Muscle Issues: Managing Stiff Neck and Pain in the Upper Back

Stiff neck due to muscle issues?

Hello Doctor, I have cervical spine hyperlordosis.
On May 7th, I experienced a stiff neck on the right side.
After visiting an orthopedic doctor, I was told that aside from the hyperlordosis, there were no other issues, and it was a muscle problem.
However, after a week, on May 18th, after running, I suddenly felt like I had a stiff neck again.
The pain is located in the right rhomboid and upper trapezius areas.
A week later, on May 27th, I suddenly experienced cramping-like pain in the right upper trapezius and levator scapulae region.
(I have been taking muscle relaxants, which have alleviated the pain.) Until now, there has been no recurrence, but I still feel a tight sensation in the muscles at the back of my head on the right side and in the right cervical muscles, which is noticeably different from the left side.
When doing trapezius relaxation exercises, I feel a significant pulling pain on the right side.
Occasionally, the sternocleidomastoid muscle also hurts, about one centimeter below the clavicle.
However, I generally feel fine during daily activities.
I would like to ask how I should manage this, as it is somewhat bothersome.
I also experience a brief tight sensation upon waking, which makes me worry about potential serious issues like rheumatoid arthritis or ankylosing spondylitis.
I have visited pain management, rehabilitation, and orthopedic departments, all of which indicated it is a muscle issue.
The pain management doctor asked if I wanted to undergo rheumatoid testing, but I haven't done it yet.
The only tests I have completed are X-rays from the orthopedic and pain management departments; I have not undergone MRI or ultrasound.

Lin Xiansheng, 20~29 year old female. Ask Date: 2023/06/11

Dr. Wang Shouji reply Orthopedics

Hello, regarding muscle issues and loss of curvature in the cervical spine, it is important to pay attention to your head posture, especially if you often look down, such as when using a mobile phone for extended periods or using a pillow that is too high while sleeping.
Applying heat and performing stretching exercises can be beneficial.
Changhua Hospital cares about your health.
Wang Shou-ji.

Reply Date: 2023/06/11

More Info

Based on your description, it appears that you are experiencing a combination of muscle tension and discomfort in the upper back and neck area, particularly affecting the right side. Your symptoms, including stiffness, pain in the rhomboid and upper trapezius muscles, and occasional cramping, suggest that you may be dealing with muscle strain or tension rather than a more serious underlying condition.

Understanding Your Symptoms
1. Muscle Strain and Tension: The muscles in the neck and upper back can become strained due to various factors, including poor posture, repetitive movements, or sudden awkward positions (like "wry neck" or "falling asleep wrong"). The trapezius and rhomboid muscles are particularly susceptible to tension, especially if you have a history of cervical spine issues like cervical lordosis (excessive curvature).

2. Trigger Points: The "tight" feeling you describe, especially in the right upper trapezius and the area around the occipital bone, may indicate the presence of trigger points. These are hyperirritable spots in the muscle that can refer pain to other areas, causing discomfort and stiffness.

3. Cervical Spine Considerations: While your orthopedic evaluations have indicated that there are no significant issues with your cervical spine, the presence of muscle tension can still lead to discomfort. The muscles around the cervical spine can become overactive to compensate for any perceived instability or discomfort, leading to a cycle of pain and tension.

4. Potential for Other Conditions: While your current assessments have ruled out significant issues, it’s understandable to be concerned about conditions like rheumatoid arthritis or ankylosing spondylitis, especially given your symptoms. However, these conditions typically present with additional systemic symptoms, such as prolonged stiffness, swelling, or fatigue, which you have not mentioned.

Recommendations for Management
1. Physical Therapy: Engaging in physical therapy can be highly beneficial. A physical therapist can provide targeted exercises to strengthen the muscles of the neck and upper back, improve posture, and teach you techniques for managing muscle tension.

2. Stretching and Strengthening Exercises: Incorporate gentle stretching exercises for the neck and upper back. Focus on the trapezius, rhomboids, and levator scapulae muscles. Strengthening exercises for the shoulder girdle can also help stabilize the area and reduce strain.

3. Posture Correction: Pay attention to your posture, especially if you spend long hours sitting or working at a desk. Ergonomic adjustments to your workspace can help reduce strain on your neck and upper back.

4. Heat and Cold Therapy: Applying heat to the affected areas can help relax tense muscles, while cold therapy can reduce inflammation if there is any swelling. Alternating between the two can also be effective.

5. Medication: Continue using muscle relaxants as prescribed, but also consider over-the-counter anti-inflammatory medications (like ibuprofen) if appropriate for your situation, to help manage pain and inflammation.

6. Mindfulness and Stress Management: Stress can contribute to muscle tension. Techniques such as mindfulness, yoga, or meditation can help reduce overall stress levels and may alleviate some of the muscle tightness.

7. Follow-Up with Healthcare Providers: Since you have already consulted with various specialists, it may be beneficial to follow up with a rheumatologist if your symptoms persist or worsen, especially if you develop new symptoms. They can perform specific tests to rule out any autoimmune conditions.

Conclusion
While your symptoms are concerning, they appear to be primarily related to muscle tension rather than a serious underlying condition. With appropriate management, including physical therapy and lifestyle modifications, you should be able to alleviate your symptoms and improve your quality of life. If you notice any new symptoms or if your condition does not improve, do not hesitate to seek further medical evaluation.

Similar Q&A

Understanding Upper Back Pain and Neck Stiffness: Causes and Treatments

Hello Dr. Lin, my current symptoms include soreness in the upper back and stiffness and pain in the shoulders and neck that extend to the upper arms. These symptoms only occur when I am standing; they do not appear when I am lying down. I am currently undergoing acupuncture and m...

Dr. Lin Ruixiang reply Rehabilitation
Hello Alen: Based on your description, it appears to be a posture-related issue. According to the theory of fascial lines, this falls under the deep back arm line. In principle, treatment and diagnosis should start with the fascia to keep it as simple as possible. If further exam...

Effective Ways to Alleviate Neck Stiffness and Tension

Dear Doctor: My neck muscles on both sides often feel tight and stiff. How can I improve this? Thank you!

Dr. Chen Xianchang reply Rehabilitation
Hello, Miss: Thank you for your inquiry. Here are my responses and recommendations: 1. Generally speaking, it is important to determine whether the issue is related to muscle (poor posture, overuse) or nerves (cervical nerve compression), and an examination is necessary. 2. It is...

Understanding Neck Stiffness and Muscle Tension: Causes and Solutions

Hello doctor, for the past six months, I have been experiencing stiffness in my neck muscles when turning my head, often unable to turn it fully, especially when using my phone or computer. I find that it alleviates a lot when I engage in exercise or physical activity. Additional...

Dr. Peng Shiwei reply Neurology
Hello, based on your symptoms, it is likely that chronic tension in the upper neck is caused by prolonged poor posture. I recommend starting with improving your posture and incorporating relaxation exercises for your neck. If these methods provide limited improvement, it would be...

Understanding Upper Back Pain: Causes and Treatment Options

Hello, I would like to ask a question for a friend who has just started military training. During the recent drills, he often holds a salute for a long time without moving, and then immediately raises his hand again. When I visited him recently, he mentioned that he has pain in t...

Dr. Li Huixiong reply Internal Medicine
Based on the symptoms you described, your friend may be suffering from muscle fatigue caused by long-term improper muscle use. In our daily lives, we often unknowingly overuse certain muscles, such as carrying a camera or backpack on the right shoulder. Over time, this can lead t...