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Suggest Treatment For Severe Pain And Swelling In The Neck
Question: HI, Doctors,life savers. I am Suffering from severe left side neck and back nerves are swelling. I tried neurologist, they say you are neurologically fine, Taken Mri of Cervical & Brain , all normal except lose of curvature in neck. checked with Ent, they say all good. Please some one suugest. Whenver i am exposed to cold it triggers a lot, even cold food, cold climate fan too effects. Please some one help me out of this sufferign life.
Advance Thanks,
xxxxx XXXXXXX V
0000
Advance Thanks,
xxxxx XXXXXXX V
0000
Brief Answer:
Differential Diagnosis of disease
Detailed Answer:
Hi XXXXXXX XXXXXXX thanks for asking from HCM.
I can understand your concern. You are having a type of cold intolerance. There are various causes which can cause it in you, for instance:-
: Anaemia - It means low haemoglobin. It is less common in male, but it can occur due to intestinal worms/poor diet/some chronic infection. Kindly get Hb value estimation done and tell me what is the value. In males, usually 14-18 gm% is considered normal.
: Hypothyroidism - Altered thyroid profile can cause cold intolerance, low haemoglobin and nonspecific weakness/pain in body. As your MRI is almost normal, other causes must be ruled out. Kindly get thyroid profile done and message me the value with reference range.
: Fibromyalgia - It is a diagnosis of exclusion when other other causes have been totally ruled out. It presents as- Generalised body ache, muscle pain, joint pain in otherwise normal body, stiffness in body, lethargy and weakness, intolerance to cold and increased symptoms with cold, migraine or tension headache, loss of sleep and depression.
If your symptoms are matching with above mentioned symptoms and other causes have been ruled out, you might be suffering from it.
You should discuss these possibilities with your doctor and get advised investigations done. Kindly message me those reports and then depending upon the diagnosis, I will tell you how to manage it.
Till then, continue Naxdom and avoid cold environment as much as possible.
Eat green leafy vegetables and fruits, especially vitamin C rich food like lemon everyday.
Take a capsule B complex once a day.
Hope you got my point. If still in doubt, do let me know.
Thanks. Take care.
Differential Diagnosis of disease
Detailed Answer:
Hi XXXXXXX XXXXXXX thanks for asking from HCM.
I can understand your concern. You are having a type of cold intolerance. There are various causes which can cause it in you, for instance:-
: Anaemia - It means low haemoglobin. It is less common in male, but it can occur due to intestinal worms/poor diet/some chronic infection. Kindly get Hb value estimation done and tell me what is the value. In males, usually 14-18 gm% is considered normal.
: Hypothyroidism - Altered thyroid profile can cause cold intolerance, low haemoglobin and nonspecific weakness/pain in body. As your MRI is almost normal, other causes must be ruled out. Kindly get thyroid profile done and message me the value with reference range.
: Fibromyalgia - It is a diagnosis of exclusion when other other causes have been totally ruled out. It presents as- Generalised body ache, muscle pain, joint pain in otherwise normal body, stiffness in body, lethargy and weakness, intolerance to cold and increased symptoms with cold, migraine or tension headache, loss of sleep and depression.
If your symptoms are matching with above mentioned symptoms and other causes have been ruled out, you might be suffering from it.
You should discuss these possibilities with your doctor and get advised investigations done. Kindly message me those reports and then depending upon the diagnosis, I will tell you how to manage it.
Till then, continue Naxdom and avoid cold environment as much as possible.
Eat green leafy vegetables and fruits, especially vitamin C rich food like lemon everyday.
Take a capsule B complex once a day.
Hope you got my point. If still in doubt, do let me know.
Thanks. Take care.
