Brief Answer:
Muscle strain vs. nerve contusion

Detailed Answer:
Good morning- My name is Dr. Saghafi and I am a neurologist. I have read your question and information as to how you may have injured yourself. I have also read your question in similar format and content to 2 other network physicians as well as their responses. Please accept the following direct answers to each of your questions. Hopefully, you are continuing to get better. I will copy some of the most important information from your consultation request:
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I feel a small pressure on the spot, as if some was pushing a finger into my head.
I have it all the time. I got those feelings next day in the afternoon and have had it for 2 days. It doesnt hurt but I don't like it.

COMMENT: It appears that this symptom is slight different from what you described your sensation to be while Dr. Spaho answered your question which is the feeling of a "tickling sensation/pins and needles on the spot. Like a small a small pressure. It doesn't hurt but I don't want it."

It would appear that this complaint is different from the current one of "...as if someone was pushing a finger into my head."

You no longer mention anything about the tickling sensation or pins and needles which is uncomfortable.

I think a nerve is being pinched.


1. What do you think this is?

RESPONSE: If may have at first had symptoms as if a nerve were being pinched with the feeling of pins and needles and pressure at the point of contact, however, he seems to be quickly evolving therefore, I believe a strained or pulled muscle in the neck or possibly shoulder is more likely. It is also possible that a nerve branch could have been contused or bruised in the process of committing this injury.

2. Do you think it has to do with the "sharp whip"?
If so why wouldnt I feel it same day it happened?

RESPONSE: Hard to say whether it was caused by the "whip" of the neck or was a consequence. I think that it would be very difficult for a person to jerk their heads so forcefully or violently that they could actually entrap a nerve like this unless the nerve was on the verge of being entrapped anyways or muscle spasms were already present or imminently present from a condition such as heavy physical exertion, dehydration, or trauma. Certainly a BLOW to the head as in an accident or being struck in the head with an object or a fist or falling on the ground and striking the head could produce enough of a rebound of the neck to produce these symptoms but not from oneself simply flicking their head in response to dozing off in an armchair or similar situation.

3. Do you think time can heal? After some days it might get over?

RESPONSE: I believe that time is already causing this injury to heal and things to get better. I wouldn't be surprised that by the time you even read this response if things are not much better.

4. What should I do now? I mean how could the doctor solve this? Treatment?

RESPONSE: I don't think you necessarily need to make a special trip to either a doctor or emergency room. I believe conservative treatment with ice packs over the area of concern for 20-30 minutes at a session and 2-3 sessions per day will quickly resolve the problem. I also believe that for every session you have using the ice pack you should do some very gentle stretching exercises with your neck in both the forward, backward, sideways, and rotating directions. Do not overdo the stretches and do not do them quickly. 5-10 repetitions for each exercise. Total time doing stretches- 5 min. per ice pack session for the next 3-5 days only.

5. Can this be anxiety for some reason?

While I'm sure the initial stages of the problem were anxiety provoking for you because the discomfort did not initially disappear I do not believe that ongoing symptoms and especially as they've evolved or changed can be blamed on simple anxious feelings.

I hope these answers satisfactorily addresses your question. If so, may I ask your favor of a HIGH STAR RATING with some written feedback?

Also, if there are no other questions or comments, may I ask you CLOSE THE QUERY on your end so this question can be transacted and archived for further reference by colleagues as necessary?

Please direct more comments or inquiries to me in the future at:

bit.ly/drdariushsaghafi

I would be honored to answer you quickly and comprehensively.

Please keep me informed as to the outcome of your situation.

The query has required a total of 48 minutes of physician specific time to read, research, and compile a return envoy to the patient.

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Brief Answer:
Highly unlikely to be permanent

Detailed Answer:
I am sorry you feel that nervous of things, however, sometimes it can take more than a few days to work out problems such as muscle strains or even pinched nerves if that's what this is....since you had written to me the first time that you had the pins/needles sensation my impression was that it had resolved. Now, you say it's there. Therefore, perhaps you do a small pinched nerve or nerve branch which is giving that sensation.

However, if based upon the injury you noted a few days ago then, my expectation is that with conservative treatment of applying some ice packs initially and switching to some heat as well as performing the gentle maneuvers I mentioned in my first note, your symptoms will improve.

But again, this is nothing to be worried or afraid of and you should go about your daily business without thinking too much about it and you will notice that it will have gone away soon enough. You may also take some acetaminophen, aspirin, or ibuprofen if you'd like but my guess is the dose need not be high at all.

At this time you may switch your regimen to some warm moist towels applied for 20 min. at a time 2-3x/day over this area and this will make it feel very good.

I hope these answers satisfactorily addresses your question. If so, may I ask your favor of a HIGH STAR RATING with some written feedback?

Also, if there are no other questions or comments, may I ask you CLOSE THE QUERY on your end so this question can be transacted and archived for further reference by colleagues as necessary?

Please direct more comments or inquiries to me in the future at:

bit.ly/drdariushsaghafi

I would be honored to answer you quickly and comprehensively.

Please keep me informed as to the outcome of your situation.

The query has required a total of 57 minutes of physician specific time to read, research, and compile a return envoy to the patient.

