[24M] With chronic neck and shoulder muscle fatigue and soreness

Patient Description

A 24-year-old male has been experiencing severe muscle weakness and fatigue in the muscles at the back of his neck for years, rated as 8 out of 10 in severity. This tired feeling temporarily improves when he pulls his head forward to stretch those muscles. The muscle weakness significantly affects his daily activities, requiring him to lie down frequently to relax his neck. Additionally, he has soreness in his shoulder and back muscles, rated as 7 out of 10. This soreness is exacerbated by activities like sleeping on his side or putting weight on one of his arms. He also experiences brain fog and sometimes headaches, especially when the neck pain is severe. His neck is stiff, particularly in the morning or after periods of inactivity, and he has some difficulty and discomfort when moving his neck. However, he does not experience numbness or tingling in his arms or hands, and the neck pain does not seem to cause his shoulder pain. He has been diagnosed with a loss of curve in his cervical spine, confirmed by an X-ray. Physical therapy did not help, but he has made some ergonomic adjustments, such as moving his monitor to eye level. He is not currently taking any medications for his neck pain or muscle soreness, and he has no pre-existing conditions or chronic illnesses.

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Arora's Assessment

What might be happening

Based on the information you have provided, here are some possible explanations for your symptoms:

  • Cervical Spondylosis: This is a common age-related condition that affects the joints and discs in your cervical spine. It can cause neck pain, stiffness, and muscle fatigue. The loss of the natural curve in your cervical spine, as diagnosed by your X-ray, could be contributing to your symptoms.

    • Treatment: Treatment typically includes physical therapy, pain medications, and sometimes corticosteroid injections. In severe cases, surgery may be considered.
  • Muscle Strain: Chronic poor posture, especially from activities like looking down at a screen or sleeping in an awkward position, can lead to muscle strain and fatigue in the neck and shoulder muscles.

    • Treatment: Treatment involves improving posture, ergonomic adjustments, physical therapy, and over-the-counter pain relievers.
  • Tension Headaches: These can be caused by muscle tension in the neck and shoulders and can lead to headaches and brain fog.

    • Treatment: Treatment includes stress management, physical therapy, and medications to relieve pain and muscle tension.

What you can do

While it's important to consult a healthcare professional for a formal diagnosis and treatment plan, here are some steps you can take to help alleviate your symptoms:

  1. Ergonomic Adjustments: Ensure your workstation is set up to promote good posture. Your monitor should be at eye level, and your chair should support your lower back.
  2. Neck Exercises: Gentle stretching and strengthening exercises for your neck and shoulders can help reduce muscle tension and improve posture. Consider consulting a physical therapist for specific exercises.
  3. Heat and Cold Therapy: Applying a warm compress to your neck can help relax tense muscles, while a cold pack can reduce inflammation and numb pain.
  4. Over-the-Counter Pain Relievers: Medications like ibuprofen or acetaminophen can help manage pain and inflammation.
  5. Proper Sleep Position: Use a pillow that supports the natural curve of your neck. Avoid sleeping on your stomach, as this can strain your neck.
  6. Stay Hydrated and Maintain a Healthy Diet: Proper hydration and nutrition can support overall muscle health and reduce fatigue.
  7. Use MDandMe: Journal your symptoms, track your progress, get insights, and share your medical notes with your healthcare provider.

What you should look out for

Seek medical attention if you experience any of the following:

  • Severe or worsening pain: If your pain becomes unbearable or significantly worsens, consult a healthcare professional.
  • Numbness or tingling: If you develop numbness, tingling, or weakness in your arms or hands, seek medical attention promptly.
  • Difficulty with daily activities: If your symptoms are severely impacting your ability to perform daily activities, it's important to get a professional evaluation.
  • New or unusual symptoms: If you notice any new or unusual symptoms, such as dizziness, loss of balance, or changes in vision, seek medical advice.

Remember, while these suggestions can help manage your symptoms, it's important to consult a healthcare professional for a formal diagnosis and personalized treatment plan.

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5 mo ago


People Also Ask


What is cervical spondylosis and how does it affect the neck?

Cervical spondylosis is an age-related condition that affects the joints and discs in the cervical spine, leading to neck pain, stiffness, and muscle fatigue. It often results from wear and tear of the cartilage and bones, and can be exacerbated by a loss of the natural curve in the cervical spine.


How can poor posture lead to muscle strain and fatigue?

Poor posture, such as looking down at a screen or sleeping in awkward positions, can strain the neck and shoulder muscles over time. This strain can lead to muscle fatigue and soreness, as the muscles are constantly working to support the head and maintain balance.


What are tension headaches and how are they related to neck and shoulder tension?

Tension headaches are caused by muscle tension in the neck and shoulders, which can lead to pain and pressure around the head. This tension can also contribute to symptoms like brain fog and headaches, especially when neck pain is severe.


What ergonomic adjustments can help alleviate neck pain and muscle soreness?

Ergonomic adjustments that can help alleviate neck pain include setting your monitor at eye level, using a chair that supports your lower back, and ensuring your workstation promotes good posture. These changes can reduce strain on the neck and shoulders, helping to relieve pain and muscle tension.

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