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Prescribed Norco, Percocet, Flexeril And Ibuprophen For Pain. But Have Throbbing Pain In Neck Radiating To Shoulder. Suggest?

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Posted on Fri, 23 Aug 2013
Question: I was prescribed Norco 5-325mg,percocet 5-325mg,flexeril 10mg,ibuprophen 800mg for pain, the pain meds take away my other pain and knock me out.but doesn't help the throbbing pain/pressure on right side of neck.The pain radiates from shoulder to jaw around ear to back of head but the pressure and severe pain are in the neck. I do not think it is a muscle spasm.I have had a sore neck and had to get cortisone shots before and this pain is nothing like it. have taken all drugs above plus ice,heat,massage. what can I take to help this pain?
doctor
Answered by Dr. Chobufo Ditah (2 hours later)
Hi,
Thank you so much for this query.

I am so sorry to hear about this severe pain that seems to defy a good nuumber of good pain medications.

From the description of your pain, the severe nature and its resistance to respond to a good number of pain medications, I will like to pause here and re-evaluate this pain. Most pains in at the neck are often due to poor head positioning either during an activity, sleep, abnormal head movement etc. They classically respond to pain medications. Because this one is resistant, we may want to look into other possible causes.

We need to make sure there is nothing bad going on at the neck region where the pressure and severe pains are. We need to evaluate all the structures of the neck(bone, muscles, thyroid, larynx and lymph nodes) through a complete clinical exam and do some tests like Xray, CT scan, Ultrasound depending on the clinical clues to make sure there are no abnormal growths/conditions there that may explain why you have this pressure feeling and pains. It is only after this comprehensive investigations that I may consider more powerful pain medications if no possible cause is found.

For now, my suggestion is to continue the same pain medications and various relief measures while you book an appointment to XXXXXXX an ENT specialist to evaluate and treat these symptoms if they should persist beyond 4days. At times medications take a little longer before we get real relief. At least you must have noticed a mild relief in this pain intensity unless it is extraordinarily so.

I hope this addresses your query and provides guidance on the way forward. If there are however any answers you would have wished i provided that i didn't address, then please ask more follow up questions. I am ready and happy to address them.
I wish you a speedy relief from this pain.
Dr. Ditah, MD.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Chobufo Ditah (2 hours later)
My doctor didn't seem as concerned about my neck as he was with my abdomen swelling and knot protruding thru.
I will make a appt then with ENT.I was prescribed these Thursday 7/11/13 the pain has been going on for over week.I wish I had known I needed a cat scan of my neck. Thursday I had 8 xrays done and Friday had a abdomen/pelvis cat scan done with oral contrast.
Thank you again for your time

doctor
Answered by Dr. Chobufo Ditah (4 hours later)
Hi and thanks for this follow up precision.

I have a feeling that there seems to be much going on beyond the simple neck pain. Having read through the series of tests you have done, the swollen abdomen with a protruding knot, i feel like you have some other symptoms that you did not mention. Please, remember doctors see you as a whole and not that person with an isolated neck pain. So, a comprehensive presentation of what you are experiencing would have been very helpful. I feel I have been very limited approaching your query because of so much undisclosed information from you.

If I may ask, what was your doctor looking for before going about doing all of these abdominal scans? I hope you don't mind!

I wish you well and do hope we figure out the root cause and offer you some relief as soon as possible. All the best!
Dr. Ditah, MD.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Chobufo Ditah (3 days later)
I apologize, I just wanted to know what the cause of my neck pain was because yes the meds prescribed are very strong and I still had a the intense pain in my neck.I do not like taking strong pain meds.
I have been putting off making the appt with my doctor for my neck and stomach pains.What finally made me make the appt. was after being delayed 5+hours on the runway at LaGuardia and not getting home till 1 am on 7/9/11.it was late when we got home the luggage was brought in I tripped over the handle and my toe swelled up turned all colors of the rainbow.I made appt for my toe to see if it was broke,then I told him of my other symptoms and he examined me and ordered x rays of my toe and chest and abdomen.Then he said it looks like I have a umbilical hernia and the bowel has stool in it.Then he ordered th ct scan for the next day. Which I received the results in the mail the other day.
I have a surgery consult for hernia 8-5-13.The results of cat scan I do not really know what to make of them except the hernia being confirmed and my toe is not broken-I get that the other stuff not sure what it means.
Here is my xray and ct results
XR Abdomen,Supine,Upright w/chest 1 view-

Abdomen x-ray- Findings:A moderate amount of stool is identified throughout the colon.There is no evidence to suggest bowel structure.Surgical clips are seen within the right upper quandrant from cholecystectomy.On the upright view of the chest,lungs appear clear.
The osseous structures appear unremarkable.
Impression: Moderate amount of stool is seen throughout the colon.

Left foot:No definite fracture is identified.

CT ABD/PELV
Lower Thorax:Unremarkable.No pulmonary mass or pleural effusion.Heart size within normal limits.No pericardial effusion.

