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Found lump at the base of skull and having pain while moving neck. Any suggestions?

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Orthopaedic Surgeon
Practicing since : 1994
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Hi. I have had unusual limited mobility in my neck for over 6 weeks. I cannot turn to one side or the other without pain, although tilting my ear to my shoulder is not nearly so painful. This pain and stiffness persist all day and all night. It awakens me in my sleep, as it feels especially painful to lift my head when I turn over (a ripping pain) About two weeks ago, I found a lump at the base of my skull, about 4" behind my right ear (nothing on the other side of my head/neck) The lump is new, but not sore... I should also explain that my pain radiates to my upper shoulders, but there is no pain when I push against my neck or shoulders (as with a bruised or pulled muscle). I am concerned about what may be yet another manifestation of my inflammatory condition(s); Fibromialgia & Osteoarthritis... But the "lump" is an unusual concern... Any information is appreciated.
Posted Wed, 5 Dec 2012 in Bones, Muscles and Joints
Answered by Dr. Praveen Tayal 1 hour later
Thanks for posting your query.
A small painless soft lump near the ear can possibly be due to-
1. A lipoma- a benign collection of fat cells.
2. A lymph node swelling - usually seen in the presence of any infection in the area or viral illness.
3. A benign tumor usually involving soft tissue structures or underlying muscle tissue.
4. Boil or Abscess: It generally starts as a reddened, tender area. Over time, the area becomes firm and hard. Eventually, the center of the abscess softens and becomes filled with pus.
5. Sebaceous cyst: It is filled with a soft, whitish brown material that sometimes oozes out onto the skin's surface. This material is called sebum. If this protruding is accompanied by pain as well then there is a possibility of infection.
For the confirmation of diagnosis, you need to get this lump examined from a doctor and get a MRI scan for any soft tissue growth and a FNAB (fine needle aspiration biopsy) done.
Till then, you get this lump examined from a doctor, apply warm compresses on the lump because if it is a swollen lymph node or boil then application of warm compresses will help.
The pain in the neck radiating to shoulders is likely to be due to cervical spondylosis. It happens primarily due to degenerative changes secondary to age in the cervical spine. Past neck injury may also contribute to the degeneration.

X-ray of neck in lateral view or MRI will help in the diagnosis.

Treatment includes
1. Use of cervical collar helps in immobilisation and brings relief.
2. Medical drugs like pain killers - acetaminophen/ibuprofen and muscle relaxants might be helpful.
3. Methylcobalamin supplements are also recommended for nerve compression symptoms.
4. Cervical isometric exercises are beneficial to maintain the strength of the neck muscles. Neck and upper back stretching exercises, as well as light aerobic activities, also are recommended under the guidance of a physical therapist.
5. Hot fomentation helps in relieving acute symptoms.
6. You can avoid using a pillow.

As you try these measures, I also encourage you to consult an orthopedician for both evaluation and to avail stronger prescription medications (if over the counter medications are not helpful).
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Please accept my answer in case you do not have further queries.
Wishing you good health.
Dr. Praveen Tayal.
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