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Could syrinx cause shoulder and neck pain? History of sinus problems. Taking Lortab and Wellbutrin. Suggestions?

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I apologize for this long explanation on a simple question. I have and had been having pain in my shoulder (trapezoid area) and also in my neck for quite some time (7 years now). I have had numerous doctors, test, etc. This last year I have seen a neurosurgeon as syrinx was found in the C5-T2 region. Could this be an explanation of the non-stop pain? The neurosurgeon does not think so. I have also had sinus problems for years. No known allergies. I have always had a noticeably large lump on the lymph node located on my right side below my ear. Since last summer the neck pain has become noticeably worse with a "hard feeling" in my right cheek that also feels numb and/or painful. I can also have ear pain on that side. I have been a degreed personal trainer for over 15 years and now can no longer perform even regular daily activities without the need for pain killers. I do take lortab and wellbutrin. Used to take neurontin (hated it). I am very happily re-married and have a much lower level if even any stress. I have never smoked, drink alcohol in moderation, and eat very well. I have no energy and have, in the past, taken nuvigil, adderall, and most recently vyvanse. I also take a basic multi-vitamin. The numb, swollen, painful feeling in the right side of my face does not go away now and the neck/shoulder pain is at an all-time high. Suggestions?
Posted Wed, 25 Apr 2012 in Ear, Nose and Throat Problems
Answered by Dr. Sumit Bhatti 9 hours later

Thank you for your query.

1. A syrinx will cause loss of sensation rather than pain or an altered sensation.

2. You should get a USG (Ultrasound) Neck done for the neck lump. An FNAC (Fine Needle Aspiration Cytology) will settle the diagnosis.

3. In your case, trigeminal Neuralgia needs to be evaluated by your Neurologist. For this condition, typtomer (amitriptyline) or tegretol (carbamazepine) are better alternatives to Neurontin. However, these are prescription drugs and can only be obtained after you’ve been evaluated by your treating physician and the diagnosis of trigeminal neuralgia has been made

4. Side effects of multiple medications and their interactions such as Adderall and Wellbutrin (even if they have been taken in the recent past) need to be drawn to the attention of your primary physician.

5. One single lesion does not explain all your symptoms because the nerve supply of the face and of the neck and shoulder are different.

6. Cervical Spondylosis and Migraine associated neck and shoulder pain due to muscle spasm are more likely explanations in your case.

I hope I have answered your query. Please accept my answer if you have no further questions. If you have any follow up queries I will be available to answer them.

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