Brief Answer:
Symptoms can be muscle strain vs. nerve root compression

Detailed Answer:
Good evening.

The symptoms you describe are consistent with 2 major types of problems. One would be simple muscle strain of the cervical and/or shoulder girdle muscles which could be due to torsion that occurred during sleep.

The 2nd would be compression of a nerve root or nerve roots which could've happened also from poor sleeping posture or if you may have OVEREXERTED your neck or shoulder muscles 1-2 days prior to waking up this way either doing exercises such as crossfit, yoga, or weightlifting then, perhaps this is an AFTERMATH effect of that overuse.

The most immediate TREATMENT I would advise you consider would be to obtain an ICEPACK and to place that pack directly over the affected area which sounds like it would be somewhere around the back of the neck toward the lateral side where the shoulder joins. I would "FREEZE" that area for at least 20-30 minutes with ice and I would also prescribe an analgesic such as IBUPROFEN, NAPROXEN, OR DICLOFENAC so long as you do not have any type of allergy to NSAIDS and so long as you do not have any type of bleeding diathesis (disorder). Otherwise, TYLENOL would be the choice and I would take up to 3 grams in a 24 hr period and no more of acetaminophen.....or if ibuprofen, no more than 800-1200 mg. in 24 hrs.

I would also ask you to see what type of position you can place your neck and shoulder into that feels best and try to maintain that position while awake for a long enough period of time so that you can apply the ice without too much movement.

I would recommend this regimen for at least the next 48 hrs. since this all seems to have just happened in the last 24 hrs. After the first 48-72 hrs. from when you first awoke you can switch the twice or 3x/daily FREEZEDOWNS and switch that to HEATPACKS using hot towels, or HEATING PADS. Depending upon how much progress you'd made over the first 2-3 days I might consider sending you to PHYSICAL THERAPY to start a light program of range of motion of the affected shoulder and neck since you cannot simply lie still or without any type of movement otherwise, things may start to tense up and then, you'll have a different set of problems.

The other thing PHYSICAL THERAPY could potentially do for you that could accelerate healing would be to add ULTRASOUND/DIATHERMY treatments once daily and if this doesn't settle down within 7 days I would order a TENS unit to apply electrical stimulation which tends to have an analgesic effect.

I would also start backing off the active pain medications in terms of the NSAIDs (if being taken) and even the TYLENOL if you have been taking it continuously. If pain and soreness persisted at the same levels after 7-10 days I might consider a program of AQUATHERAPY and then, after 2-3 weeks I would consider getting some imaging studies such as an MRI of the cervical spine to check for actual visual evidence of a nerve root compression going on or perhaps spinal canal stenosis though I doubt it's either of those....unless you do a lot of heavy and repetitive lifting.

There are also other alternatives that could be tried after 2-3 weeks such as acupuncture, cervical traction, and massotherapy. I would highly recommend staying away from chiropractic manipulation of the neck if there are any RAPID HEAD THRUST maneuvers that the operator would be performing. Those are risky and should not be performed on anybody's neck no matter what the situation or what the patient's status.

If I've provided useful or helpful information to your questions could you do me the utmost of favors by CLOSING THE QUERY along with a few positive words of feedback and maybe even a 5-star rating if you feel it is deserving? I am definitely interested in getting updated information on your condition if you'd care to drop me a line at www.bit.ly/drdariushsaghafi and let me know how things turned out.

You can always reach me at the above address for this and other questions. I wish you the best with everything and hope our discussion has aided in your understanding of a few concepts related to your concerns.

Cheers young lady and wishin' you the best!

This query required 45 minutes of professional time to research, assimilate, and file a response.

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Brief Answer:
A muscle relaxant is typically good for ACUTE problems

Detailed Answer:
If your neck and shoulder pains are relatively recent in nature (meaning within the past few days to few weeks) then often times if there is no obvious cause a short run of some type of muscle relaxant could help. However, you should avoid using muscle relaxants either LONG TERM or for problems that themselves are chronic in nature (meaning several months or longer) since it is much better to try and identify the underlying cause for the pains/cramps/sprain, etc.

I typically do not recommend any type of massotherapy of the neck if I have not imaged the cervical spine since I do not wish to submit the patient for physical manipulation of that area of the body without knowing what's below the surface first...make sense? Of course, 99 times out of 100 there is nothing that a massage could hurt. But boy is it tough to make friends with someone if you just recommended a massage for a painful neck and it turns out that the masseuse makes a simple fracture WORSE or somehow RUBS a subcutaneous abscess a little bit farther into the depper tissues which then, seeds more bacteria farther around to make more problems! LOL....

And so, I would say a short term muscle relaxant may be of benefit and should not carry a high risk associated but should likely be discontinued within a few days if there is no success. However, a massage done blindly without doing at least a plain film of the c-spine (if not CT) is not something I would recommend to one of my patients.

Once again young lady....If you think the information in my responses have been useful or helpful to your questions I'd really appreciate your CLOSING THE QUERY along with just a few nice words of feedback along with perhaps a 5-star rating? I am definitely interested in hearing updated information if you'd drop me a line at www.bit.ly/drdariushsaghafi and let me know how things turned out.

You can always reach me at the above address for this and other questions. I wish you the best with everything and hope our discussion has aided in your understanding of a few concepts related to your concerns.

Be well and wishin' you the best!

This query required 69 minutes of professional time to research, assimilate, and file a response.

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