Above answer was peer-reviewed by :
Dr. Sonia Raina
Dear Dr. Following are the tests done and readings. 1. Heamoglobin value - 15.6 g/ dl ( Male Range - 13.5-18.0 ) 2. Thyroid Function Test -Tri iodothyronine (T3) - 1.97 ng/ml ( Adults Range - 0.7-2.0 ) 3. Thyroxine (T4) - 9.66 mcg/dl (Adults Range - 4.5- 11.0 ) 4. Thyroid Stimulating Hormone ( TSH ).
i forgot inform in earlier that this nerve swelling effects in neck stiffness and head ache, some time i feel some movement / tingling in nerves. as per you fibromyalgia says it pains throughout the body for me its only shoulder back neck and head nerves, remaining parts i dont find any pain in other bodies.
Dr. Please suggest, i am striving very badly also i have informed earlier tried multiple doctors and treatments.
i forgot inform in earlier that this nerve swelling effects in neck stiffness and head ache, some time i feel some movement / tingling in nerves. as per you fibromyalgia says it pains throughout the body for me its only shoulder back neck and head nerves, remaining parts i dont find any pain in other bodies.
Dr. Please suggest, i am striving very badly also i have informed earlier tried multiple doctors and treatments.
Brief Answer:
Differential Diagnosis of disease and management
Detailed Answer:
Hi XXXXXXX XXXXXXX welcome back.
I got your point. I have read your reports and they are normal. As per reports, you are a healthy male. I have mentioned few differential, but they are negative in your case, which is good.
There is one possibility which can explain pain occurring only in neck, shoulder, left side back along with intermittent tingling
: Muscle fatigue and spasm due to bad posture - It is very common these days and I find lots of patients who seem like patients of disc disease and turn out to be case of muscular pain. The pain starts due to bad posture, weak muscles and continuos working from that muscle. The neck muscle pain leads to headache. I am mentioning features of pain to you, kindly correlate and tell me
Pain is dull, becomes severe on pressure over neck/back/shoulder or stretching the muscle, no radiation to hand/lower limb, no current like sensation, no redness/warm skin, relief occurs after massage/warm compresses/rest/painkillers.
I am suspecting it as your MRI and blood reports are normal. You can follow few tips to get relief
: Apply warm compresses 4-6 times daily
: Consult physiotherapist for good posture, ultrasonic therapy
: Start stretching to make muscles flexible
: You can take painkiller like Naxodom/Diclofenac/Ibuprofen after proper prescription. Avoid prolonged use.
: Take some rest from work and observe if you get relief or not.
Hope it will help you. If still no relief or any doubt, do let me know.
Thanks. Take care.
Differential Diagnosis of disease and management
Detailed Answer:
Hi XXXXXXX XXXXXXX welcome back.
I got your point. I have read your reports and they are normal. As per reports, you are a healthy male. I have mentioned few differential, but they are negative in your case, which is good.
There is one possibility which can explain pain occurring only in neck, shoulder, left side back along with intermittent tingling
: Muscle fatigue and spasm due to bad posture - It is very common these days and I find lots of patients who seem like patients of disc disease and turn out to be case of muscular pain. The pain starts due to bad posture, weak muscles and continuos working from that muscle. The neck muscle pain leads to headache. I am mentioning features of pain to you, kindly correlate and tell me
Pain is dull, becomes severe on pressure over neck/back/shoulder or stretching the muscle, no radiation to hand/lower limb, no current like sensation, no redness/warm skin, relief occurs after massage/warm compresses/rest/painkillers.
I am suspecting it as your MRI and blood reports are normal. You can follow few tips to get relief
: Apply warm compresses 4-6 times daily
: Consult physiotherapist for good posture, ultrasonic therapy
: Start stretching to make muscles flexible
: You can take painkiller like Naxodom/Diclofenac/Ibuprofen after proper prescription. Avoid prolonged use.
: Take some rest from work and observe if you get relief or not.
Hope it will help you. If still no relief or any doubt, do let me know.
Thanks. Take care.
