[65F] With chronic neck and lower back pain, numbness, and weakness

Patient Description

A 65-year-old female has been experiencing a dull, constant neck pain for over a year, sometimes with a burning sensation, rated as 9 out of 10 in severity. The pain persists in all positions—sitting, standing, and lying down. Additionally, she reports lower back pain for six months, described as dull, with rest providing some relief. The patient also experiences numbness and weakness in her hands and arms, loss of feeling in her toes and the balls of her feet, and changes in balance and coordination. She has frequent constipation and occasionally feels her head is heavy, making it difficult to hold up. She has not had any imaging tests or seen a healthcare provider for the neck pain. Treatments tried include stretching and pressure points, which offer temporary relief. Her medical history includes asthma, sudden acute respiratory distress syndrome, carpal and tarsal tunnel syndrome, and hypothyroidism. She is allergic to penicillin, aspirin, bees, cats, and has seasonal allergies. Medications include an Albuterol nebulizer (1 vial morning and night, sometimes an additional dose), Kenalog injections for allergies every 3 to 5 months, ibuprofen (600 mg, 2 to 3 times daily), and ranitidine for heartburn. She uses tobacco, approximately 2 to 3 times per day, and has no history of cardiovascular issues, recent weight loss, fever, infections, or surgeries on her neck or spine.

Arora's Assessment

What might be happening

Your symptoms suggest a few possible conditions:

Cervical Spondylosis: This is age-related wear and tear affecting the spinal disks in your neck. It can cause neck pain, numbness, and weakness in your arms and hands. Imaging tests like an X-ray or MRI can help diagnose this.
Carpal and Tarsal Tunnel Syndrome: These conditions can cause numbness and weakness in your hands and feet. Your existing diagnosis may be contributing to your symptoms.
Hypothyroidism: This can cause fatigue, muscle weakness, and constipation. Ensuring your thyroid levels are well-managed is important.
Chronic Pain Syndrome: Given the duration and severity of your pain, this could be a factor. It often requires a comprehensive approach to management.

What you can do

Neck and Back Pain:

See a healthcare provider: It's important to get a proper diagnosis. They may recommend imaging tests or refer you to a specialist.
Physical Therapy: A physical therapist can provide exercises to strengthen your neck and back muscles.
Pain Management: Over-the-counter pain relief like ibuprofen can help, but consult your doctor for long-term use.

Numbness and Weakness:

Ergonomic Adjustments: Ensure your workspace is set up to reduce strain on your neck and arms.
Stretching and Exercises: Gentle stretching and strengthening exercises can help alleviate symptoms.

Constipation:

Dietary Changes: Increase your fiber intake with fruits, vegetables, and whole grains.
Hydration: Drink plenty of water throughout the day.

General Health:

Quit Smoking: Reducing tobacco use can improve overall health and circulation.
Symptom Tracking: Use MDandMe to journal your symptoms, track progress, and share insights with your provider.

What you should look out for

Seek medical attention if you experience:

Sudden worsening of symptoms
Severe headaches or vision changes
Loss of bladder or bowel control
Significant changes in balance or coordination

Remember, it's important to consult with a healthcare professional for a formal diagnosis and treatment plan.

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5 mo ago

Top picked over-the-counter products for Carpal Tunnel Syndrome: Get Better With At-Home Conservative Treatment

[65F] With chronic neck and lower back pain, numbness, and weakness

What might be happening

What you can do

What you should look out for

Experiencing symptoms?