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Dr. Andrew Rynne

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What causes pain in the neck and head while lying down?

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Dr. Ahmed Aly Hassan

Orthopaedic Surgeon

Practicing since :2002

Answered : 441 Questions

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Posted on Mon, 3 Apr 2017 in Back Pain
Question: Can I ask a question on behalf of my fiancé who currently lives in Kazakhstan please? Public health there is very poor and doctors usually unhelpful and uncommunicative. She has had pain in her neck and head for several months, especially when she lies down. I at last persuaded her to visit a doctor. It took several visits to get anywhere. She has had a neck x-ray but the doctor has not explained what she saw on it so my fiancé is none the wiser. However she has put on a 10 day course, each day receiving 3 injections in her bottom of Artoxane, Benevron B and Diclofenac plus intravenously through her arm Actovegin. On checking online I note that of the injections two are anti inflammatory and one for nerves, whilst I believe Actovegin is a performance enhancing drug. I am very concerned because there does not seem to have been proper process and analysis leading to this prescription and I am particularly worried about the length of the course of so many simultaneous medicines. I regret I do not know the dosage being administered and the nurse doing it bites ones head off if a question is asked. If something was seen on the x-ray nothing has been explained to my fiancé. Can you firstly advise me please about the safety of the medicines and secondly whether the action taken seems normal for someone with the complaint of long term neck and head pain. I am not medically trained but I looked online for symptoms of brain tumour and my fiancé is not nauseous, is not having vision or hearing problems or any kind of fit.

Further to the above, do you think an MRI scan of her head should be requested as there appears to have been nothing done to actually address the problem of the constant headache, especially when she lies down. Could it be stress related as she looks after her daughter's extremely active, demanding and noisy son and finds this very difficult?
doctor
Answered by Dr. Ahmed Aly Hassan 52 minutes later
Brief Answer:
Hi i am Dr Ahmed Aly thanks for using HealthcareMagic site , I had gone

Detailed Answer:
Hi i am Dr Ahmed Aly
thanks for using HealthcareMagic site ,
I had gone through your question and understand your concerns ..


In my opinion the medication is fine and i do not think a 10 day course is extensive , from your given history i think she may have a kind of cervical spondylitis .
May be her doctor will shift to tab form after that 10 day period .some doctors choose injection prescriptions as a beginning as they may have stronger and faster relieving action for her pain symptoms then shift to tab form to maintain her pain status and prevent them from coming back .
Hope your wife feels better soon and i think her constant headache is due to stress or blood pressure instability . i think lying down affects her vascular profile and thus her pressure may increase while lying causing such headache .
For my patients i may recommend some B12 supplementation and hot massages with topical gels will be helpful .
Try to let her follow her blood pressure more frequently for a 4 day period to rule any blood pressure problems .
If the pain and headache persists i suggest CT and MRI on her brain to exclude any masses that may cause such pain . you mentioned that she does not have nausea or vomiting so i think by the treatment and some relaxation and rest she will be fine .



Please click and consider a 5 star rating with some positive feedback if the information was helpful. Wish you good health,
Any further clarifications feel free to ask.
Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. Ahmed Aly Hassan 32 hours later
Hello Dr XXXXXXX Aly,

Very many thanks for your helpful advice and I am reassured to know that the cocktail of 3 injections and intravenous Actovegin daily for 10 days is all right.

My fiancé has mentioned some other matters now. She says the pain in her head is constant but general; she cannot identify a particular place in her head where she feels it most. She also says that over the last few months she feels that she is not remembering things so well. It is not people she forgets but more things like where she has put something. And thirdly she has now said that about a week ago she did have one standing black out. She had NOT stood up quickly but was standing talking when she says her vision went black for a few seconds. However she remained conscious and did not fall and just held on to a table.

Finally I have some copies of the neck x-ray she had about two weeks ago. I mentioned above that the doctor had not made any comment on this x-ray so she has no idea what it showed. It would be really useful if you could take a look. Whilst I know photographed x-rays might not be as clear as the real thing the quality of the photos seems quite good and you might be able to spot something out of the ordinary. Unfortunately there is no way of attaching the jpegs to this reply so could you advise me how I can do this?

Thank you so much for your help so far.

Regards, XXXXXXX
doctor
Answered by Dr. Ahmed Aly Hassan 14 hours later
Brief Answer:
Digital X rays or MRI are the best diagnostic tools, you can upload them, click the button on the right hand side of this page.

Detailed Answer:

Hi I am Dr Ahmed Aly


You may ask for a digital x ray for the best clearance

There is a button on the right hand side of this query, please use that to upload reports or images, if you are having any difficulties in uploading the reports, please send those reports as attachments by email to the HealthcareMagic customer care at YYYY@YYYY , with the following as the subject, "Attn: Reports for Dr Ahmed Aly Hassan".



Hope that helps you


Any further clarifications feel free to ask
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Ahmed Aly Hassan 2 days later
Hello Dr XXXXXXX aly,

I was unable to send the x-rays as attachments because they were forwarded to me via a XXXXXXX phone. So I have sent two emails to: YYYY@YYYY which I hope they can still forward to you as emails. The emails are named "Attn: Reports for Dr XXXXXXX Aly XXXXXXX - x-ray 1" and a second named x-ray 2.

Thank you for your help.

Best wishes, XXXXXXX
doctor
Answered by Dr. Ahmed Aly Hassan 6 hours later
Brief Answer:
follow-up advice

Detailed Answer:
Hi again,

I have seen both the X-rays. The anteroposterior view may show mild cervical muscular spasm that causes nerve compression on the cervical spinal roots which supply the neck, shoulders, arm, forearm and hands.


Such compression may make her feel a kind of neuropathic pain, numbness, tingling. Not to worry, some relaxation and spinal straightening exercises will be helpful. muscle relaxants, Tylenol tabs when needed, hot massages with topical gels will be effective for most of cases.

If pain persists I'd recommend her to visit the neurosurgeon for a thorough re-evaluation and management accordingly, some endoscopic interventions may be recommended in severe cases.

Let me know if I can assist you further.
Regards


Above answer was peer-reviewed by : Dr. Arnab Banerjee
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