What are the best low back and neck pain management options?

Question

Hi doctor,

I have had frequent headaches on and off for the past year. Since last month, I have suffered from severe headaches and neck and shoulder pain on my right side. Sometimes pain occurs in my right hand, and I cannot bear it. Last week I did an MRI of the brain, cervical spine, and a blood test.

All reports came back normal, but the report of the cervical spine shows a conclusion of minimal focal posteroventral protrusion of the C 5/6 disc and desiccation with the mild diffuse annular bulge of L 4/5. My BP also remains normal.

Please help me.

Answer 1

Hi,

Thanks for your query.

I can understand your concerns.

I have checked the attached reports (attachment removed to protect the patient's identity). From what you mentioned, there are two possible differential diagnosis:

1. Headache and neck pain due to cervical disk prolapse. The data you provided supports the diagnosis of neck muscles, painful spasms, pain moving down the right arm, and the CT (computed tomography) findings.

2. For migraine, the data you provided that supports this diagnosis is the episodic nature of the headache, which is on and off and affects one side. The CT (computed tomography) findings are mild, not severe.

Please, provide details to give an accurate diagnosis and decision :

1. Are the headache and neck pain associated with certain neck positions or movements?

2. For how long does the headache last? And how frequent is it?

3. Does it respond to painkillers and Paracetamol?

In my opinion, the headache and neck, and shoulder pain are due to disk prolapse, but I recommend further discussion and follow-up to exclude migraine.

We can discuss the management after excluding migraine. It will include some local medications and oral medications besides physiotherapy and lifestyle modifications.

I suggest that you follow up and provide me with more details for more accurate advice.

I hope this helps.

Thank you.