ABDOMEN:
Liver:-Low-attenuation of the liver parenchyma compared to the spleen suggesting fatty infiltration.No discrete masses.Patent hepatic veins and portal vein
Gallbladder & biliary system:Cholecystectomy.No ductal dilation.
Spleen: Normal
Pancreas:Normal
Adrenal glands: Normal
Kidneys and Collecting System:Both kidneys enhance symmetrically.There is a 2mm calcified stone mid pole calyx on the right.
Gastrointestinal tract: Normal.Appendix is normal.
Peritoneum/Retroperitoneum: No adenopathy.No ascites.No free air.
Vascular:Abdominal aorta and its major branches are unremarkable.No aneyrysm.

PELVIS:
Urinary bladder: Normal
Reproductive organs: Normal uterus no adnexal masses
cont... below
Continue of the rest of the CT Results-

Peritoneum/Retroperitoneum: No adenopathy.No ascites.No free air
There is a umbilical hernia containing some mesenteric fat to midline fascial defects just to the right of midline measuring 16 mm & midline slightly inferior left sagittal defect at the umbilicus measuring 18mm.No stranding or inflammatory changes in the herniated fat to suggest incarceration.The overlying skin thickening.
Vascular: Normal.

Musculoskeletal: No aggressive appearing osseous lesions.
doctor
Answered by Dr. Chobufo Ditah (3 hours later)
Thank you so much for this follow up information.
Honestly, I must applaud your efforts to put all of these results in writing for me to review. Sorry about the toe trauma. Hope it is getting better.

I have taken time to read over all of the reports. Though umbilical hernia and right kidney stones have been identified, I don't think they need any medical attention now unless they should cause some further problems. Don't bother about them just yet but stay alert for any abdominal symptoms that may indicate the need for further evaluation and maybe treatment.

How is the neck pain at this time? If it hasn't gotten better, then I will suggest you go on and set the appointment with your ENT as i mentioned earlier. However, if you are feeling a lot better, you can call this off. Can you update me on what the present state of the neck pain is? Thanks.

I wish you good health.
Dr. Ditah, MD.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Chobufo Ditah (48 hours later)
The neck pain is somewhat better but I am getting a headache everyday in the back of my head on the rightside ,the pain is still in my neck , the pressure has subsided some.I go to sleep at night with a ice pack on my neck and take a pain pill or muscle relaxer and 800mg motrin.I have a appt with a ENT 8-1-13.I think the motrin helps more with the pain.I can't take the Percocet and the Flexeril every night.It makes me very sleepy and I can't function the next morning.I have been taking one or the other only if the pain gets to extreme level and a motrin everynight.
]I guess the hernia is what was causing the twisting and pain when I would cough or bend and move a certain way.I didn't know I had a kidney stone but it explains why I get pain sometimes in my lower back on right side and my urine has been dark like tea color and sometimes it is orange color.I just thought I was dehydrated or drank to much fruit juice,so I increased my water intake.

Thank you again for your time and I will let you know what the ENT says.
doctor
Answered by Dr. Chobufo Ditah (15 hours later)
Hi and thanks for these updates.

I am happy to know you are getting better. I wish you even more total pain free days as soon as possible. Which ever drug works better for you should be preferred over others.

All the best as your XXXXXXX and explore further answers and treatment options with your ENT. I wish you well.

Dr. Ditah, MD.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Chobufo Ditah

General & Family Physician

Practicing since :2009

Answered : 6323 Questions

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Prescribed Norco, Percocet, Flexeril And Ibuprophen For Pain. But Have Throbbing Pain In Neck Radiating To Shoulder. Suggest?

Hi,
Thank you so much for this query.

I am so sorry to hear about this severe pain that seems to defy a good nuumber of good pain medications.

From the description of your pain, the severe nature and its resistance to respond to a good number of pain medications, I will like to pause here and re-evaluate this pain. Most pains in at the neck are often due to poor head positioning either during an activity, sleep, abnormal head movement etc. They classically respond to pain medications. Because this one is resistant, we may want to look into other possible causes.

We need to make sure there is nothing bad going on at the neck region where the pressure and severe pains are. We need to evaluate all the structures of the neck(bone, muscles, thyroid, larynx and lymph nodes) through a complete clinical exam and do some tests like Xray, CT scan, Ultrasound depending on the clinical clues to make sure there are no abnormal growths/conditions there that may explain why you have this pressure feeling and pains. It is only after this comprehensive investigations that I may consider more powerful pain medications if no possible cause is found.

For now, my suggestion is to continue the same pain medications and various relief measures while you book an appointment to XXXXXXX an ENT specialist to evaluate and treat these symptoms if they should persist beyond 4days. At times medications take a little longer before we get real relief. At least you must have noticed a mild relief in this pain intensity unless it is extraordinarily so.

I hope this addresses your query and provides guidance on the way forward. If there are however any answers you would have wished i provided that i didn't address, then please ask more follow up questions. I am ready and happy to address them.
I wish you a speedy relief from this pain.
Dr. Ditah, MD.