Above answer was peer-reviewed by :
Dr. Sonia Raina
Dr. Thanks for your valuable feedback. Dr. as u have mentioned , i have this usual neck pain thats the place where i feel more problem, then this radiates to left ear and head, which makes me very dull since head ache. This will pain will get reduced immidiately if i give hot pack treatment, i stopped from some days since i was taking it every day and some one said it may effect my smaller veins if i use too hot water pack. Even if i take naxdom 500 or muscle relaxer it will come down completely for next 24 hours. Also there was a time in between one year where it was pain came down also note it was summer. then i thought of going to gym make bit mujscles strengther, usually from childhood very less execrcises and less physical work demand. for first two days for smaller streches pain aggregated very badly , immidiately i left gym and started massages to get releif. Also i try to bear to XXXXXXX to avoid continuous naxdom or muscle relaxer to avoid side effects. But when the pain goes un controllable , i take the naxdom. But since its happening from long time .. i am worried that i am not come to proper conclusion and medication.
My Working environment is sitting in front of computer, but after this pain started lot of research and correction in desktop height chair and many things i altered which is not giving any solution. Once i go home i dont do any physical work , even if i want i cant due to this pain, also i have a god gift mom who take cares of all. where physical work demand at home too not there.
Pain is dull,- i didnt understand this part, my pain is severe i can say. becomes severe on pressure over neck/back/shoulder or stretching the muscle, no radiation to hand/lower limb,- yes no radiation to lmb /hand no current like sensation, no redness/warm skin, relief occurs after massage/warm compresses/rest/painkillers- yes.
My most pain point is neck and back shoulder nerves , radiating to left ear eye and head. Naxdom release the pain immidiately. There are times were i will search for Naxdom 500 like a drug as a drug addict. If i dont take the naxdom at maximum pain , i feel like im finished going to die in pain. this pain is so terrible.
My last neuro dr. too thought it as fibromyalgia. is there any way to confirm whether i am suffering from fibromyalgia, and what is the treatment or medication ??
He prefered retense and amino some name tablet which didnt help in anyway.
Also taking care to avoid two wheeler driving, using cervical pillow, sleeping in flat area instead of un even bed, correcting maximum my posture of sitting in office, taking regular intervals of break.
My Working environment is sitting in front of computer, but after this pain started lot of research and correction in desktop height chair and many things i altered which is not giving any solution. Once i go home i dont do any physical work , even if i want i cant due to this pain, also i have a god gift mom who take cares of all. where physical work demand at home too not there.
Pain is dull,- i didnt understand this part, my pain is severe i can say. becomes severe on pressure over neck/back/shoulder or stretching the muscle, no radiation to hand/lower limb,- yes no radiation to lmb /hand no current like sensation, no redness/warm skin, relief occurs after massage/warm compresses/rest/painkillers- yes.
My most pain point is neck and back shoulder nerves , radiating to left ear eye and head. Naxdom release the pain immidiately. There are times were i will search for Naxdom 500 like a drug as a drug addict. If i dont take the naxdom at maximum pain , i feel like im finished going to die in pain. this pain is so terrible.
My last neuro dr. too thought it as fibromyalgia. is there any way to confirm whether i am suffering from fibromyalgia, and what is the treatment or medication ??
He prefered retense and amino some name tablet which didnt help in anyway.
Also taking care to avoid two wheeler driving, using cervical pillow, sleeping in flat area instead of un even bed, correcting maximum my posture of sitting in office, taking regular intervals of break.
Brief Answer:
Treatment
Detailed Answer:
Hi XXXXXXX XXXXXXX welcome back.
It is not fibromyalgia as it is one sided only. After reading your clinical history, it seems muscular pain along with some element of depression induced by it. As your symptoms are getting relieved by above mentioned measures, it is muscular pain. Dull pain can be severe. The difference is that it is not burning, sharp localisation, current like, stabbing type.
You should follow above measures. Do not worry, you will get relief. Along with it, consult Psychiatrist to rule out depression. Regarding posture correction and rest all measures, continue doing it. In longterm, you will definitely see improvement.
