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Having shoulder and neck pain. Asked to go for X-ray. Need suggestion

Jul 2013
User rating for this question
Very Good
Answered by

Orthopaedic Surgeon, Joint Replacement
Practicing since : 1996
Answered : 2148 Questions
Hello Doctor,
I had posted a query for a general physician some days back as follows for my wife and want to take an expert opinion now:

"I am having shoulder and neck pain (mainly right side), specially after getting up from from bed early morning.
The pain also happens when I take physical/mental stress.
This has been there for couple of years now. I have consulted a Physio and a homeopathic doctor.
Physio suggested some sessions for massage/exercise, but it did not help much.
Homoepathic medicine taken for a couple of months, helped in relieving pain to some extent.

Doctor's reply to your question above...
Brief Answer:
Possibility of extra cervical rib or loss of curvature

Detailed Answer:
Thanks for posting query.
From history it seems that your wife Smt XXXX, age 31 years of age might have following things which can give rise to problem of having stiff neck and shoulder of right side perticularly in the morning.
1, Might have Extra cervical rib,
2, Loss of normal curvature of neck spines.
At this age degenerative changes of spines are less likely.
Loss of normal curvature might be due to altered posture of sitting or some works involving neck muscles more.
Early morning due to remaining neck muscles on one side through out night and having constant pressure on nerves might be causing this problem.
Extra cervical rib too can cause irritation or pressure in nerves giving rise to this problem.
Go for X-ray cervical spines, which will give some information of condition.
Consult orthopedic surgeon and get examined.
Physiotherapy of neck and shoulder muscles, short way diathermy will be helpful.
Advice her not keep pillow under neck while sleeping.
Give her calcium, vitamin A and D supplements.
I hope, i answered your query."

Based on this, could you tell me if we should go for an XRay or any other test to start with?
Posted Tue, 5 Nov 2013 in Bones, Muscles and Joints
Answered by Dr. K. Naga Ravi Prasad 21 hours later
Brief Answer:
Might be due to Cervical disc disease

Detailed Answer:
Hi, thanks for writing to XXXXXXX

If your pain is primarily starting from the neck region and spreading into the shoulder, it signifies some problem in the cervical spine. Most propably, it could be due to a cervical disc protrusion. An MRI scan of the cervical spine will confirm the diagnosis.

If the pain is starting in the shoulder and radiating into the neck, it could be due to a rotator cuff lesion of the shoulder. The movements of the shoulder joint will be painful and restricted in this case. Here also, MRI scan will confirm the diagnosis.

As the symptoms are persisting since years, a detailed evaluation is necessary for establishing the correct diagnosis.

The conservative management of cervical disc disease is as follows -

Soft Collar: Soft collar allow the muscles of the neck to rest and limit neck motion. This can help decrease pinching of nerve roots with movement. Soft collars should only be worn for short periods of time, because long-term wear can decrease the strength of neck muscles.

Medicines: Analgesic are needed in the acute phase. Muscle relaxants are essential for relieving muscle spasms once the acute pain subsides. Neurotropic vitamins like METHYLCOBALAMINE (activated Vit B12) or PREGABALIN will help in alleviating the neuropathic pain.

Cervical traction: may enlarge the disc space, permitting the prolapse to subside. Intermittent cervical traction for not more than 30 minutes at a time.

Physiotherapy: Once the acute phase of pain has subsided, Isometric strengthening exercises of the paravertebral muscles are started. Improving neck strength and flexibility with simple exercises may lessen discomfort and pain. Moist heat can be useful

Hope I have addressed your query. Happy to help further

Above answer was peer-reviewed by
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