Unexplained Neck Pain: When to Seek ENT or Orthopedic Help - Otolaryngology

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Understanding unexplained neck pain can be quite challenging, especially when the symptoms are not clearly defined. Based on your description, it seems that you are experiencing discomfort in the anterior neck region, particularly near the thyroid and carotid artery, which is exacerbated by certain movements, such as opening your mouth and pushing your chin towards your chest. This type of pain can be indicative of several underlying issues, and it is essential to approach this systematically.

Firstly, the fact that you do not experience pain while swallowing and there are no visible lumps is a positive sign, as it may suggest that there is no significant pathology involving the thyroid gland or other structures in the neck. However, the pain you describe, especially when it feels like a bruise and occurs with specific movements, could be related to muscular or skeletal issues.

Given that you have already consulted an ENT specialist who prescribed muscle relaxants without significant improvement, it may be beneficial to consider other potential causes. The pain could be related to muscle strain, particularly if you have a history of poor posture or repetitive strain from activities such as prolonged computer use. Muscles in the neck can become tense and painful due to overuse or improper ergonomics, leading to discomfort that may feel like a bruise.

Additionally, the involvement of the cervical spine cannot be overlooked. Conditions such as cervical spondylosis, herniated discs, or other degenerative changes can lead to referred pain in the neck and may also affect nearby structures, including muscles and nerves. If the pain is related to the cervical spine, it may be worthwhile to pursue imaging studies, such as an MRI of the cervical spine, to rule out any structural abnormalities.

Since you have been referred back and forth between ENT and orthopedic specialists, it may be helpful to seek a multidisciplinary approach. A consultation with a physical medicine and rehabilitation specialist or a neurologist could provide further insights. They can assess for any neurological involvement and recommend appropriate physical therapy, which may include exercises to strengthen and stretch the neck muscles, improve posture, and alleviate pain.

In summary, your symptoms could stem from muscular strain, cervical spine issues, or possibly a combination of both. It is advisable to pursue further evaluation, potentially including imaging studies, and consider a referral to a specialist who can provide a comprehensive assessment of both muscular and skeletal components. Physical therapy may also play a crucial role in your recovery, helping to address any underlying muscular imbalances and improve your overall neck function. Remember, persistent pain that affects your daily life warrants thorough investigation and a tailored treatment plan.