Dizziness and Neck Pain: When to Seek Medical Help

Dizziness and issues with the neck and shoulders?

I'm not very good at describing it, but right now I feel a bit dizzy, though not extremely so.
It feels somewhat like having a heavy head and light feet, with a sensation that my head might drop off, almost like being startled awake from a nap at school.
It feels as if someone is inflating my brain.
My neck and shoulders also feel a bit uncomfortable, and sometimes I find myself rubbing them.
Whenever I massage those areas, the discomfort goes away temporarily, but it returns afterward.
I work in a long-term office setting.
My father has high blood pressure, and my blood pressure has been above 140 during annual company check-ups, reaching 150 this year.
Whenever I go to the hospital to check my blood pressure, it's always high.
However, I'm unsure which specialist to see—whether for hypertension, cervical spondylosis, or stress.
Could you please advise me on what tests I should undergo and which specialist I should consult first regarding my autonomic nervous system issues?

Mr. Pan, 30~39 year old female. Ask Date: 2015/11/25

Dr. Lan Shengxing reply Neurology

Dear Mr.
Pan, many of the symptoms you mentioned are common among neurology patients.
I recommend that you directly schedule an appointment with a neurologist, as the conditions you mentioned cannot rule out the possibility of multiple sclerosis.

Reply Date: 2015/11/25

More Info

Based on your description of experiencing dizziness, a floating sensation in your head, and discomfort in your neck and shoulders, it is essential to approach this situation methodically. Your symptoms could be indicative of several underlying issues, including cervical spine problems, hypertension, or even anxiety-related disorders. Given your family history of high blood pressure and your own elevated readings, it is prudent to consider these factors seriously.

Understanding Your Symptoms
1. Dizziness and Floating Sensation: The sensation of dizziness or feeling "light-headed" can be attributed to various causes. It may stem from issues related to the inner ear, which is responsible for balance, or it could be related to cervical spine problems that affect blood flow to the brain. Additionally, anxiety can manifest physically, leading to sensations of dizziness or light-headedness.

2. Neck and Shoulder Discomfort: The discomfort in your neck and shoulders, which temporarily alleviates with massage, suggests that muscle tension or strain could be contributing to your symptoms. Prolonged periods of sitting, especially in a poor posture, can lead to muscle tightness and discomfort in these areas.

3. High Blood Pressure: Your consistently high blood pressure readings (140 and above) are concerning. Hypertension can lead to various complications, including headaches, dizziness, and increased risk of cardiovascular events. It is crucial to manage this condition effectively.

Recommended Steps
1. Consult a Primary Care Physician (PCP): Your first step should be to see a primary care physician. They can conduct a thorough evaluation of your symptoms, including a physical examination and a review of your medical history. They may also check your blood pressure and assess whether it is contributing to your dizziness.

2. Blood Pressure Management: If your PCP confirms that you have hypertension, they may recommend lifestyle changes, such as dietary modifications (reducing salt intake), regular exercise, and possibly medication to help control your blood pressure.

3. Neurological Evaluation: Given your symptoms of dizziness, it may be beneficial to consult a neurologist. They can perform tests to rule out any neurological conditions that might be causing your symptoms. This could include imaging studies like an MRI or CT scan if deemed necessary.

4. Physical Therapy: If your neck and shoulder discomfort is significant, a referral to a physical therapist may be warranted. They can provide exercises and techniques to improve your posture, strengthen neck and shoulder muscles, and alleviate tension.

5. Stress and Anxiety Management: Since you mentioned the possibility of stress, consider consulting a mental health professional. They can help you develop coping strategies for managing stress and anxiety, which may be contributing to your physical symptoms.

6. Lifestyle Modifications: Incorporate regular physical activity into your routine, as this can help manage both blood pressure and muscle tension. Additionally, ensure that your workspace is ergonomically designed to reduce strain on your neck and shoulders.

Conclusion
In summary, your symptoms warrant a comprehensive evaluation starting with a primary care physician. They can guide you through the necessary steps, including managing your blood pressure, assessing for any neurological issues, and addressing muscle tension. By taking a proactive approach, you can work towards alleviating your symptoms and improving your overall health. Remember, early intervention is key to preventing potential complications associated with high blood pressure and other underlying conditions.

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