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Pain From Neck To Lower Lung, Shaking Hands, Weakness. What Is Wrong?
Question: Hello Doctor, I did ask a Respected General/Family Physician Dr XXXXXXX Maji he suggested me to consult a neurologist first about my pain pattern that switches sides starts from brain neck shoulder and lower part of lung it starts as soon as i wake up and continues variably throughout the day also when i breathe fully i feel a slight tension/pain in lower part of lung. apart from that if i pickup anything heavy or hold it for a long time in hand my hands start shaking/trembling like weakness felt when doing heavy job. (whenever the pain episode starts say right hand side i experience slight fear like some increase in pressure and slight pain/pressure/tension at part behind right ear follows down neck (like same nerve/vein) then lower lung same happens in left hand side) over 3 years without taking any allopathic medication i somehow managed to live with it but i want to get rid of it its making my life horrible would you please help me diagnose what's exactly wrong with it. (the only medication i had taken was 5 yrs ago by name cinzan something i don't know its full name when i went to local doc because he said it was depression that my mind did not withstand my fathers epileptic attack and he passed away 2 yrs after... but the pain never subsided it continued.)
---------note by doctor starts here-----------
Dr XXXXXXX Maji Replied me hope this will be helpful to you
Recurrent attack of the pain described by you seems to me a vague poorly localised pain and it may be caused by many reasons like spinal diseases, myopathic pain, pain sensation due to depression and panic attack, cervical spondylosis etc. Tremor with this pain may also bring thyroid disorders and cerebellar disorders into the differential diagnosis list.In all probability, this pain has something to do with the depression and the anxiety you report. However, other conditions also need to be ruled out. Therefore I advise you to go through following investigations first:1. Chest x-ray,2. ECG,3. X-ray cervical and upper thoracic spine (digital)4. FT4 (free thyroxine), TSH assay,5. Fasting and post-prandial blood sugar.Along with these you should get yourself examined by a neurologist to exclude nervous system disorders.Once we have the reports, we can discuss them in this forum.If no abnormality is detected in the investigations then probably your suffering is functional and in that case you would need psychotherapy and probably some anti-depressant/anti-anxiety medications.
The pain in the lower part of lung when you breathe fully may be due to dry pleurisy in your lung that may be caused by many reasons like underlying TB, pneumonia or rarely malignancy. I suggest chest x-ray for evaluation of chest causes that may cause dry pleurisy. If nothing is found, on x-ray, you can have non-steroidal anti-inflammatory drugs like ibuprofen for 2 weeks or so to relieve such pain. Other pain described by you seems to me your subjective feeling. If anything is there that will be detected by tests told by me.Most labs accept self testing though I do not prefer it. If the labs insist for a prescription I would appeal you to go see a Neurologist first and then get them prescribed. I am sure your Neurologist would look for the same as tests.
-------------note by doctors end here-----------------
info - over 2-3 years i noticed some foods like instant noodles nescafe/tea with milk/chinese foods with msg/eggs(boiled/fried) aggravate my pain. my diet is vegetarian exception for eggs now stopped no smoke drink very ocassionally. hope this helps
else i did not experience any other symptoms.
thanks a million,
regards XXXXXXX
---------note by doctor starts here-----------
Dr XXXXXXX Maji Replied me hope this will be helpful to you
Recurrent attack of the pain described by you seems to me a vague poorly localised pain and it may be caused by many reasons like spinal diseases, myopathic pain, pain sensation due to depression and panic attack, cervical spondylosis etc. Tremor with this pain may also bring thyroid disorders and cerebellar disorders into the differential diagnosis list.In all probability, this pain has something to do with the depression and the anxiety you report. However, other conditions also need to be ruled out. Therefore I advise you to go through following investigations first:1. Chest x-ray,2. ECG,3. X-ray cervical and upper thoracic spine (digital)4. FT4 (free thyroxine), TSH assay,5. Fasting and post-prandial blood sugar.Along with these you should get yourself examined by a neurologist to exclude nervous system disorders.Once we have the reports, we can discuss them in this forum.If no abnormality is detected in the investigations then probably your suffering is functional and in that case you would need psychotherapy and probably some anti-depressant/anti-anxiety medications.
The pain in the lower part of lung when you breathe fully may be due to dry pleurisy in your lung that may be caused by many reasons like underlying TB, pneumonia or rarely malignancy. I suggest chest x-ray for evaluation of chest causes that may cause dry pleurisy. If nothing is found, on x-ray, you can have non-steroidal anti-inflammatory drugs like ibuprofen for 2 weeks or so to relieve such pain. Other pain described by you seems to me your subjective feeling. If anything is there that will be detected by tests told by me.Most labs accept self testing though I do not prefer it. If the labs insist for a prescription I would appeal you to go see a Neurologist first and then get them prescribed. I am sure your Neurologist would look for the same as tests.
