Neck Pain and Numbness: When to See a Specialist - Neurology

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It sounds like you are experiencing a complex set of symptoms that could be related to various underlying issues, particularly involving your neck and shoulder region. Given your history of extensive computer use during your school years, it is possible that you have developed some form of cervical spine pathology or muscular strain that is contributing to your current discomfort.

The symptoms you describe—numbness in the skin on the right shoulder, swelling in the neck, stiffness in the shoulder and neck, weakness in the right side of your face, and difficulty turning your head—are concerning and warrant a thorough evaluation. The presence of a "clicking" sound when moving your neck, along with respiratory difficulties and coughing, further complicates the situation and suggests that you may be dealing with a more serious condition.


When to See a Specialist
1. Neurologist: Given the numbness and weakness in your right shoulder and face, it would be prudent to consult a neurologist. They can assess for any potential nerve compression or neurological issues that may be causing these symptoms. Conditions such as cervical radiculopathy, which occurs when a nerve in the neck is compressed or irritated, could lead to the symptoms you are experiencing.

2. Orthopedic Specialist: An orthopedic doctor specializing in spine issues can evaluate your cervical spine for any structural problems, such as herniated discs, degenerative disc disease, or other spinal abnormalities that could be contributing to your pain and neurological symptoms.

3. Physical Medicine and Rehabilitation (PM&R): A physiatrist can help manage your symptoms through non-surgical means, including physical therapy, which may be beneficial for improving your neck mobility and reducing pain. They can also provide guidance on exercises to strengthen the muscles around your neck and shoulders.

4. Ear, Nose, and Throat (ENT) Specialist: Since you mentioned experiencing difficulty breathing and coughing, it may also be wise to consult an ENT specialist. They can rule out any issues related to your airway or other anatomical structures that might be contributing to your symptoms.


Recommended Diagnostic Tests
Before seeing a specialist, it may be beneficial to have some imaging studies done, such as:
- MRI of the Cervical Spine: This can help visualize any disc herniations, spinal stenosis, or other abnormalities that could be pressing on nerves.

- CT Scan: If MRI is not available, a CT scan can provide detailed images of the cervical spine.

- Electromyography (EMG) and Nerve Conduction Studies: These tests can assess the electrical activity of your muscles and the speed of nerve conduction, helping to identify any nerve damage.


Management Strategies
While waiting for your appointment, consider the following strategies to manage your symptoms:
- Posture Correction: Ensure that your workstation is ergonomically set up to reduce strain on your neck and shoulders. Use a chair that supports your back and keep your computer screen at eye level.

- Gentle Stretching and Strengthening Exercises: Engage in gentle neck and shoulder stretches to improve flexibility. Strengthening exercises for the upper back and neck can also help support your spine.

- Heat and Cold Therapy: Applying heat can help relax tight muscles, while cold therapy can reduce inflammation.

- Over-the-Counter Pain Relief: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help alleviate pain and reduce inflammation.


Conclusion
In summary, your symptoms suggest that you should see a neurologist or an orthopedic specialist as soon as possible. They will be able to conduct a thorough evaluation and recommend appropriate diagnostic tests to determine the underlying cause of your symptoms. Early intervention is key to preventing further complications and improving your quality of life. Please do not hesitate to seek medical attention, as your symptoms warrant a comprehensive assessment.