I am again stressing you that you are not suffering from any serious illness as your all reports are normal. One more thing, kindly get Vitamin D level done. As its deficiency can cause non specific pain. If it is low, kindly tell me. I will tell you the management.
Hope you got my point. Thanks. Take care..
If still in doubt, do let me know.
Treatment
Detailed Answer:
Hi XXXXXXX XXXXXXX welcome back.
It is not fibromyalgia as it is one sided only. After reading your clinical history, it seems muscular pain along with some element of depression induced by it. As your symptoms are getting relieved by above mentioned measures, it is muscular pain. Dull pain can be severe. The difference is that it is not burning, sharp localisation, current like, stabbing type.
You should follow above measures. Do not worry, you will get relief. Along with it, consult Psychiatrist to rule out depression. Regarding posture correction and rest all measures, continue doing it. In longterm, you will definitely see improvement.
I am again stressing you that you are not suffering from any serious illness as your all reports are normal. One more thing, kindly get Vitamin D level done. As its deficiency can cause non specific pain. If it is low, kindly tell me. I will tell you the management.
Hope you got my point. Thanks. Take care..
If still in doubt, do let me know.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
hi Dr. Following are my VitaminD results, 25-HYDROXY VITAMIN D3, 25-HYDROXY VITAMIN D2 ( LC/MS/MS METHOD ) 35.0 ng/ml ( Range less than 10 deficient, 10-30 insufficient, 30-76 normal ) whereas when i checked initialy on 25.11.2015 it was < 4.2 ng/ml, i was taking liver cord oil hence it is recovered to normal.
Parallelly Homocysteine level on 25.11.2015 was >65umol/L NOW Latest is >50umol/L. ( Range Male : 6.6 -14.8 , Female : 4.7 -12.6 ) Does this has any effect doctor??
Climate in XXXXXXX is too cold , hence frequency of pain is more, Running in Naxdom 500. But how good is it to continue in long term, but i take it only when it is un controllable.
Also Dr. as per your suggestion for muscular pain what are the medicines to take and rule out muscle pain.
Your Suggestions please. Today i am going to try accupuncture to try my luck and relief in pain.
Parallelly Homocysteine level on 25.11.2015 was >65umol/L NOW Latest is >50umol/L. ( Range Male : 6.6 -14.8 , Female : 4.7 -12.6 ) Does this has any effect doctor??
Climate in XXXXXXX is too cold , hence frequency of pain is more, Running in Naxdom 500. But how good is it to continue in long term, but i take it only when it is un controllable.
Also Dr. as per your suggestion for muscular pain what are the medicines to take and rule out muscle pain.
Your Suggestions please. Today i am going to try accupuncture to try my luck and relief in pain.
Brief Answer:
Muscular pain management
Detailed Answer:
Hi XXXXXXX XXXXXXX welcome back.
I have read the reports. It is good that your Vitamin D is normal. The serum Homocysteine level is not related to muscular pain. Its high value can predispose you to early atherosclerosis. It means fat deposition in arterial wall. Later on it can cause
: Hypertension
: Heart disease
: Stroke
So consult physician to lower it.
Now coming to muscular pain relieving medication
You can take
: NSAIDs like Ibuprofen/Diclofenac/Aceclofenac
: Muscular relaxants like Thiocolchicoside/Chlorzoxazone/Tolperisone
: Local application of painkiller gel like Diclofenac gel
: Pain reliever patch like Fentanyl patch/Diclpfenac patch
: Acupuncture
: Ultrasonic therapy
: Infrared therapy
: Physiotherapy and stretching along with rest
You are going for acupuncture which is considered good for such type of pain. You should go ahead and let me know about response.
Hope it will help you. Thanks. Take care.
Muscular pain management
Detailed Answer:
Hi XXXXXXX XXXXXXX welcome back.
