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Nexk, back, shoulder pain, headache, swollen lymph nodes, blurred vision, groin pain, neck carotid arteries. Done thyroid and kidney tests. Cause?

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Neurologist, Surgical
Practicing since : 1997
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I am a 37 year old female and not being well in the last year. Neck, back,shoulder and head pain on the back side ( when bending down or breathing in , I can feel this pain more). Many times I had swollen lymph nodes on left side of my neck. Blurry vision, imbalance, hand and leg weakness mainly when walking upstairs or doing harder activities, I also had groin pain. Weakness on my throat, sometimes under-active bladder early in the morning. I also had pain on carotid arteries on my neck. I feel very tired/fatigue sometimes. Dry throat sometimes during night time. Feeling cold and I also put on weight 6 pounds in the last 2 months. It happened that my eyelids were swollen in the morning sometimes. My blood pressure is 110/60 , up and down by 10 units , but my heart rate is sometimes over 85 per minute and I feel it. I did FBC and Kidney, Liver, Thyroid blood tests and everything came back as normal. Also EMG and symptoms come and go in the last year. Can you please help me with diagnosing. At the moment I feel weak, cold and have the neck pain and also pain on my back of my head. Thank you XXXXXXX
Posted Tue, 22 May 2012 in Alzheimer's
Answered by Dr. Shivakumar S. Kupanur 15 hours later

Thanks for posting your query.

After going through your history, I feel possibly the neck pain is due to cervical spine pathology like cervical spondylosis or degenerative disc disease. It can even cause hand weakness as you have.

I suggest you to get cervical spine MRI (Magnetic resonance Imaging) done under the guidance of Neurosurgeon to confirm the exact pathology. Whole spine screening will carry additional importance in diagnosing.

Neck exercises, when pain is not severe, will be helpful. Exact treatment will depend as per MRI findings.

I would also suggest you to get yourself checked for Tuberculosis as you have swollen lymph nodes in neck, though your recent weight gain goes against this pathology. Get yourself examined by a Physician and get your ESR (Erythrocyte sedimentation rate) checked.

Recheck your thyroid status to rule out Hypothyroidism by testing your thyroid profile. Even stress can cause the symptoms you are mentioning like neck pain, fatigue, weakness. So avoid stress by regular yoga and exercise.

Take well balanced diet.

I hope, I have answered your query. I will be available for follow up queries if any.

Above answer was peer-reviewed by
Follow-up: Nexk, back, shoulder pain, headache, swollen lymph nodes, blurred vision, groin pain, neck carotid arteries. Done thyroid and kidney tests. Cause? 12 hours later
Dear Dr Kupanur. Thank you for your answer. I am happy with the answer but just wanted to explain more in detail my symptoms and I wanted to make sure if there is anything else possible.

A year ago I had pain behind my head (at the lower occipital bone or where the first neck vertebra is) also the pain spreads on the left side of occipital bone and including the left side of my neck . This symptom comes and goes every couple of months.
Also I had swollen and tender glands on my left side of my neck quite painful which go back to it's small size after a week or two. I had around 5 gland attacks till now.
Furthermore I had back pain for what I did kidney bloods and kidney scan which were fine. The back pain was more at night time and in early mornings.
I had pain on carotid arteries and felt quite pressure on my head and also pain behind my eyes. Blurry vision sometimes especially on the right eye. I have been checked by ophthalmologist and results were fine.
July-August 2011 I had 3 sore throat attacks during this time I had a problem with imbalance.
I also had a mammography in December 11 because of the tender tissue under my left armpit. And the result was fine.
In October 11 I had lots of weakness on my neck, back , arm, groin and legs with lots muscular pain , fatigue so I could not push the baby pushchair or carry him. Lots of fast heart beats, weakness on the throat when swallowing the food. I was in so much pain and could not do much of daily routines. When walking upstairs I felt very tired and weak. When stretching in the morning all my limbs gone very very weak and my heart beat so fast. I have been seen by ENT specialist and found some reflux when inserting the camera inside of my throat. I aslo have been seen by Neurologist and did EMG and NCS on my arms and legs and everything fine. He suggested me to see a Reumatogist.

In December 2011 I started to take some natural tea and drops (made natural as Chinese remedies) to reduce acid uric in urine which helped me but still since October 2011 I do not feel good because I still have been left with weakness mainly on my shoulder and arms(when lifting them) and also on my legs(when stretching them). I can do daily routines but around 15% of my ability to use my body as I want has been lost.
In February 2012 I had dry throat, burning sensation and slightly pain on my tongue which gone after 3-4 weeks.
Since October I also take Neurozan tablets. I am seeing a physiotherapist and will have some treatment regarding my back on the lumbar curve.
In addition to my weakness sometimes I feel dizzy, fast heart beats, imbalance when I have the pain on my neck, restless in morning, shivery and some days I feel quite good. I forgot to mention that in the last year I am loosing more hair than normal. I checked the THYROID in January 12 and all General Bloods are fine, we never checked ESR. When I sleep with hands risen over my head my hands go numb, or certain position at night time make my shoulder pain worse for couple of minutes. I agree that there is something due to cervical spine pathology or brain but also I am very worried if there is anything else also? I also think that can be something related to Cerebrospinal Fluid (CFS) because sometimes when I bend or breath in I find the pain on my neck unusual like nerve pain or fluidly pain, or I think that can be MS(Multiple Sclerosis), or Gout ? How come that these symptoms go worse or better itself sometimes?

Dear Dr Kupanur can you please help me once more with the above.
Thank you for your help.

Answered by Dr. Shivakumar S. Kupanur 21 hours later

Thanks for detailed history.

Your symptoms are more of chronic type. You need to investigate first for cervical pathology. I again suggest you to get MRI Cervical spine and CV (Cranio-vertebral) junction.

You have more of nerve compression symptoms. Additionally, there might be some chronic inflammatory process going on as you have inflamed glands and frequent sore throat.

Meeting Rheumatologist for evaluation will definitely help you. Get your ESR done. Gout can be considered in your case based on symptoms, but it cannot be Multiple sclerosis (MS). MS will have acute severe symptoms. Anyway, MRI will give the exact clue.

I think, there nothing very serious with your health other than some chronic inflammation either due to rheumatological disorder or chronic infection, that is why you have waxing and waning of symptoms. It will settle over a period of time.

Avoid physical and mental stress. Have a healthy life.

Hope, this helps to solve your anxiety. I will be glad to answer any apprehension you have.


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