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Diagnosed with lipoma. Pain in neck and base of skull. Are they related?

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Orthopaedic Surgeon
Practicing since : 1994
Answered : 10334 Questions
Hi , I have had a bump on the left side of my neck for three years now, ever since an injury resulting from a suitcase striking the left side of my head. At that time, the ER called it an edema, it has also been called a spasm and now my docs have said it's a lipoma. My neck has been in significant pain and I have had chronic daily headaches ever since, left side worse than right and the head pain seems to refer from that neck area. I was told after a general cervical mri that it is subcutaneous and well-encapsulated, that the pain is just coincidental and it's likely underlying structural issues (ligaments that may have torn that never healed properly) that is the source of my pain and the lipoma is likely not impinging on nerves. The quality of the pain is very burning and sharp (stabbing) through mid-neck and base of skull and refers up the left top of skull. I did hear some crunching sound when the suitcase fell on the left side of my head. I have tried everything - PT, every pain medicine known to mankind, ice, heat, stretches... It also seems to constrict movement and is tender to the touch. I go through two jars of Tiger Balm a week. I don't have precise measurements but I would say it is 5 cm long and likely deep. Could this be a possible source of pain and what is the best imaging to show what's going on? Thanks so much!
Posted Wed, 23 Oct 2013 in Back Pain
Answered by Dr. Praveen Tayal 3 hours later
Brief Answer:
MRI and FNAC will help in exact diagnosis.

Detailed Answer:
Thanks for posting your query.
The soft tissue swelling at the back of your neck on the left side can be best imaged by an MRI scan. Since it is a well encapsulated mass, it can be a lipoma or a neurofibroma which can cause some compression symptoms. The exact nature of the lump can be detected by an FNAC.
The crunching noise that you heard at the time of injury could be due to a ligament damage that can cause the pain that you are having now but an MRI scan of neck should have detected any such injury.
It is best to consult a neurologist and rule out the causes of one sided primary headaches like migraine. Doing a hot fomentation and a light massage in the area might help you for a short term relief.
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.
Wishing you good health.
Dr. Praveen Tayal.
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