
Having Neck And Shoulder Pain. Chest X-ray Normal. Lymph Nodes Felt Above The Collarbone. Any Cure?

Thanks for writing in.
The lymph node which you felt right above the collarbone might be the right supraclavicular lymph node. It is quite unlikely for the lymph node to cause the pain and stiffness you are experiencing.
When your doctor examined this particular lymph node, did he/she make it a point to examine other nodes around the neck,axilla or groin.There are lot of associated factors which would worry us , like
1.the presence of other cervical or axillary lymph nodes(generalised lymphadenopathy).
2.the presence of unexplained weight loss , fever, fatigue, night sweats etc
so on and so forth.
3.the presence of a stony hard lymph node is more in favour of a malignancy
The right supraclavicular lymph node mainly drains the region of lungs, retroperitoneum ,oesophagus and is enlarged in cases of malignancy.
Some physicians would wait for 3-4 weeks(if there are no other worrisome factors) and observe if the lymph node resolves on its own or if there is any increase in size.
However, I would suggest you to get a second opinion from another physician to put your mind at ease and get an FNAC(fine needle aspiration cytology) or Excision biopsy of the lymph node if suggested by the doctor.
About the pain in the neck, have you tried pain relief gel ,hot fomentation and application of a soft cervical collar. Try to have an ergonomically designed workplace.
Hope I have answered your question. If you have any further questions, I will happy to answer them.
In case you have no further queries, kindly accept the answer. Any reviews are welcome.
Have a wonderful day.
Regards,
Dr.Divya Kuttikrishnan


Thank you so much for your help.
Thanks for the reply.
Maintain the appointment with the ENT doctor.That is a good enough second opinion.Probably the supraclavicular lymph node has been there for some time, we do not know that for sure. If it was any other lymph node , that normally enlarges when you have cough or cold, it could be left alone. However, we do not want to take a chance with the supraclavicular lymph node, especially when you say at times it feels hard. It could be harmless ,maybe not. Supraclavicular lymph node is enlarged in cases of lung and gastro intestinal malignancies .Sometimes there is no cause for enlargement, it would have enlarged at some point when you had some infection and failed to regress back to its original size.
Probably your physician was not too concerned about the lymph node, Maybe because it was not an enlarged supraclavicular lymph node,probably just a node that gets enlarged when you have sore throat etc.
I presumed it is supraclavicular, since you said the lymph node was felt immediately/just above the collar bone at the base of the neck. I would advise you not to be anxious about the lymph node, but definitely do get a second opinion from your ENT doctor.
Meanwhile for the problem of clearing the throat and slight nasal drainage, I would suggest you have plenty of warm water and warm fluids to drink. Saline water gargles might help.In addition you could try doing steam inhalation 3 times a day.
Hope this helps.
Do get back to me if you have any further queries.
Have a nice day.
Regards,
Dr.Divya Kuttikrishnan


Maybe I just haven't noticed it because that is not a part of my body that I normally would feel and I only noticed it because of my neck and shoulder pain by massaging that area. I do not know.
Please advise on your opinion of both the Doctors diagnoses.
Thank you again.
Thanks for updating me with the reports.
Well, it is a relief to know that there is no abnormality in the lymph nodes around the neck region.Another good sign is that there is no pain / altered sensation in the arm on palpation.Yet another positive thing is that your cervical X XXXXXXX and MRI reports have come back as normal.
Probably as you said, the pea sized nodule might have been there for a long time but it came to your notice now, because of your muscle pains and while massaging the area.
What you can do now is to be calm.Don't be anxious about this pea sized nodule. Maintain good posture and avoid over straining the neck and back muscles.
However , observe this nodule as to whether there is an increase in size over the next one or three months.If it stays the same size, don't worry about it.If it gets bigger , visit a surgeon, as a CT scan/MRI/FNAC/Biopsy might need to be done to rule out neurogenic tumors etc.
Hope I have answered your query. I will be happy to answer any further queries you might have . In case you don't have any further queries, kindly accept this answer.Any reviews are welcome.
Have a wonderful day.
Regards,
Dr.Divya Kuttikrishnan


I apologize for missing that part of your question earlier about muscle/brachial plexus, and I will try to make it as simple as possible for you.
Brachial plexus is a network of nerve fibres arising from near the neck and shoulder(cervical spinal cord), and these nerves control the muscles and sensations of the fingers,hands,arms and shoulders.This network is located in the supraclavicular region(above the collar bone) between the scalenus anterior and scalenus medius muscle.Brachial plexus are present on both sides right and left.
Since you use the computer a lot, it is quite possible that you unconsciously tense your upper trapezius,scalene and forearm muscles while using the keyboard.The tension in the scalenus muscle,might have caused the muscle fibers to get matted together into a nodule.And it is only on one side,maybe because of a prediliction to keep your head rested on one side of your neck, while working on the computer.This is what I am assuming both the doctors meant. If that is the case , there is nothing to worry about. However, continue to observe the growth over 1-3 months and look for any increase in size. If it stays the same without any other major symptoms,leave it alone.
As for the neck pain continue with the physical therapy and do the physiotherapy exercises he/she might have suggested. XXXXXXX up with an oocupational therapist and have an ergonomically designed workplace. I feel once your posture and workstation is good, your neck pain and shoulder pain should subside.
Hope my answers have been of some help this time around.I will be happy to answer any further queries.
Have a great day.
Regards,
Dr.Divya Kuttikrishnan


Thank you so much.
1. Your family physician may be right, and yes, he is. It has got to do with the muscle and the ligament and the strain on them due to continuous use of computer.
2. Your ENT specialist is also right. He is given you the name of the diagnosis as lymph node may or may not be right. However, its presence or absence has no much of impact on your outcome.
To sum up, both your family physician and ENT specialist are pointing towards one condition and I am giving you an opinion of a lymph node enlargement which may be associated sign.
Hope this helps.
Take care and regards,

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