Chronic Neck and Shoulder Pain: Seeking the Right Specialist for Relief

Shoulder, back, neck, and facial issues?

Hello, doctor: In my younger days, I often stayed up late using the computer with poor posture, which caused a stabbing pain in the right side of my neck and shoulder.
I didn't pay much attention to it at the time.
Over time, the area where I felt the pain has lost sensation, and my right shoulder and neck have become completely stiff.
Now, my right neck has started to swell, and my entire right face feels uncomfortable, especially around the eyes, which feel weak (eyebrows).
I often experience double vision, and things seem off; I have difficulty concentrating and feel tension and numbness in my entire right face, extending to my right shoulder and back.
I cannot lie down comfortably to sleep, nor can I turn my head to the right while sleeping, as it makes it hard to breathe and causes an itchy throat and cough.
Each time I see a doctor and undergo X-rays, the nerve conduction tests come back normal.
The muscle relaxants prescribed have not helped.
I am very troubled by this, as it often makes it difficult for me to face crowds.
I have seen both orthopedic and neurology specialists, but my issues remain unresolved.
Which specialty should I consult next?

Fen Dou, 20~29 year old female. Ask Date: 2016/01/04

Dr. Shi Guozheng reply Orthopedics

Shoulder and neck pain is often caused by maintaining the same posture for too long.
In addition to reducing work, it is important to take appropriate breaks and not to sustain the same movement for extended periods.
Medications and rehabilitation may be necessary, and it is advisable to consult a rehabilitation specialist.

Reply Date: 2016/01/04

More Info

Chronic neck and shoulder pain can be a debilitating condition that significantly impacts daily life and overall well-being. Given your history of poor posture, prolonged computer use, and the development of symptoms such as numbness, stiffness, and discomfort in the right side of your neck and face, it is crucial to approach this issue comprehensively.

Firstly, it is essential to recognize that your symptoms may be indicative of several underlying conditions, including cervical radiculopathy, myofascial pain syndrome, or even tension-type headaches. The fact that you have experienced numbness and weakness in the right side of your face, along with difficulty concentrating and visual disturbances, raises concerns that warrant further investigation.

Since you have already consulted with orthopedic and neurology specialists without satisfactory results, it may be beneficial to consider a few additional avenues:
1. Physical Medicine and Rehabilitation (PM&R): A specialist in this field, often referred to as a physiatrist, focuses on restoring function and improving quality of life through non-surgical means. They can provide a comprehensive evaluation and develop a tailored rehabilitation program that may include physical therapy, pain management techniques, and lifestyle modifications.

2. Physical Therapy: Engaging in physical therapy can be particularly beneficial for addressing musculoskeletal issues. A licensed physical therapist can assess your posture, muscle strength, and flexibility, and design a program that includes exercises to strengthen the neck and shoulder muscles, improve posture, and enhance overall function. Modalities such as ultrasound, electrical stimulation, and manual therapy may also be utilized to alleviate pain and improve mobility.

3. Chiropractic Care: If you haven't already explored chiropractic treatment, it may be worth considering. Chiropractors specialize in spinal manipulation and can help realign the spine, which may relieve pressure on nerves and improve function. However, it is crucial to ensure that the chiropractor is licensed and has experience treating similar conditions.

4. Pain Management Specialists: If your pain is severe and persistent, consulting a pain management specialist may provide additional options. They can offer various treatments, including injections (such as corticosteroids) to reduce inflammation and pain, as well as alternative therapies like acupuncture or biofeedback.

5. Neurology or Neurosurgery: Given the neurological symptoms you described, it may be prudent to seek a second opinion from a neurologist or even a neurosurgeon. They may recommend advanced imaging studies, such as an MRI, to assess for any structural abnormalities in the cervical spine that could be contributing to your symptoms.

6. Psychological Support: Chronic pain can lead to emotional distress, anxiety, and depression. Engaging with a mental health professional can provide coping strategies and support to help manage the psychological aspects of chronic pain.

In summary, your situation requires a multidisciplinary approach. It is essential to continue advocating for your health and seeking out specialists who can provide a comprehensive evaluation and treatment plan. Remember that chronic pain is often multifactorial, and addressing it may require a combination of therapies and lifestyle changes. Keep a detailed record of your symptoms, treatments tried, and any changes you notice, as this information can be invaluable in guiding your healthcare providers toward the most effective interventions.

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