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modsev headneck ache in a male 67 hx PAD Diabetes high blood pressure blocked carotids

He began experiencing neck pain a few days ago to the right of the
cervical spine. His pain has gotten worse. It
is at the base of his skull and down his neck, mostly on the right side of the
spine. He is having a difficult time turning his head. He has taken Excedrin and
I have rubbed Anesthol down his neck and across his shoulders with little
relief.
No hx of migraines.
This type of pain or headache is not normal for him.
Is this cause for concern of possible stroke?

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  • 2 Answer(s)

    Hello,
    Welcome to the AMD forum of doctors. I can very well understand your apprehension about stroke with such symptoms and history. The four main risk factors for stroke like high blood pressure, diabetes, atrherosclerosis and peripheral artery disease and advancing age are present in the concerned person, so he is always at risk of stroke. But the symptoms described point to some spinal cord pathology rather than a stroke. Stroke presents with numbness, weakness of muscles and reduction in sensory and vibratory sensation rather than headache and pain. From these symptoms it looks like typical cervical spondylosis. With advancing age there is degeneration (‘wear & tear’) of the vertebrae and discs in the neck region. This can cause compression of the nerves and severe pain in the neck, shoulder and arm. Diagnosis can be confirmed by x-ray neck or MRI spine. Apply warm compresses on the area and ask him to take some anti-inflammatory pain killer like ibuprofen or diclofenac. Application of topical muscle relaxants and avoiding shoulder stretching will also help. Cervical spondolysis also responds to anti-inflammatory drugs and cervical collars. Also it is essential that he corrects any posture imbalances that he may have, whether while sitting or standing. It is also very important to make sure that the pillow used under the head is the correct size and thickness. Severe cases may need steroid injections or surgical approach. Another likely possibility that can present with such symptoms is thoracic outlet syndrome nut here the pain is centered mostly around the shoulder and arm. But it is important to rule it out. So my sincere advice is to consult an orthopedician/ physician and get a color Doppler of the blood vessels (to rule out any impending stroke), x-ray and MRI spine( to rule out cervical spondylosis) and electromyogram and somatosensory evoked responses (to rule out thoracic outlet syndrome). I hope it helps. Take care and please do keep me posted in case you have any additional doubts. You can refer to the following sites for more relevant information: http://en.wikipedia.org/wiki/Spondylosis
    http://en.wikipedia.org/wiki/Stroke

    Answered on May 11, 2014.
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    Hi
    Your medical question on the AMD forum has been answered very well by Dr Bhupinder. As she said your concern is understandable with so many relevant diseases. As Dr Bhupinder said, it could be a pinched cervical nerve or even a thoracic outlet syndrome.
    However since this 67 year old’s carotids are blocked, consult the vascular doctor too once regarding his symptoms. At times blocked carotids can present with head and neck pain.
    Hope this helps. Please let me know if there is any thing else and do keep me posted. Take care!

    Answered on May 11, 2014.
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