Upper Abdominal to Neck Pain: A Neurological Perspective - Neurosurgery

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The symptoms you are experiencing, which range from upper abdominal discomfort to neck pain, can indeed be complex and multifactorial. Given the extensive evaluations you've undergone, including various imaging studies and specialist consultations, it seems that the medical community is leaning towards a neurological explanation for your pain, particularly since no clear organic cause has been identified.

Firstly, it's important to understand that pain can often be a manifestation of neurological issues, even when traditional imaging and tests do not reveal any abnormalities. This is particularly true for conditions like neuropathic pain, which arises from damage to or dysfunction of the nervous system. The fact that your pain has migrated from the upper abdomen to the chest and neck suggests that there may be a central nervous system component involved, possibly related to how your brain processes pain signals.

The description of your pain as sometimes being sharp or sudden, along with sensations of numbness or tingling in the neck, could indicate involvement of the cervical nerves or even the brachial plexus. These nerves can become irritated or compressed due to various factors, including muscle tension, posture, or even stress, which can lead to referred pain in different areas of the body. Additionally, the anxiety you mentioned can exacerbate the perception of pain, creating a cycle where stress leads to muscle tension, which in turn increases pain, further heightening anxiety.

Your experience of sudden abdominal contractions or spasms could also be linked to a neurological issue, particularly if there is any involvement of the autonomic nervous system, which controls involuntary bodily functions, including gut motility. Stress and anxiety can significantly impact gastrointestinal function, leading to symptoms such as abdominal pain, bloating, and changes in bowel habits.

Moreover, the findings from your BAEP and SSEP tests suggest potential peripheral nerve dysfunction, which could be contributing to your symptoms. While the neurologist you consulted may have felt that these findings were not within their scope, they could still be relevant in understanding the broader picture of your pain. Peripheral nerve issues can sometimes manifest as pain in seemingly unrelated areas, including the abdomen and neck.

In terms of management, it may be beneficial to explore a multidisciplinary approach. This could include physical therapy to address any musculoskeletal components, cognitive-behavioral therapy to help manage anxiety and pain perception, and possibly medications that target neuropathic pain, such as gabapentin or pregabalin. These medications can help modulate the way your nervous system processes pain signals.

Lastly, it’s crucial to maintain open communication with your healthcare providers. If you feel that your concerns are not being adequately addressed, seeking a second opinion or consulting a pain specialist might provide additional insights and treatment options. Chronic pain is a complex condition that often requires a tailored approach, and it’s important to advocate for your health and well-being throughout this process.