What Causes Severe Muscle Pain In The Shoulder And Neck Area?

Posted on Fri, 4 Nov 2016

Question: I have bi-polar and anxiety disorder. part time cleaner. severe muscle pain in neck back and shoulders, tingling hands especially in am. 8 weeks of pt did not help at all. symptoms 3 months. sleep apnea, alergies caused me to breath through my mouth, not getting proper sleep for 3-4 months. new mask, sleeping very well for 5 nights, not getting better. wondering about fibromyalgia, chronic fatigue syndrome, hep-c. cannot take muscle relaxers due to Nardil (STARTED 2 WEEKS AGO), psych med. also take clonapin. severe stomach pain and gas all night and 2-3 hours in AM. also suffer 3-5 migraines a month. can you help me narrow down possibilities? I have an apt with PA on nextWED. she is uncomfortable prescribing pain meds due to psych issues/ suicidal idealization. mind is very foggy, trouble concentrating. no libido, no desire to do anything. I have an apt with allergist on Thurs both knees ache and yesterday had sciatica attack. had cortisone shot in right knee a few months ago that helped, but aching again. lost 35 lbs over last 18 months, not trying hard, but did tighten up diet. have both strains of herpes taking Valtrex daily. in severe depresiion right now, feel may be contributed partially to chronic pain. whi[plash injury in 1980, 10 yrs old, undiagnosed until age 25 by chiroppractor

Answered by Dr. Seikhoo Bishnoi (3 hours later)

Brief Answer:
This could be occurring due to depression and somatic symptoms.

Detailed Answer:
Hi, thanks for asking from HCM for your health related doubts

I can understand your concern. Your main symptoms are poor sleep, pain abdomen, foggy mind, poor concentration, poor desire, reduced libido, suicidal ideation etc. You have history of bipolar disorder too. You have persistent severe pain in muscles of neck and shoulder, tingling in hands.

If we go by symptoms and history then in my opinion the symptoms then most likely possibility of these symptoms is Depressive Disorder most likely Moderate Depression with somatic symptoms. Fibromyalgia could be a possibility but only if depression is ruled out. Swollen lymph nodes, chronic fatigue, tiredness through out the day are common symptoms. So we can rule out chronic fatigue syndrome and fibromyalgia on the basis of clinical history.

For Hepatitis C you can go for serological tests. This will rule out hepatitis.

Once we rule out we are left with Depression with somatic symptoms. Medicines like SNRIs can be used. Venlafaxine or Desvenlafaxine or Duloxetine etc have great efficacy in controlling depressive symptoms and pain related symptoms. These medicines will help in depression and will control the fatigue, pain etc symptoms. Motivation, desire etc will take time to improve. So if possible ask for at least one appointment of a Psychiatrist and get yourself evaluated.

Thanks. Take care

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Above answer was peer-reviewed by : Dr. Nagamani Ng