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Suggest treatment for neck stiffness and choking sensations

Answered by
Dr.
Dr. Anshul Varshney

Internal Medicine Specialist

Practicing since :2009

Answered : 3072 Questions

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Posted on Mon, 17 Aug 2015 in Medicines and Side Effects
Question: Hello, I have a couple questions about neck stiffness and choking sensations that I've been experiencing the past week or two.

I work as a computer programmer and usually stare at a terminal 8 hours a day, I have been in this business 35 years. This is the first time that my neck stiffness and choking sensations have occurred. I walk about 3 miles a day for exercise and lead a generally healthy lifestyle, eat nutritious meals and get 7 -8 hours of sleep each night. Do not smoke, rarely drink. The choking sensations are in the front part of my neck. Also, the past few months I have frequently awakened about 2 - 3 AM and feel the need to sleep the rest of the night in a rocking chair rather than bed. Tylenol alleviates the neck symptoms of late. My mother had thyroid issues in old age, but I don't feel any enlarged tissue anywhere in my neck, and look well in the mirror. My father had a stroke at age 69. I started a new job about July 1st and feel a fair amount of stress from that. I was wearing a badge around my neck the first 3 weeks and it was somewhat heavy so I started putting in my pocket instead, think it was causing the neck stiffness problem. But since I stopped wearing it July 21st, the symptoms haven't gong away. Also, I have Erbs paralysis of my right arm owing to a birth injury during which the delivery doctor pulled on my arm stretching the brachial plexus nerves when I was born in 1958.
I don't know what the long term effects of that are now that I'm 56 years old.
I'm concerned the neck stiffness and chocking sensations will get worse.
I also wonder if the problem are stress induced or have a physical cause.

-- XXXX
YYYY@YYYY
doctor
Answered by Dr. Anshul Varshney 1 hour later
Brief Answer:
Larygeo Esophageal Reflux

Detailed Answer:
Welcome to Healthcaremagic.
Hi, I am Dr Anshul Varshney , I have read your query in detail , I understand your concern.
Based on the symptomatology described by you, your symptoms fit into Laryngeo Esophageal Reflux (LER). This is the most common cause of choking that one gets particularly in night time.
As far as your neck stiffness is concerned, if you are talking about the throat area, it could be due to LER only.

However, if you are taking about the neck area particularly, it seems to be due to Cervical issues only.

With family history of stroke and thyroid issues, you should be little more conscious for these, as you are prone to them.

As far as thyroid issues are concerned, it's not that one would necessarily have enlarged thyroid area in case of thyroid issues. You should get a thyroid profile done for the purpose.
I would also advice you to get following tests done on routine basis:
1. fasting blood sugar
2. Lipid profile
3. Blood Pressure monitoring.

Now, as far as LER is concerned, i would advice you to get:
1. Upper GI Endoscopy- To rule out Peptic ulcers, and Hiatus hernia causing reflux
2. Ultrasound Abdomen- To rule out Gall Bladder stones.

I would advise you to take a combination of Pantoprazole and Domperidone and to take anti flatulent and anti acidity syrup like Digene/Gelusil for symptomatic relief. Don't consume any alcohol.
Take soft and bland diet and walk after all meals.

This is my personal opinion based on details available here. If you still have any other query, you may please ask me.
Stay Healthy.
Dr Anshul Varshney , MD

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Anshul Varshney 8 hours later
Hello Doctor,

Thank you for your reply.

I don't seem to have any gastro-intestinal problems. My digestion is
normal and I never have heartburn.

Can you please expand on the cervical neck issues?
I'm round-shouldered so my head slumps over my chest more than normal.
And my neck muscles seem weak. I find my neck stiffens
after sitting at a computer terminal or reading a book for several hours.
Is this a sign of arthritis? Can this also cause the choking sensations?
Are there neck muscles I can do? I've also noticed that my neck
thickness has decreased the last few years -- is this a symptom of aging
and can it lead to these problems?

I went to a health clinic yesterday and my vital signs seemed normal:
BP 106/60, pulse 53, temp 98.1, weight 205, height 6'1". I was evaluated
by a cardiologist 7 months ago and he didn't think the low BP and pulse
were abnormal or a problem, and he ran EKG, echo cardiogram and 24-hour
monitoring tests which came out normal.

Thank you!
XXXX
YYYY@YYYY

Oh, one other thing. This morning my neck seemed OK after waking up.
It was bothering me a lot last night when I was carrying groceries home --
stiffened and choking sensations. So it seems like my neck stiffens and
tires during the day. Is this a further symptom of arthritis?
doctor
Answered by Dr. Anshul Varshney 52 minutes later
Brief Answer:
Start Cervical exercises.

Detailed Answer:
Hi.
If you feel there it's not related to LER still then I would advice you to take Pantoprazole and Domperidone and see the effect.
Now as far as Cervical related issues are concerned, you should start Cervical strengthning exercises.
People with short neck are prone to have obstructed sleep apnea that can also cause the choking symptoms.
In case if there is really a weakness of neck muscles (that you describe as thinning) then you should go for MRI Cervical spine done to be sure there is no Cervical nerve compression or any degeneration of the Cervical spine.
The MRI would also clear if there is any Cervical Arthritis.
Start exercises, do regular hot fomentation of the neck.
You can also use a Cervical collar for the giving support to your neck specially when you are at your desk for work.
If you have any further query, please ask me.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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