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Question:

Severe neck and shoulder pain and numbness for three days

Dear Ask The Doctor:
I have been experiencing severe neck and shoulder pain for 3 days along with numbness of the skin in the area of the pain. I did not sustain an injury to the area and it was not caused by sleeping in the wrong position. Any idea what may be causing this and what I can do about it?


Answer:

 The pain in your neck and shoulder as you described it may be  due  to a cervical nerve compression , but it would be also important to rule out inflammation of the Rotator cuff tendons in the shoulder. In the younger patients,  cervical radiculopathy may be a result of a disc herniation or an acute injury causing impingement of an exiting nerve. In the older patient, cervical radiculopathy is often a result of spinal canal narrowing from bone (osteophyte) formation, decreased disc height and degenerative changes due to aging process. The treatment strategy usually includes: physical therapy program aimed to reduce pain and inflammation, and the use of anti-inflammatory medication (“Motrin”, “Aleve”), also a re-education of your habits and posture to improve quality of life. You should be independent in a stretching and strengthening program and continue with these exercises under the periodic supervision of a physical therapist initially and then completely on your own. Patients whose condition fails to improve with a comprehensive rehabilitation program and selective injections should be presented with a surgical evaluation. Often, patients should show progressive improvement over the first 6-8 weeks with conservative treatment. If there is no significant improvement in this time frame, consider a surgical evaluation.



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