[23F] Experiencing severe neck pain and dizziness

Patient Description

A 23-year-old female reports experiencing severe neck pain every day, which began at age 15 and has intensified over the years. The pain is described as a deep, dull ache that sometimes radiates to the upper back, causing significant discomfort. Activities such as lifting, standing, bending, and stretching exacerbate the pain, and finding a comfortable sleeping position is challenging. Temporary relief is achieved with a heating pad, cold rag, and tiger balm. The patient also experiences persistent fatigue, dizziness, and constant migraines. The dizziness occurs whether sitting or standing, often accompanied by a sensation of being in a wind tunnel or the room spinning, and can lead to visual disturbances when standing. The patient reports feeling unwell at times without being actually sick. These symptoms have been persistent and significantly impact daily activities.

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Arora's Assessment

What might be happening

Based on your symptoms, there are a few possible explanations for what you are experiencing:

  1. Cervical Spondylosis: This is a common age-related condition that affects the joints and discs in your neck. It can cause chronic neck pain, stiffness, and sometimes radiating pain to the upper back. The dull, deep ache you describe could be related to this condition. Treatment often includes physical therapy, pain management with medications, and sometimes lifestyle modifications.

  2. Chronic Migraine and Tension-Type Headaches: Your constant migraines and neck pain could be related. Tension-type headaches often accompany neck pain and can be exacerbated by stress or poor posture. Treatment may involve medications, stress management techniques, and physical therapy.

  3. Postural Orthostatic Tachycardia Syndrome (POTS): Given your dizziness and lightheadedness, especially when standing, POTS could be a consideration. This condition affects circulation (blood flow) and can cause symptoms like dizziness, fatigue, and a feeling of being in a wind tunnel. Diagnosis typically involves a tilt table test, and treatment may include lifestyle changes, increased fluid and salt intake, and medications.

  4. Fibromyalgia: This condition is characterized by widespread musculoskeletal pain, fatigue, and other symptoms like dizziness and headaches. It can be challenging to diagnose, as it often overlaps with other conditions. Treatment usually involves a combination of medications, exercise, stress management, and sometimes cognitive behavioral therapy.

What you can do

Neck Pain and Upper Back Discomfort:

  • Continue using heat and cold therapy as recommended by your physical therapist.
  • Consider gentle stretching exercises and maintaining good posture to alleviate strain.
  • Over-the-counter pain relievers like ibuprofen may help, but consult your doctor for long-term use.

Dizziness and Lightheadedness:

  • Stay hydrated and consider increasing your salt intake if advised by a healthcare provider.
  • When standing up, do so slowly and in stages to minimize dizziness.
  • Compression stockings may help improve circulation.

Fatigue and Migraines:

  • Maintain a regular sleep schedule and create a comfortable sleep environment.
  • Keep a headache diary to identify potential triggers and discuss them with your doctor.
  • Consider relaxation techniques such as yoga or meditation to manage stress.

General Health:

  • Use MDandMe to journal your symptoms, track progress, and share insights with your healthcare provider.
  • Regular follow-ups with your healthcare provider are essential to monitor your symptoms and adjust treatment as needed.

What you should look out for

  • If you experience new or worsening symptoms, such as severe headaches, vision changes, or fainting, seek medical attention promptly.
  • Any sudden changes in your symptoms, such as increased pain or dizziness, should be evaluated by a healthcare professional.
  • Keep an eye on any new symptoms that may arise, and discuss them with your doctor to ensure a comprehensive approach to your health.

Remember, while I can provide information and suggestions, it's important to consult with a healthcare professional for a formal diagnosis and personalized treatment plan.

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People Also Ask


What are the common symptoms of cervical spondylosis?

Common symptoms of cervical spondylosis include neck pain and stiffness, headaches, pain that radiates to the shoulders or arms, and sometimes numbness or weakness in the arms or hands. It can also cause a grinding sensation when turning the neck.


How can chronic migraines be managed effectively?

Chronic migraines can be managed with a combination of medications (such as triptans or preventive medications), lifestyle changes (like regular sleep and exercise), identifying and avoiding triggers, and stress management techniques such as yoga or meditation.


What is Postural Orthostatic Tachycardia Syndrome (POTS) and how is it diagnosed?

Postural Orthostatic Tachycardia Syndrome (POTS) is a condition that affects circulation and is characterized by an abnormal increase in heart rate when standing up. It is diagnosed through a tilt table test, which measures heart rate and blood pressure changes when moving from lying down to standing.


What lifestyle changes can help manage fibromyalgia symptoms?

Lifestyle changes that can help manage fibromyalgia symptoms include regular low-impact exercise, maintaining a healthy sleep routine, stress management techniques, and a balanced diet. Cognitive behavioral therapy and support groups can also be beneficial.


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