I am 38, female with muscle contractions. How to manage?

Question

Hi doctor,

I am a 38-year-old woman, and over the past year, I have been noticing involuntary muscle contractions in my neck and shoulders, which cause my head to twist or tilt to one side. These movements sometimes make it difficult to write, use utensils, or perform simple daily tasks. The symptoms worsen when I am stressed or tired, and I experience intermittent pain in the affected muscles. I also have a history of mild anxiety and occasionally take medications for it.

My neurologist noted that my reflexes are normal, but muscle tone is slightly increased in my neck. Blood tests, including thyroid function tests (TSH 3.2 mIU/L) and a routine metabolic panel, are within normal limits.

I am concerned about whether this is cervical dystonia or another form of dystonia, and I would like to know the possible causes. I want guidance on diagnostic tests such as EMG or imaging, as well as treatment options including medications, botulinum toxin injections, or physical therapy.

I would also like advice on lifestyle adjustments and exercises to manage the symptoms, and to understand the long-term prognosis and whether this condition may worsen over time.

Please advise.

Answer 1

Hi

Welcome to icliniq.com

I understand your concern regarding neck muscle contraction. According to your symptoms and past history, this is most likely neck muscle spasm.

Muscle spasm is an involuntary, painful tightening of the neck muscles, often caused by:

Strain from poor posture, overexertion, or stress. Poor posture when spending long hours at a computer or with a mobile, or sleeping in an awkward posture.

Overstrain or strain - Neck muscles that are overworked from exercise or activities like carrying a heavy bag.
Stress - Emotional stress can cause muscle tension.
Injury - A sudden movement or a minor injury can trigger a spasm.

Treatment -

The primary treatment in your case is to apply a cold ice pack.
Additionally, stay active and rest. If not relieved, then shift to medical treatment like:

Take Tablet Ibuprofen and Paracetamol 400 325mg twice a day for one week to relieve pain.
Apply Diclofenac diethylammonium three to four times a day.

Certain lifestyle changes to be done include:

Minimize activities that cause pain.
Avoid heavy weight lifting.

If not relieved, then please go for magnetic resonance imaging (MRI) neck to evaluate cervical spondylitis or herniated disc, slip disc other vertebral joint problems.

Do not worry, it is treatable and not a life-threatening condition.

I hope this answers your query. Please revert to me if you have any further questions.

Thank you.