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What Causes Painful Stiffness On Lower Left Side Of Head, Neck And Shoulder?

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Posted on Mon, 7 Mar 2016
Question: my husband has unexplained pain and stiffness starting on the back lower left side of his head, continuing down his back of his neck, into his shoulders. he can't turn his head or even look down. he did have a head cold last week. He has not hit his head, strained his neck, nor any other injury. He's 65. He says the pain is beyond a headache. I gave him two Ibuprofen , it relieves the pain slightly.
doctor
Answered by Dr. Olsi Taka (54 minutes later)
Brief Answer:
Read below

Detailed Answer:
I read your question carefully and I understand your concern.

I am assuming he doesn't have any other signs which might point to a serious issue such as cervical artery dissection, spinal cord compression etc. Such signs might be intense vertigo, trouble with balance and movement coordination, weakness or sensation changes of the limbs or face, difficulty swallowing or articulating words.

Judging from your description and in ghe absence of other signs, the most probable cause of his neck pain and stiffness, irradiating in the head and shoulders is a neck muscular strain. It justifies all the symptoms including their distribution in the head and shoulder. Now I imagine you relate such an issue with a trauma or heavy physical activity, but it can originate under many circumstances such as a particular posture during work or sleep, stress with increased tension in neck muscles, the cold you mention to have had as well.

Treatment is with anti-inflammatory pain killers like Ibuprofen and muscle relaxants such as Flexeril taken regularly for a couple of weeks at most. A soft cervical collar may help as well. Improvement is a gradual one, not overnight.

I remain at your disposal for other questions.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Olsi Taka (34 minutes later)
Thank you for your quick response. It makes sense about muscle strain. He does sit at a desk all day working on his computer. I read your response to him, it made him feel better. Do you think a heating pad would help? How long can he be on Ibuprofen? Can he continue to take two at a time? He is being treated for depression, so sometimes pain is exaggerated, making it hard for me to determine how severe his pain is. He is currently on fluexotine, bupropion, and a low dose of lorazepam. Will Ibuprofen interfere with his meds?
doctor
Answered by Dr. Olsi Taka (1 hour later)
Brief Answer:
Read below

Detailed Answer:
Thank you for your feedback and the additional information.

Heating pads are beneficial in some patients. Not all of them, but since it is a measure without side effects they can be safely tried.
There is not a precise length of treatment for Ibuprofen use as it depends on the evolution of the symptoms. I suggested a couple of weeks, as it is the average time for most patients to recuperate. But many get better sooner and it can be interrupted, if symptoms persist for over two weeks though it can be used again for a few more weeks. Extra care in prolonging the treatment too much is needed if there is a history of stomach ulcer, high blood pressure, kidney disease, conditions which can be negatively influenced by long term Ibuprofen use.
Regarding the dosage, I do not know what do you mean two at a time. Ibuprofen comes in 200 mg or 400 mg pills (in some countries 600 mg ones as well). If they are only 200 mg ones, yes, can be taken 2 at a time.

As for interactions....the fact that he takes fluoxetine and bupropion makes him prone to interact with the muscle relaxant I suggested before, Flexeril. So I suggest not to take Flexeril at all. The lorazepam he is taking has some muscle relaxing qualities itself, so it's beneficial in that sense.
Coming to interaction with Ibuprofen, there is some interaction between it and Fluoxetine, they increase each other's level and effect. So the dose of Ibuprofen shouldn't be very high, 800 mg a day, 1200 mg at most if still in a lot of pain.

I hope to have been of help.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Olsi Taka (57 minutes later)
Thank you once again for your help. I feel I have a better "handle" on how to help him.
doctor
Answered by Dr. Olsi Taka (1 minute later)
Brief Answer:
Wishing a speedy recovery.

Detailed Answer:
You're welcome. I hope he'll recover very soon.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Olsi Taka

Neurologist

Practicing since :2004

Answered : 3672 Questions

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What Causes Painful Stiffness On Lower Left Side Of Head, Neck And Shoulder?

Brief Answer: Read below Detailed Answer: I read your question carefully and I understand your concern. I am assuming he doesn't have any other signs which might point to a serious issue such as cervical artery dissection, spinal cord compression etc. Such signs might be intense vertigo, trouble with balance and movement coordination, weakness or sensation changes of the limbs or face, difficulty swallowing or articulating words. Judging from your description and in ghe absence of other signs, the most probable cause of his neck pain and stiffness, irradiating in the head and shoulders is a neck muscular strain. It justifies all the symptoms including their distribution in the head and shoulder. Now I imagine you relate such an issue with a trauma or heavy physical activity, but it can originate under many circumstances such as a particular posture during work or sleep, stress with increased tension in neck muscles, the cold you mention to have had as well. Treatment is with anti-inflammatory pain killers like Ibuprofen and muscle relaxants such as Flexeril taken regularly for a couple of weeks at most. A soft cervical collar may help as well. Improvement is a gradual one, not overnight. I remain at your disposal for other questions.