center

Reply Date: 2021/05/28

More Info

Neck and occipital pain can be concerning, especially when it persists for an extended period, as you have described. Your symptoms, including the heaviness in your head, neck stiffness, and occasional visual disturbances, warrant careful consideration. While it is understandable to be apprehensive about seeking medical attention during a pandemic, it is crucial to prioritize your health and well-being.

Firstly, let's break down your symptoms. The pain you are experiencing at the junction of your neck and occipital area (the back of your head) could be attributed to several factors. Common causes include muscle tension, cervical spine issues, or even nerve irritation. Given that you mentioned the pain has been ongoing for nearly a week, it is essential to consider whether there are any accompanying symptoms, such as fever, numbness, weakness, or changes in vision, which could indicate a more serious underlying condition.

Muscle tension is a frequent culprit for neck and occipital pain. This can arise from poor posture, stress, or prolonged periods of inactivity. If you have been working from home or spending more time on screens, this could contribute to muscle strain. In such cases, simple interventions like stretching, applying heat, and ensuring ergonomic workspaces can provide relief.

However, if the pain is severe, persistent, or accompanied by neurological symptoms such as visual disturbances (like seeing shadows), it is crucial to seek medical attention. Visual disturbances can sometimes indicate issues related to the optic nerve or other neurological conditions. Additionally, if you experience any weakness or numbness in your arms or legs, this could suggest nerve involvement or a more serious condition that requires immediate evaluation.

In the context of the ongoing pandemic, many healthcare facilities have adapted to provide care safely. Telemedicine options are available, allowing you to consult with a healthcare provider without needing to visit a clinic in person. This can be an excellent first step to discuss your symptoms and determine whether an in-person evaluation is necessary.

If you decide to visit a healthcare provider, they may perform a physical examination, assess your range of motion, and evaluate for any neurological deficits. Imaging studies, such as X-rays or MRI, may be ordered to rule out structural issues in the cervical spine or other potential causes of your symptoms.

In summary, while muscle tension and posture-related issues are common causes of neck and occipital pain, the persistence and nature of your symptoms suggest that a medical evaluation is warranted. Don't hesitate to reach out to a healthcare provider, whether through telemedicine or an in-person visit, to discuss your symptoms and receive appropriate care. Your health is paramount, and addressing these concerns early can help prevent further complications and improve your quality of life.

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