[49M] Experiencing worsening neck pain and neurological symptoms

Patient Description

A 49-year-old male has been suffering from chronic neck pain for 4 years, with a significant increase in severity over the past 2 months. The pain is persistent and becomes particularly intense when moving the neck, which is accompanied by a loud cracking sound and severe pain, especially when looking down and then up. The patient also reports numbness in the hands and fingers, with concurrent knuckle pain and bilateral elbow pain. He has a history of spinal stenosis and nerve entrapment, leading to chronic pain and neuropathy, but has not been given a specific diagnosis despite extensive consultations with various healthcare providers. Recently prescribed Cyclobenzaprine and Diclofenac, the patient has not started these medications due to past experiences of ineffectiveness with similar treatments. Additionally, the patient had an allergic reaction to Cyproheptadine, which caused blisters and hives on hands and feet. The patient also experiences heel pain causing a limp and occasional dizziness, but no changes in bowel or bladder function have been noted.

Arora's Assessment

What might be happening

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

Cervical Spondylosis: This is a general term for age-related wear and tear affecting the spinal disks in your neck. As the disks dehydrate and shrink, signs of osteoarthritis develop, including bony projections along the edges of bones (bone spurs). Cervical spondylosis is very common and worsens with age. Symptoms often include pain and stiffness in the neck.
- Treatment typically involves a combination of medication, physical therapy, and sometimes surgery.
Cervical Radiculopathy: This occurs when a nerve root coming off the spinal cord becomes compressed. The compression can occur for various reasons, including from a herniated disc, spinal stenosis, or bone spurs. This can cause pain in the neck and may spread to the arms and hands.
- Treatment typically involves medication, physical therapy, and possibly surgery.
Fibromyalgia: This is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. Researchers believe that fibromyalgia amplifies painful sensations by affecting the way your brain and spinal cord process painful and nonpainful signals.
- Treatment often involves a combination of medication, exercise, stress management, and healthy lifestyle habits.

Please note that these are just possibilities and the exact cause of your symptoms can only be determined by a healthcare professional.

What you can do

Over-the-counter pain relievers: Non-prescription medications like acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve) might help.
Heat or cold: Apply a heating pad or a cold pack to your neck to relieve neck pain.
Physical therapy: A physical therapist can teach you exercises to help stretch and strengthen the muscles in your neck and shoulders.
Neck exercises and stretching: Gentle neck stretches and exercises can help with some types of neck pain. Avoid jerking, twisting or straining your neck.