As of Saturday, April 27, 2013
DEAR DOCTOR K: My neck hurts, but my doctor hasn’t been able to figure out why. I think if I had the words to better describe my pain, it might give him the clues he needs. Can you help?
DEAR READER: Many of my patients have trouble describing their discomfort beyond telling me “it hurts.” Even a slightly more specific description can help me identify — or exclude — a particular diagnosis.
To better describe your neck pain, start with the following questions. Be prepared to answer them next time you see your doctor:
— How severe is the pain? On a scale of 1 (least pain) to 10 (most pain), how bad is it?
— If the pain changes with different movements, how bad is it at its least painful, and how bad is it at its most painful?
— What movements of the head, neck, shoulders or back make the pain better, and what movements make it worse?
— Are your neck and shoulders stiff? Does it seem like more work than usual to move them?
— How would you describe the pain? Is it an ache, is it sharp, is it just in one spot or does it travel (for example, into your arm)?
— Do you feel pain only when you turn your head, or does the pain get worse when you turn your head?
— Along with the pain, do you have any other symptoms? For example, is your arm or hand weak?
Neck pain can vary a great deal based on what’s causing it. Use the following descriptions to help explain your symptoms:
— Muscle pain causes aching or sore neck and shoulder muscles. Muscles may develop hard knots that are sore to the touch.
— A muscle spasm is a sudden, powerful contraction of neck muscles. The muscle usually feels painful, tight or knotted, and may be temporarily difficult to move.
— Neck-related headache is usually felt in the back of the head and upper neck. It is typically dull or aching, rather than sharp. It is often accompanied by stiffness and tenderness of neck muscles.
— The facet joints are where two spine bones (vertebrae) contact each other. Often described as deep, sharp or aching, facet joint pain typically worsens if you lean your head toward the affected side. It may radiate to your shoulder or upper back.
— Nerve pain may be sharp, fleeting, severe, or accompanied by pins and needles. The pain may shoot down your arm or into your hand.
Also tell your doctor about your non-pain symptoms:
— Stiffness, tightness and rigidity in the muscles. Bending or moving your neck may be difficult or cause sharp pain.
— Limited range of motion. This is evident in a reduced ability to flex and extend your neck and bend or rotate your head from side to side.
The more specific you can be about your neck pain, the more your doctor can help you.
Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.