Neck Pain: Seeking Answers for Persistent Symptoms

Doctor, please help me?

Hello, Director Pan.
In mid-August, I went for folk therapy and ended up getting injured, resulting in swelling of my jaw and a feeling of dizziness, along with difficulty focusing on near objects.
Initially, I didn't think much of it, so I just visited a clinic.
The doctor there diagnosed it as a muscle strain, so I took medication and rested at home.
However, a week later, the issue with my eyes not being able to focus persisted.
One morning, I woke up with such severe neck pain that I couldn't move my neck off the pillow; it took about ten minutes for me to get up.
I then went to a large hospital for an X-ray.
The doctor mentioned that my cervical spine was overly straight but didn't say much else, prescribing anti-inflammatory medication.
I took the anti-inflammatory medication for two and a half months, but due to the start of school, I switched to another hospital.
Eventually, I had an allergic reaction to the medication, but since I had taken different medications, the doctor couldn't determine which one caused the allergy, so I stopped taking medication.
I had another X-ray done, and I asked the doctor if it could be a herniated disc.
He said it was possible, and I had a carotid artery examination, which showed no abnormalities (at Veterans General Hospital), and a muscle ultrasound, where the doctor said the minor symptoms were not visible (at Zhubei Hospital).

Recently, my neck continues to hurt, and I feel weakness in my hands and legs.
I repeatedly requested the doctor to perform an electromyography (EMG), and only after several requests did he agree, stating that since I didn't have numbness, it was unlikely that a nerve was compressed.
I also wanted to request an MRI, but I know that the health department has strict regulations, making it difficult to get an MRI without justification.
However, I am in pain every day and unable to attend classes, which is truly distressing.

Currently, my symptoms are:
1.
Weakness in my hands and legs, with one instance of numbness on the right side lasting about three hours.
2.
Daily neck pain; when I look down to read for about 1-2 hours, the right side of my neck experiences heat and sharp pain (the doctor said it was a muscle strain, but I don't have pain points when pressing on my muscles, and since the injury, I have rarely used the computer for more than an hour a day).
3.
Limited neck mobility; holding my head up for too long makes it worse.
4.
Occasional dizziness (not the kind from darkness or spinning).
I really don't know what to do now.
I'm afraid that there may be pressure on my spinal cord that could lead to gradual disability.
I'm also hesitant to swim for rehabilitation for fear of worsening my condition.
Doctor, what could these symptoms indicate? Should I insist on an MRI with my doctor? If he refuses, what should I do? Can I swim for rehabilitation on my own, or is traction more effective? The neck pain has persisted since August 20, and the issues are numerous and troublesome.
I apologize for bothering you, and I hope you can take some time to respond.

Lin, 20~29 year old female. Ask Date: 2006/12/08

Dr. Pan Yingda reply Rehabilitation

Basically, if what you described is accurate, I think it’s quite serious.
When I say "if," I mean that some symptoms are very subjective.
For example, I had a case where a patient complained of chest pain, and after seeing multiple doctors without relief, she ended up in the emergency room at midnight, in excruciating pain.
That’s quite serious, right? I thought there was no good solution since all the tests came back normal, so I suggested acupuncture (she had undergone it before).
To my surprise, she screamed loudly, begging me to stop, and I was taken aback.
She said the discomfort from acupuncture was dozens of times worse than her chest pain.

Returning to the main point, when we assess a patient's condition, we need some objective evidence.
Without finding any evidence, subjective descriptions make it difficult to reach a diagnosis.
Many patients come in claiming that they had been harmed by folk remedies or other doctors, believing that their current symptoms are a result of that "medical intervention," while overlooking the fact that they sought medical help for a reason (there must have been an existing problem, right?).
The current symptoms may simply be a continuation of the original issue or possibly a result of inappropriate medical practices.
I would ask the following questions:
1.
Why did you seek folk medicine? During the treatment, was there any sudden pain or dizziness with any specific action?
2.
Are you still having trouble focusing your eyes?
3.
When you turn your head quickly, do you feel dizzy? If so, how long does the dizziness last? Do you experience nystagmus (this may need to be evaluated by a professional)? When you turn your head to the extreme left and right, do you feel dizzy if you pause?
4.
Is there any muscle atrophy in your upper limbs? Is there any difference in skin sensation on your face and upper limbs (you can use a toothpick to test)?
5.
Are there any abnormalities in your bowel movements or sexual function?
6.
Which direction does turning your head and neck cause pain?
My recommendations are:
1.
If there are any abnormalities in the questions above, an MRI should be performed.
It’s not strictly regulated by the Department of Health, but by the National Health Insurance Bureau, so doctors do have their difficulties.
If financially feasible, consider paying out of pocket for it.
2.
Swimming depends on your skill level; if you can swim over 1000 meters, that should be fine.
Some people cannot relax in the water, which may not be beneficial.
3.
Rehabilitation is fine! If you feel uncomfortable, communicate with your doctor and therapist.
Make sure to find a qualified rehabilitation physician and physical therapist, as the quality can vary greatly outside.
If something feels wrong, seek a different provider.
4.
Pay attention to your posture; avoid maintaining the same position for too long, especially looking down or up.
Keep your head up and spine straight, similar to a ballroom dancing posture.
5.
Practice isometric contractions of the neck muscles.
6.
If you can find someone who does craniosacral therapy, that should help you.
Don’t ignore this issue; you should see a doctor again.

