Q: I am a 32-year-old woman. For the past few months, I've been experiencing pain and soreness in my left shoulder and neck. Medical plasters and pain relief cream do not help. Recently, the pain has worsened; it has travelled up to my left ear and head, causing mild discomfort. I have had heart palpitations since 2011. Do I have an orthopaedic problem or is the pain related to my heart?
A: The main sources of your pain could include muscle strain or nerve irritation. The muscle at the back of the neck is called trapezius. This flat sheet of muscle drapes from the back of the skull to the upper shoulders, and extends to the upper part of the back.
Having your neck in a flexed position for prolonged periods may strain this trapezium-shaped muscle, causing soreness that stretches from the head to the shoulders.
The pain may be further aggravated by turning the head in a particular direction. This results in prominent pain primarily on one side.
In some cases, the pain can be more than just muscle strain - it can originate from nerve root irritation.
The spinal cord is an extension of our brain encased within the vertebrae. At every level, a pair of nerves branch out from the spinal cord.
In the neck, eight pairs of nerve roots branch out to travel to other areas, such as back of the skull, around the ears, shoulders, arms, forearms or fingers. The wear and tear of the joints may pinch the nerve roots as they exit the vertebrae.
This may result in the feeling of pain in the areas that these nerve roots supply to. This is called cervical radiculopathy and treatment options include anti-inflammatory medication and surgery. Treatment depends on the underlying cause of symptoms, as well as their severity.
The palpitations experienced may be a separate issue. It is important to consider systemic conditions, such as a thyroid problem or rheumatoid arthritis, that may cause concomitant palpitation and neck pain. Do see a doctor for a detailed evaluation.
DR LAU LEOK LIM
Consultant at the University Spine Centre at National University Hospital
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