What causes severe upper neck and shoulder pain?
Question: I had an ACDF of c6/c7 in 2011, RA for 15 years. Surgery went well, no complications, happy with results. Follow-up MRI at 1yr showed slight posterior bulge at c4/c5 with anterior osteophyte. All has been fine until this year. It seems I have had some increasing upper neck/shoulder pain begginning in XXXXXXX 2014 and peaking after a snorkeling trip in March 2014. The pain was strong enough in the neck, head, shoulder, pectoral region that I could not sleep or ride in a car without the aid of hydrocodone for a few days. I visited my primary when the pain was still present after 2 weeks. He suggested I wait to see if it improved on my own, no meds were prescribed. It seemed to settle, flares on occasion with increased activity. I had a week off of work and returned today. The pain is back again. I teach and have to write on the board quite a bit. I have upper posterior neck pain that wants to radiate over the right side of my head towards my forehead. I have dull pain or tingling on both arms from the top of my shoulder to just above my elbows. If it gets bad enough, the pain goes across my clavicle, to my jaw, ears, and on the outside of my lower leg. Since it comes and goes, I'm trying to dtermine at what point I need x-rays or a repeat MRI. I have insurance, but money is tight right now (tax day) and my co-pay is $50 for a specialist.
Brief Answer: Please, get an Xray first and then MRI is needed. Detailed Answer: Hi and thank you so much for this query. I am so sorry to hear about this pain. The history of osteophytes and the characteristics of this pain makes it concerning for a possible nerve compression or narrowing of spinal cord/nerve passages. It seems to really follow nerve roots making this suspicion somewhat very strong and likely to be confirmed. It would be best to get some imaging studies done to find out what the exact problem is and to establish a treatment plan. otherwise, we would keep guessing, not addressing the exact problem and not making any meaningful progress. In all, go for imaging studies. It is not an emergency and you can plan on doing that later. I wish you well. Feel free to ask for more information and clarification if need be. Thanks for using our services. Dr. Ditah, MD.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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