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Having pain and stiffness in neck. X-ray and MRI normal. Could it be lymph node?

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General Surgeon
Practicing since : 2002
Answered : 77 Questions
I am a 44 year old male. About 6 months ago I started developing pain and stiffness on the the righ side of neck that radiated to my upper back and shoulder. We were in temporary offices at my place of employment at the time while own offices were being remodeled. I was sitting just at a plain table with a chair the did not move up or down and was probably tilting my head slightly upward to see the monitor through my bifocals. About 3 months ago I woke up with my right arm pinned against the side of my body and I felt pain that was much worse. I went to the orthopedic dr. had a neck xray, a non-contrast cervical mri and they were normal. I did 4 weeks of physical therapy which actually made things worse. I don't know if I injured myself more by doing the streches, but when i do the strech where you tilt your head all the way to the right where your ear touches your shoulder, when I would lift my head back up to the staightforward position i would feel a sharp, knifelife pain between the neck and shoulder while i lifted the head back up which has continued. I get that pain now when i make sudden moves or turn my neck without thinking etc. Well while massaging that area a few weeks ago I felt i very small, pea sized nodule on the side of my neck a little bit above the collar bone. Painless, can roll it under my finger, but it is bascically in the center of where my pain is. It could have been there forever for all I know. My chiropractor told me it was a supraclavical lymph node and since I am a smoker and a few years found a 2 mm granuloma at the base of my left lung. Did a follow up CT scan 6 months later and nothing had changed and they said it was not suspicious and there was no need for follup up. This was 4 years ago. So I had my primary care dr. look at the nodule on my neck and he said it was where the muscle connects to the ligament and was nothing. I saw and ENT and he said it was caused by muscle/brachial plexus and was nothing to worry about but would probably remain. I am a worrier and i continuously feel it and move it to see if it has changed. It is somewhat hard and moveable and can be rolled under the finger and if i really push on it hard it goes back into the tissue. I know you cannot diagnose me without seeing or feeling what I am talking about, but I would certainly like your opinion as to what it could be from my description and what the 2 doctors said. It sure feels like a lymph node to me, but maybe other things can feel the same. I think me continuously pushing on it and checking it is making it worse, but I am that type and can’t help it. Your opinion or advise would be appreciated. I am very concerned both about the pain but even moreso about the nodule even though 2 doctors have told me not to worry about it but gave me to different diagnoses.
Posted Mon, 23 Jul 2012 in Bones, Muscles and Joints
Answered by Dr. Rajat Gupta 3 hours later

Went through the detailed description of your problem.

I think the problem of pain what you are having is upper limb neurogenic pain due to fibrosis around brachial plexus. It takes a very long time before you just rub it off for anything.

As for lump in neck, which seems to be a supraclavicular node of probably benign nature as it has been there for long.. But still if it is worrying you get excised by a surgeon and then send it for histopathology.. It is better to get a confirmation excision than handling it constantly and keeping worriful thoughts in the head. This is my opinion although it is just not needed.

Hope this helps your query.. Feel free to ask any more doubts you have.. Wishing yoy a speedy recovery :-)

Dr. Rajat Gupta
Above answer was peer-reviewed by
Follow-up: Having pain and stiffness in neck. X-ray and MRI normal. Could it be lymph node? 53 minutes later
Think you for your reply. What do you mean that your opinion "is just not needed"? I also have been going to a licensed XXXXXXX tissue massage therapist. She felt and when she felt it, trust me, I felt it too, a big knotted up muscle XXXXXXX in between the area i am referring to. Between the neck and should. I could have never went in with my hand that XXXXXXX to feel it. It seemed to be somewhat of the source of my pain especially when she was trying to rub some of it loose. She was able to get it loosend somewhat and I am suppose to return in a week. She suggested that I get a TheraCane. I am not sure if you are familiar with that. Apparently it is very useful in doing your own XXXXXXX tissue massages. So the pain and painless nodule are not related? It seems odd that my dr told me that nodule was where the muscle and ligament connect and the ENT told me it was brachial/plexus - muscle related. I went to see them for the nodule not the pain. The nodule has only been noticed for 3 weeks and like I said it could have been there for a long time for all I know. An answer back these items would be appreciated and I won't bother you again.

Thank you.
Answered by Dr. Rajat Gupta 16 minutes later

Sorry I misunderstood your earlier message that nodule (supraclavicular node) is there for few years and meant that this is not worrisome. However as you have clarified now that it is enlarged or start noticing it for last 3 weeks only.. don't ignore it, consult a surgeon near your place and get an excisional biopsy of the nodule.. As I said earlier this will stop your worrying thoughts once you dont feel it. Very difficult to say anything without biopsy report.

Pain and lump can very well be because of two different pathologies.. However single pathology can not be ruled out with examining you.. I would advise you consult a surgeon near your place to take this further..

Hope I could help you with your doubts.. Wishing you a speedy recovery

Dr. Rajat Gupta
Above answer was peer-reviewed by
Follow-up: Having pain and stiffness in neck. X-ray and MRI normal. Could it be lymph node? 17 hours later
Well, I did consult an ENT surgeon and he without hesitation said that it was from a brachial plexus/muscle strain or injury and my Primary Care Dr like I said, told me it was where the muscle connects to the ligament. Neither even mentioned a biopsy or excision and told me it was nothing to worry about. It has not enlarged over the last 3 weeks. It is still very small, smaller than a pea actually unless I keep messing with it. That is the problem. I should just leave it alone and check maybe weekly if I can. And even though it does not hurt at all and I can roll it around and push it into the tissue, it seems to be in the center of where my neck and shoulder/back pain and stiffness is located. Could this be just a coincidence or could a muscle/brachial plexus strain or injury cause something such as that.
Answered by Dr. Rajat Gupta 8 minutes later

Thanks for writing back.

What I make out of your explanation is the pain is because of brachial plexus involvement. And the nodule may be something totally unrelated to it as well.

If the nodule is supraclavicular lymph node, it is always better to biopsy it or at least do an FNAC to look at it histopathologically.

Hope I have answered your queries. Please do write back for further clarification on this.

Dr. Rajat Gupta
Above answer was peer-reviewed by
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