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Brief Answer:
Relaxation techniques are a great idea

Detailed Answer:
I'm sorry that you are still being bothered by this entity. If conventional approaches with ice packs and stretching doesn't seem to help or if it makes you feel less comfortable then, by all means I am in favor of relaxation sorts of techniques....including listening to what is bothering you about this pressure you refer.

Perhaps, you can upload a snapshot of exactly where around your head/neck this point of pressure is located so I can more readily envision it as you describe?

I don't think anybody can tell you with absolute certainty how long this sensation will last. The assumption on all the doctors' parts (as well as yourself) is that it is somehow related to when you were sitting in your chair the other day leaning your head forward. I believe I've done the same thing at times when trying to OVERstretch my shoulder or hand in an attempt to get something from the ground and felt a sudden twinge. Therefore, a reasonable assumption is that conservative approaches for a few days should solve the problem.

If in your case it's not the case then, I'm not sure how to "guess" the number of days more that you may feel this but I can tell you that doing deep breathing exercises, engaging in meditative thoughts, very much in the style of yoga and similar "mind clearing" exercises can help something like this dramatically. I am no expert on these techniques by any means, however, I have patients that do these maneuvers for pain syndromes and tell me that it works very well for them.

The other thing I might counsel you to try is a warm pack instead of ice. Not uncomfortably warm mind you but warm enough for you to tolerate a session of about 15-20 minutes and to be able to repeat that process at least twice daily. Perhaps, a calming and relaxing massage would be soothing as well.

I would want to counsel you AGAINST CHIROPRACTIC MANIPULATION of the neck, however, even though many people may give you advice in favor. Many of the maneuvers of chiropractors place the neck and the main blood vessels in that area in jeopardy for damage which can be devastating so I do not support these maneuvers.

From your description of the situation I would say that there is a possibility that this has irritated a branch of one of your cervical nerves that supply that portion of the skin and muscle of your neck. If that is the case then, recovery time can vary from hours, to days, to weeks. I've had such things happen to me due to the type of workouts I perform and I can tell you that I've also experienced such "nerve pinches" which have taken ALL OF THESE LENGTHS of time to heal. I would say to you there is nothing to worry about in such cases because healing is automatic but it is true that irritated nerves can be a little stubborn in terms of speed of recovery so I would be patient and really not think too much about it. Instead focus on relaxing and doing relaxation maneuvers on a daily basis.

I see no role for surgery as a treatment for this type of event from the information you've presented. My hope is that you will start feeling better sooner rather than later and that you will try implementing some of the relaxation techniques I've mentioned.

It would also be greatly appreciated if you'd close the query at this time so that the transaction may be settled for end of month tallies but by all means we may renew these discussions under a separate thread if you so desire.

It would be honor to answer your questions quickly and comprehensively.

This query has required a total of 80 minutes of physician specific time to read, research, and compile a return envoy to the patient.

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Brief Answer:
I believe you're improving but it can take a LONG TIME

Detailed Answer:
Thank you for your updated information.

Every time a patient asks a question and obtains a response from a physician they will then, have the option to CLOSE THE QUERY or CLOSE OUT THE QUESTION. I'm not exactly sure what the verbage is on your end because I don't know what your screens look like. However, there should always be a way for you to CLOSE DOWN THE QUESTION and then, RATE THE DOCTOR'S ANSWER(S). The rating system is on a STAR system which goes from 1-5. The better you like the interaction you had with the doctor the higher the number of stars. You may also leave feedback of a written nature which doctors very much appreciate and which also can help us when other patients look at our profiles and decide whether or not they'd like to consult with us...make sense?

Again, I don't know exacty what your screens look like on your end but Technical Support could probably help you to walk you through the process of CLOSING DOWN THE QUERY and then, rating my work (which I hope you find useful and deserving of a high star status and positive comments). By the same token if you find a doctor's responses unsatisfying or less than professional, etc. then, you are at your XXXXXXX to make appropriate comments to let the doctor know why you are less than thrilled with their answers.

As far as re-opening the thread with a new charge of questions- if you are happy with my answers and how I've been advising you throughout this case then, you may return to my service and direct your next set of questions to me (usually a total of 3 or 4 in total per charge) by simply going to the following web address: bit.ly/drdariushsaghafi

That will take you to my webpage on this network and then, you can enter your question as a DIRECT QUERY to my attention. I will be notified of your inquiry and then, answer you as I have been. Make sense? Again, if there are more questions on how to accomplish this (called a DIRECT QUERY) then, TECHNICAL SUPPORT would be able to walk you through the process.

As far as your condition is concerned....my impression from what you've described is that you are SLOWLY getting better. The feelings you describe are very consistent with a "pinched nerve" and the time to heal can be days, weeks, or months. In some cases the problems may never go away, however, in your case I get the impression that you are little by little making some strides.

Don't be so totally focused on minute details (I know to you they are EXTREMELY DISTURBING events that you may not view as "details"....but trust me when I tell you that your symptoms, as you're describing them would be classified as very, very mild in the whole scheme of things).

We can speak in more specific terms in the future if you choose to recharge your thread with me as your physician...which of course, I am happy to do if you'll agree.

And so would you do the favor of CLOSING THIS SET OF QUESTIONS and rating the responses as I described above?

This query has required a total of 100 minutes of physician specific time to read, research, and compile a return envoy to the patient.

Cheers!

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