I have read the reports. It is good that your Vitamin D is normal. The serum Homocysteine level is not related to muscular pain. Its high value can predispose you to early atherosclerosis. It means fat deposition in arterial wall. Later on it can cause
: Hypertension
: Heart disease
: Stroke
So consult physician to lower it.
Now coming to muscular pain relieving medication
You can take
: NSAIDs like Ibuprofen/Diclofenac/Aceclofenac
: Muscular relaxants like Thiocolchicoside/Chlorzoxazone/Tolperisone
: Local application of painkiller gel like Diclofenac gel
: Pain reliever patch like Fentanyl patch/Diclpfenac patch
: Acupuncture
: Ultrasonic therapy
: Infrared therapy
: Physiotherapy and stretching along with rest
You are going for acupuncture which is considered good for such type of pain. You should go ahead and let me know about response.
Hope it will help you. Thanks. Take care.
Above answer was peer-reviewed by :
Dr. Yogesh D
Dear Dr. Thanks for your suggestion. Please give me a proper prescription for following medicines you have suggested , so that i can strictly follow and find some results.:
1. Ibuprofen/Diclofenac/Aceclofenac
2. Muscular relaxants like Thiocolchicoside/Chlorzoxazone/Tolperisone
3 Local application of painkiller gel like Diclofenac gel
4 Pain reliever patch like Fentanyl patch/Diclpfenac patch
PLease sugest on 1 & 2 nd point when to take tablets ( morning / afternoon/ night ) and before food/ after food .
3rd & 4th i will do it whenever pain is more or in nights.
Advance Thanks,
xxxxx XXXXXXX V
0000
1. Ibuprofen/Diclofenac/Aceclofenac
2. Muscular relaxants like Thiocolchicoside/Chlorzoxazone/Tolperisone
3 Local application of painkiller gel like Diclofenac gel
4 Pain reliever patch like Fentanyl patch/Diclpfenac patch
PLease sugest on 1 & 2 nd point when to take tablets ( morning / afternoon/ night ) and before food/ after food .
3rd & 4th i will do it whenever pain is more or in nights.
Advance Thanks,
xxxxx XXXXXXX V
0000
Brief Answer:
Drug dosing and prescription
Detailed Answer:
Hi XXXXXXX XXXXXXX welcome back.
I can tell you the drug doses which I prescribe to my adult patients. You can take these medication after proper prescription.
: Usual dose of Ibuprofen is 800mg twice a day in 60-80kg patient.
: Diclofenac can be taken as 50mg thrice a day or 100mg sustained release twice a day.
: Thiocolchicoside dose is 4 to 8 mg twice a day. It should be taken only for 5-7 days.
: Chlorzoxazone dose is 500 to 750 mg thrice a day for 7 days. After it general painkiller like Ibuprofen/Diclofenac.
: Tolperisone dose is usually 100 to 150 mg twice or thrice a day.
All these medications should be taken after food (around 1-2 hour later).
Do not self medicate. Kindly consult doctor and take medication only after prescription.
Hope it will help you. Thanks. Take care. If still in doubt, do let me know.
Drug dosing and prescription
Detailed Answer:
Hi XXXXXXX XXXXXXX welcome back.
I can tell you the drug doses which I prescribe to my adult patients. You can take these medication after proper prescription.
: Usual dose of Ibuprofen is 800mg twice a day in 60-80kg patient.
: Diclofenac can be taken as 50mg thrice a day or 100mg sustained release twice a day.
: Thiocolchicoside dose is 4 to 8 mg twice a day. It should be taken only for 5-7 days.
: Chlorzoxazone dose is 500 to 750 mg thrice a day for 7 days. After it general painkiller like Ibuprofen/Diclofenac.
: Tolperisone dose is usually 100 to 150 mg twice or thrice a day.
All these medications should be taken after food (around 1-2 hour later).
Do not self medicate. Kindly consult doctor and take medication only after prescription.
Hope it will help you. Thanks. Take care. If still in doubt, do let me know.
Above answer was peer-reviewed by :
Dr. Veerisetty Shyamkumar
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