[59M] With sudden onset neck and back pain, headaches, and blurred vision

Patient Description

A 59-year-old male, with a history of diabetes and past military service, reports sudden onset neck pain on the left side, extending from behind the ear to the collarbone, and right-sided back pain. These symptoms have been present for about two weeks and are exacerbated by turning the head to the left, particularly towards the end of the day. The patient also experiences headaches localized to the left side at the back of the head and occasional blurred vision. He smokes 8 to 10 cigarettes daily. The patient has a history of three heart attacks following a military-related incident but has no other known heart or vascular conditions. Current medications include Metformin and Sitagliptin for diabetes management. There are no known allergies or recent infections reported.

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Arora's Assessment

What might be happening

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

  • Cervical Radiculopathy: This condition occurs when a nerve in the neck is compressed or irritated where it branches away from the spinal cord. This can cause pain that radiates from the neck into the shoulder and arm, which might explain the pain radiating from your neck to your collarbone and back. The numbness in your hands could also be related to this condition. Treatment often involves physical therapy, pain management, and sometimes corticosteroid injections.

  • Muscle Strain or Sprain: Given your work as a mechanic, it's possible that your neck pain is due to a muscle strain or sprain from repetitive movements or awkward positions. This type of pain can be managed with rest, ice or heat application, and over-the-counter pain relievers.

  • Cervical Spondylosis: This is age-related wear and tear affecting the spinal disks in your neck. It can cause neck pain and stiffness, and sometimes headaches. Treatment may include physical therapy, medications, and in some cases, surgery.

  • Tension Headaches: These are often caused by stress, poor posture, or muscle tension in the neck and shoulders. They can cause pain in the back of the head and neck. Managing stress, improving posture, and using pain relievers can help alleviate symptoms.

Given your history of heart attacks and diabetes, it's important to consider cardiovascular causes for your symptoms, although your description does not strongly suggest this.

What you can do

  1. Consult a Healthcare Provider: It's important to see a doctor to get a formal diagnosis and appropriate treatment. They may recommend imaging tests like an X-ray or MRI to better understand the cause of your pain.

  2. Symptom Management: In the meantime, you can try applying heat or cold packs to your neck to help reduce pain and inflammation. Over-the-counter pain relievers like ibuprofen or acetaminophen may also help.

  3. Posture and Ergonomics: Pay attention to your posture, especially while working. Consider ergonomic adjustments to your workspace to reduce strain on your neck.

  4. Use MDandMe: You can use the MDandMe app to journal your symptoms, track your progress, and share your medical notes with your healthcare provider. This can help in managing your condition and providing your doctor with detailed information.

What you should look out for

Seek medical attention more urgently if you experience:

  • Severe or worsening pain
  • New or worsening numbness or weakness in your arms or hands
  • Changes in your vision that persist or worsen
  • Any signs of a heart attack, such as chest pain, shortness of breath, or pain radiating to your arm or jaw

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

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1 mo ago

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People Also Ask


What is cervical radiculopathy and how is it treated?

Cervical radiculopathy occurs when a nerve in the neck is compressed or irritated, causing pain that can radiate into the shoulder and arm. Treatment often includes physical therapy, pain management, and sometimes corticosteroid injections.


How can I differentiate between a muscle strain and cervical spondylosis?

A muscle strain is often due to repetitive movements or awkward positions and can be managed with rest and pain relievers. Cervical spondylosis is age-related wear and tear on spinal disks, causing neck pain and stiffness, and may require physical therapy or medication.


What are tension headaches and how can they be managed?

Tension headaches are caused by stress, poor posture, or muscle tension in the neck and shoulders, leading to pain in the back of the head and neck. Managing stress, improving posture, and using pain relievers can help alleviate symptoms.


When should I seek urgent medical attention for neck pain?

Seek urgent medical attention if you experience severe or worsening pain, new or worsening numbness or weakness in your arms or hands, persistent changes in vision, or any signs of a heart attack such as chest pain or shortness of breath.


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