[44F] With severe headache, neck pain, and night sweats

Patient Description

A 44-year-old female presents with severe pain radiating from her shoulders into her neck and head, accompanied by intense pressure behind her right eye. The pain has been progressively worsening and is excruciating today. She also reports night sweats for the past couple of nights, chills, and a weight loss of around 5 pounds. The neck pain has been present for the past two nights and is rated as 10 out of 10 in severity. She experiences yellow floaters in her vision, weakness, numbness, and tingling in her right arm, with pain extending from her upper arm down to her hand. Additionally, she has difficulty with coordination and balance, neck stiffness, and difficulty moving her neck. The patient has a history of multilevel degenerative disc disease and spondylosis, most pronounced at C5-6 and C6-7, resulting in minimal thecal sac narrowing, diagnosed this year. She is allergic to Cipro and is currently taking Gabapentin occasionally, Diclofenac daily, and Adderall daily for hypersomnia. Heating pads provide minimal relief, and medications like Diclofenac and Gabapentin have not been effective.

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Arora's Assessment

What might be happening

Based on the symptoms and history you've provided, here are some possible explanations for your condition:

Severe Headache, Pressure Behind the Eye, and Night Sweats

  1. Infection or Inflammatory Condition: Given your night sweats, chills, and severe headache, an infection or inflammatory condition could be a possibility. This could include conditions like meningitis or a severe sinus infection. However, these conditions often come with fever, which you are unsure about.
  2. Pituitary Tumor: Your hormone-extracting pituitary tumor could be contributing to your symptoms, especially the headache and vision changes (yellow floaters). Pituitary tumors can cause headaches and visual disturbances due to their location near the optic nerves.
  3. Cervical Spine Issues: Your history of multilevel degenerative disc disease and spondylosis could be contributing to your neck pain and headaches. Cervical spine issues can sometimes cause referred pain to the head and eyes.

Neck and Shoulder Pain

  1. Cervical Radiculopathy: Given your history of degenerative disc disease and spondylosis, cervical radiculopathy (nerve compression in the neck) could explain the pain radiating from your shoulders into your neck and head, as well as the weakness, numbness, and tingling in your right arm.
  2. Muscle Strain or Ligament Injury: The severe pain and feeling of tearing in your shoulder and neck could be due to muscle strain or ligament injury, possibly exacerbated by your existing cervical spine issues.

Coordination and Balance Issues

  1. Neurological Involvement: The difficulty with coordination and balance, along with the other symptoms, could indicate a neurological issue. This could be related to your cervical spine condition or potentially the pituitary tumor.

What you can do

Severe Headache, Pressure Behind the Eye, and Night Sweats

  • Seek Immediate Medical Attention: Given the severity of your symptoms and the potential for serious underlying conditions, it is crucial to seek medical attention as soon as possible. Go to the emergency department or contact your healthcare provider immediately.
  • Document Symptoms: Use MDandMe to journal your symptoms, track progress, and share longitudinal medical notes with your provider. This can help in diagnosing and managing your condition.

Neck and Shoulder Pain

  • Consult a Specialist: See a healthcare provider, preferably a neurologist or an orthopedic specialist, to evaluate your neck and shoulder pain. They may recommend imaging studies like an MRI to assess your cervical spine.
  • Pain Management: While waiting for your appointment, you can:
    • Apply a heating pad or ice pack to the affected area for short periods.
    • Avoid activities that exacerbate the pain.
    • Continue taking Diclofenac as prescribed, but consult your doctor if it is not providing relief.

Coordination and Balance Issues

  • Safety Precautions: Take precautions to prevent falls or injuries due to balance issues. Avoid activities that require precise coordination until you have been evaluated by a healthcare provider.

What you should look out for

Given the severity of your symptoms and the potential for serious underlying conditions, you should seek medical care as soon as possible. Reasons to seek care even more urgently include:

  • Fever or worsening chills: This could indicate an infection.
  • Severe or sudden vision changes: This could indicate a neurological issue or complications from your pituitary tumor.
  • Severe weakness or numbness: This could indicate nerve compression or a neurological issue.
  • Difficulty breathing or chest pain: These are signs of a medical emergency.

Remember, while I can provide information and suggestions, I am not a doctor. It is essential to seek care from real health professionals to receive a formal diagnosis and appropriate treatment. If you have more questions or need further assistance, feel free to continue the conversation.

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4 mo ago


People Also Ask


What could be causing the severe pain radiating from my shoulders into my neck and head?

The severe pain radiating from your shoulders into your neck and head could be due to cervical radiculopathy, which is nerve compression in the neck. This is often associated with degenerative disc disease and spondylosis, which you have a history of.


Why am I experiencing intense pressure behind my eye along with headaches?

The intense pressure behind your eye and headaches could be related to a pituitary tumor, which can cause headaches and visual disturbances due to its proximity to the optic nerves. Alternatively, it could be linked to cervical spine issues or an inflammatory condition.


What might be the reason for my night sweats and chills?

Night sweats and chills could indicate an infection or inflammatory condition, such as meningitis or a severe sinus infection. These symptoms are often accompanied by fever, so it's important to monitor for any additional signs.


How can my history of degenerative disc disease and spondylosis affect my current symptoms?

Your history of degenerative disc disease and spondylosis can contribute to symptoms like neck pain, headaches, and neurological issues such as weakness, numbness, and tingling in your arm. These conditions can lead to nerve compression and referred pain.

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