Reply Date: 2006/12/08

More Info

Dear Patient,
I understand that you are experiencing significant discomfort and distress due to persistent neck pain and associated symptoms following an injury in August. Your situation is understandably concerning, especially given the range of symptoms you are experiencing, including neck pain, difficulty focusing your eyes, and sensations of weakness in your limbs. Let's break down your symptoms and discuss potential next steps.

Firstly, it is important to recognize that neck pain can arise from various causes, including muscle strain, cervical spine issues, or even nerve compression. Given your history of an injury and subsequent symptoms, it is possible that you are dealing with a combination of muscle strain and potential cervical spine issues, such as a herniated disc or cervical radiculopathy.

1. Muscle Strain vs. Cervical Spine Issues: The initial diagnosis of muscle strain is common after an injury, especially if there was a sudden movement or trauma. However, if your symptoms persist despite conservative treatment, further investigation is warranted. The fact that you have experienced weakness and numbness, even if transient, raises the possibility of nerve involvement. This could be due to a herniated disc or other cervical spine pathology.

2. Diagnostic Imaging: You mentioned that your doctor has been hesitant to order an MRI. While X-rays can provide some information about the alignment of the cervical spine, they do not show soft tissue structures like discs and nerves. An MRI is a more comprehensive imaging modality that can help identify issues such as disc herniation, spinal stenosis, or other abnormalities that may be compressing nerves. If you feel that your symptoms warrant further investigation, it is reasonable to advocate for an MRI. You can express your concerns about the persistence of your symptoms and the impact they have on your daily life and academic performance. If your current physician remains unresponsive, seeking a second opinion from another neurologist or orthopedic specialist may be beneficial.

3. Physical Therapy and Rehabilitation: While you are apprehensive about swimming or physical therapy, gentle rehabilitation exercises can be beneficial for neck pain. A physical therapist can guide you through exercises that strengthen the neck muscles and improve flexibility without exacerbating your pain. It is crucial to avoid activities that cause increased pain or discomfort, but a tailored rehabilitation program can help you regain function and reduce pain over time.

4. Managing Pain and Symptoms: In addition to physical therapy, consider discussing other pain management options with your healthcare provider. This may include non-steroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, or even alternative therapies such as acupuncture or chiropractic care, depending on your comfort level and preferences.

5. Monitoring Symptoms: Keep a detailed log of your symptoms, including when they occur, their intensity, and any activities that exacerbate or alleviate them. This information can be invaluable for your healthcare provider in determining the best course of action.

In conclusion, while muscle strain is a common diagnosis, the persistence of your symptoms suggests that further evaluation is necessary. Advocating for an MRI and exploring physical therapy options are reasonable next steps. Remember, your health and well-being are paramount, and seeking the appropriate care is essential for recovery. Please do not hesitate to reach out to your healthcare provider with your concerns, and consider seeking a second opinion if necessary.

Wishing you a speedy recovery and relief from your symptoms.

Best regards.

Similar Q&A

Understanding Chronic Neck Pain: Seeking Solutions for Persistent Discomfort

I would like to ask the doctor for some guidance. For the past year or two, I have been experiencing a sensation of heaviness and dizziness in the back of my head and neck. I used to spend a lot of time on the computer, and I wondered if I had a neck issue. I consulted a doctor w...

Dr. Gao Chunde reply Neurology
If the neurological examination shows no significant issues, you may consider a rehabilitation assessment to evaluate your shoulder and neck muscle condition and receive recommendations for some lifestyle maintenance strategies. Additionally, it is important to consider stress ma...

Understanding Chronic Headaches and Neck Stiffness: Seeking Help

I have been experiencing persistent headaches for 2 to 3 months, with a constant feeling of tightness in my head that often escalates to pain. Recently, I have also developed dry eye syndrome. I underwent an MRI of my head, which showed normal results. Due to my headache issues, ...

Dr. Wang Xiumei reply Psychiatry
It is recommended to consult a neurologist for a specialized evaluation of headaches.

Understanding Neck Pain: Causes, Symptoms, and Treatment Options

Hello, Doctor! I have been experiencing pain and numbness in my cervical spine for six months. Initially, I had trouble sleeping and tried several different pillows. Later, I experienced alternating pain in various areas of my neck, usually characterized by tenderness and sharp p...

Dr. Li Yongheng reply Orthopedics
Hello, based on the X-ray alone, there are no obvious abnormalities in your cervical spine.

Understanding Neck Pain: Causes, Symptoms, and Treatment Options

Hello Doctor: I have been experiencing neck pain for the past six months, along with lower back pain, and sometimes upper back pain. There is a feeling of tightness and stiffness in my neck when I turn it, which is painful. I have received treatment in the neurology department at...

Dr. Ye Boshou reply Neurology
1. Neck stiffness is not a precursor to a stroke. 2. Possible. 3. No. 4. If there are still issues, you may visit the rehabilitation department for physical therapy.