-------------note by doctors end here-----------------
info - over 2-3 years i noticed some foods like instant noodles nescafe/tea with milk/chinese foods with msg/eggs(boiled/fried) aggravate my pain. my diet is vegetarian exception for eggs now stopped no smoke drink very ocassionally. hope this helps
else i did not experience any other symptoms.
thanks a million,
regards XXXXXXX
Dear XXXXXXX
After understanding and reading through your query, it appears that you have been under stress probably after death of your father. And in such conditions back pains, neck pains and poorly localized muscular pains are increased in intensities and durations as well so what I feel is you need to consult a psychologist and get your self evaluated for stress and depression disorders.
Instead of relying on medication if you can undergo few counseling sessions that will help permanently because anti depression medications cause sedation and lethargy and weight gain in long run.
Also, I would like to know if you have undergone any neuro imaging (like a Xray or a MRI) or not. If yes, kindly upload the images using the 'Upload your reports' section. In such pains physiotherapy and counseling have a lot to offer apart from pain medications.
If you have any further query, kindly feel free to ask.
Regards
Dr. Vineet
After understanding and reading through your query, it appears that you have been under stress probably after death of your father. And in such conditions back pains, neck pains and poorly localized muscular pains are increased in intensities and durations as well so what I feel is you need to consult a psychologist and get your self evaluated for stress and depression disorders.
Instead of relying on medication if you can undergo few counseling sessions that will help permanently because anti depression medications cause sedation and lethargy and weight gain in long run.
Also, I would like to know if you have undergone any neuro imaging (like a Xray or a MRI) or not. If yes, kindly upload the images using the 'Upload your reports' section. In such pains physiotherapy and counseling have a lot to offer apart from pain medications.
If you have any further query, kindly feel free to ask.
Regards
Dr. Vineet
Above answer was peer-reviewed by :
Dr. Aparna Kohli
Greetings, Doctor
I really appreciate for you replying to me. I would like to tell you doctor that in the last 5-8 years i haven't undergone any sort of mri or x-ray but I will follow your advice and go through psychologist and hopefully the expert can help me sort out the pain pattern.
Anyways i really appreciate doctor for your reply I will go and see the psychologist first. Doctor, do let me know do i have to do all the tests as prescribed by Dr XXXXXXX Maji Is it necessary?. Or would it be nice if I perform a full body checkup like ( WWW.WWWW.WW just to make myselves feel good that nothing is wrong with health.
If you recommend it i will go for a full body checkup, also consult psychologist and see what is the output.
Awaiting for your opinion..
Thanks a million,
Regards,
AAA
I really appreciate for you replying to me. I would like to tell you doctor that in the last 5-8 years i haven't undergone any sort of mri or x-ray but I will follow your advice and go through psychologist and hopefully the expert can help me sort out the pain pattern.
Anyways i really appreciate doctor for your reply I will go and see the psychologist first. Doctor, do let me know do i have to do all the tests as prescribed by Dr XXXXXXX Maji Is it necessary?. Or would it be nice if I perform a full body checkup like ( WWW.WWWW.WW just to make myselves feel good that nothing is wrong with health.
If you recommend it i will go for a full body checkup, also consult psychologist and see what is the output.
Awaiting for your opinion..
Thanks a million,
Regards,
AAA
Dear XXXXXXX
If your symptoms are not very severe, you may wait until you see a psychologist or a counselor. If your problems are solved after meeting him, then probably you will save a lot of money.
However, if you feel your symptoms are severe then you may consult general physician for relevant investigations required after he examines you. I really appreciate your faith in tele medicine but there is no substitute for good clinical examination of patient. We here can only guide you but for medication and tests, it is better to first, see the doctor personally.
One particular test in your kind of profile, which I feel, is very relevant is thyroid profile. You should get it done.
You may ask me a query directly at this link in future.
WWW.WWWW.WW
Regards
Dr Vineet Saggar
If your symptoms are not very severe, you may wait until you see a psychologist or a counselor. If your problems are solved after meeting him, then probably you will save a lot of money.
However, if you feel your symptoms are severe then you may consult general physician for relevant investigations required after he examines you. I really appreciate your faith in tele medicine but there is no substitute for good clinical examination of patient. We here can only guide you but for medication and tests, it is better to first, see the doctor personally.
One particular test in your kind of profile, which I feel, is very relevant is thyroid profile. You should get it done.
You may ask me a query directly at this link in future.
WWW.WWWW.WW
Regards
Dr Vineet Saggar
Above answer was peer-reviewed by :
Dr. Shanthi.E
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