[21F] Experiencing persistent upper back and neck pain

Patient Description

A 21-year-old female has been experiencing persistent upper back and neck pain described as sharp and piercing. The pain is primarily located in the middle of the upper back and is occasionally accompanied by neck pain, which feels like muscle strain from holding her head up. The patient reports that the pain has been ongoing for a few months and rates the neck pain severity as 5 out of 10. Additionally, she experiences numbness, tingling, or weakness in her arms or legs. There is no relief from the pain with any specific activities or treatments. The patient denies any recent injuries, loss of bowel or bladder control, fever, or unexplained weight loss.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are a few possibilities:

  • Muscle Strain or Sprain: This is a common cause of back pain, especially if the pain is associated with certain movements or positions. It can occur due to overuse, poor posture, or a sudden awkward movement.

    • Treatment typically involves rest, over-the-counter pain relievers, and physical therapy exercises.
  • Herniated Disc: This occurs when the soft material inside a disc in your spine pushes out through a crack in the outer casing. This can irritate nearby nerves and result in pain, numbness, or weakness in an arm or leg.

    • Treatment can range from physical therapy and medication to surgery in severe cases.
  • Spinal Stenosis: This is a narrowing of the spaces within your spine, which can put pressure on the nerves that travel through the spine. It is often caused by wear-and-tear changes in the spine related to osteoarthritis.

    • Treatment can include medication, physical therapy, or surgery.

What you can do

  • Try to rest your back and avoid activities that make your pain worse.
  • Over-the-counter pain relievers, such as ibuprofen or acetaminophen, may help.
  • Gentle stretching exercises can sometimes help with back pain. However, it's important not to push yourself too hard and to stop if any exercise increases your pain.
  • Applying heat or cold to the affected area may also provide some relief.

What you should look out for

Please seek immediate medical attention if:

  • Your pain is severe or doesn't improve with rest.
  • You have pain after a fall or an injury.
  • Your back pain is accompanied by unexplained weight loss.
  • You have weakness, numbness, or tingling in one or both legs.
  • You have new bowel or bladder problems.

Remember, I'm an AI and this advice is based on the information you've provided. It's always a good idea to consult with a healthcare professional for an accurate diagnosis.

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7 mo ago


People Also Ask


What are common causes of persistent upper back and neck pain?

Common causes of persistent upper back and neck pain include muscle strain or sprain, poor posture, herniated discs, and spinal stenosis. These conditions can result from overuse, sudden awkward movements, or wear-and-tear changes in the spine.


How can I differentiate between muscle strain and a more serious condition like a herniated disc?

Muscle strain often results in pain associated with certain movements or positions and may improve with rest and over-the-counter pain relievers. A herniated disc might cause more severe symptoms like numbness, tingling, or weakness in the arms or legs, and may require medical evaluation for proper diagnosis.


What are some effective home remedies for managing upper back and neck pain?

Effective home remedies for managing upper back and neck pain include rest, over-the-counter pain relievers like ibuprofen or acetaminophen, gentle stretching exercises, and applying heat or cold to the affected area. It's important to avoid activities that worsen the pain.


When should I seek medical attention for back and neck pain?

You should seek medical attention if your pain is severe or doesn't improve with rest, if you experience pain after a fall or injury, if your back pain is accompanied by unexplained weight loss, or if you have weakness, numbness, or tingling in your legs, or new bowel or bladder problems.

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