Q. I have a terrible upper back and shoulder pain, and I feel drowsy. What to do?

Answered by
Dr. Atul Prakash
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on May 17, 2017 and last reviewed on: Sep 18, 2021

Hi doctor,

I am a 32 year old male, and I have a terrible upper back and left shoulder pain from past two years. The pain is radiating to the left side of the chest also. Whenever I move my neck, I hear some sound. With this pain, I feel drowsy and light-headed full day. I am not able to do routine work or sit still for a long time. I feel as if I am going to fall, so I keep moving my legs and body in the chair at the office. Even when I am lying on the bed, I feel as if I am going to faint. Whenever I feel drowsy, I feel that my heartbeat has stopped. From the past five days, the symptoms are becoming severe. I got an MRI of the neck two years back, which was normal. I have elevated cholesterol levels, and my triglycerides are around 400. My ECG was normal, but during an echocardiogram, the doctor said that there is a hole in the heart. Because of this extreme pain, I am not able to concentrate on my routine work, as I feel drowsy throughout the day. I do not have any pressure at home or work. Only because of this pain, I am very worried. I have consulted many doctors, but they give me some painkillers, which does not help relieve the pain. What should I do now?



Welcome to

  • I would like the following details.
  1. Did you take any x-ray?
  2. Have you tried physiotherapy?
  3. Was the MRI with or without contrast?
  4. Do you feel missed heartbeats when you feel drowsy?
  5. Do you get sweaty or get a sinking feeling? If yes, then you need a 24- hour Holter ECG (electrocardiography) reading to rule out any arrhythmia.
  • If you have a click on the neck, which is painful and makes you faint or feel drowsy, then I think you need an MRA (magnetic resonance angiogram). I will also suggest you consult an ENT specialist.

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Hello doctor,

Thank you for the reply. I am attaching my MRI report. I do not know if it was done with or without contrast.



Welcome back to

I have seen your MRI report (attachment removed to protect patient identity).

  • The MRI of the cervical spine is without contrast, hence of not much help, as it does not show anything about the vertebral artery system.
  • Secondly, do you have any sinking feeling and irregular heartbeat? As that will need a 24-hour Holter ECG.
  • What did your doctor say about your symptoms? Did you consult an ENT specialist?

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