Chronic neck pain for the last 9 years

Hello everyone,

Before I begin I’ll apologize for the long post, but I’m trying to give everyone a fully detailed insight into my problem so there are no, or minimal, open questions. My condition might actually be very common, but I’m certainly not getting any treatment that is helping so far…

I’m 37 and working as a graphic designer so obviously I spend a lot of time sitting in front of the computer. For the past 9 years (since 2011) I’ve been having chronic pain in the neck and it’s gotten so bad that I have to take sick days more and more often. At least once a week I’m unable to sit at the desk at all.

Reason I’m writing on this forum is that I’ve been dealing with doctors for the past 2 years unsuccessfully - they’ve been prescribing physiotherapies and medications that absolutely did nothing, so I’m really desperate at this point. I’ll do my best to describe everything in detail so you can have complete insight into the problem. I’ll also attach some images for illustrative purposes, as well as my MRI results.

Now, let me describe everything in order and in detail:

FIRST OCCURRENCE:

In 2011 I was working on a design project which involved using a new software with a lot of very tiny details on my monitor, so I was spending too much time in a forward head posture (“Image 1”). After a second day I started to feel tension and pain in the back of my neck from this kind of strain, but I dismissed it thinking it’s just temporary reaction to the volume of work I’ve been doing. Unfortunately, that kind of feeling never actually went away, apart from occasional periods of stability, but those are being more rare as the years go by.

DESCRIPTION OF PAIN:

If you already read about the first occurrence, then you can imagine what kind of feeling it is, but I’ll try to illustrate it more accurately since it’s not exactly a “pain” in the most common sense. Have a look at the “Image 2” and imagine you’re laying on bed on your stomach, but your head is not touching the bed and you have to hold it in illustrated upright position for a couple of minutes - sort of like an endurance test. Well, you can imagine what kind of feeling you would get in the back of your neck - not exactly a pain, more like a tension and feeling of restlessness because you’re not taking any break from this uncomfortable position. If I take a different part of the body for another example - like shoulder - you would get the same feeling if you were holding a weight (like dumbbell - “Image 3”) with your arm fully extended in front of you and not being allowed to lower it - after a while your shoulder would be overloaded and you would have the same feeling of pain/tension/restlessness in the shoulder as well. Now, in both of these examples - as soon as you are “released” from the uncomfortable position you would start to feel an immediate relief, and after a couple of minutes that part of the body that was overloaded would return to normal condition. Well, in my case once that feeling appears in the neck it won’t go away no matter what I do - even laying down to rest doesn’t help, the pain is still there for hours and I usually can’t fall asleep because of it.

ESCALATION OF THE SENSATION:

Once it starts to appear the pain has its phases with different symptoms in different parts of the neck. It always starts in the back of the neck (somewhere between C3 and C5 vertebrae) and a little bit to the right (“Image 4 - A”). Then, the same feeling (please refer to “Description of Pain”) will extend to the right side of my neck (“Image 4 - B”). The third and final stage is when that pain extends to the front/right side of my neck, accompanied by a feeling of slight pressure - like someone is lightly pressing their fingers against my Adam’s apple (“Image 4 - C”). At this last stage the pain is so overwhelming and persistent that no kind of rest will make it go away. I usually have to sedate myself with sleeping pills if I want to fall asleep. The ONLY thing that helps a bit is to start walking and the pain will gradually (but not completely) start to subside. But, of course this is not a solution if it’s night time and I have to go to sleep.

ESCALATION OF OTHER SYMPTOMS:

Although the symptoms described above have been consistent for the past 9 years, there are additional symptoms which started to appear in the last year. The first one is when I’m horizontally rotating my head from left side to the right side - I get a sudden and painful feeling of something being pinched in the area between neck and shoulder on the right side (“Image 5”). When that happens I instantly and instinctively bring my head to the previous position and then repeat the rotation but much more slowly so it doesn’t happen again. The other symptom is when I’m tilting my head from left to right - there are very unpleasant and a bit painful “clicks” (like when you’re cracking the joints on your knuckles) (“Image 6”). None of these symptoms happen when I’m rotating my head in the opposite direction - from right to left, or tilting the head from right to left.

WHAT I TRIED AND DIDN’T HELP:

• Therapies: Exercises for the shoulders and upper back - zero effect on neck pain.
• Medications: Ibuprofen - no effect at all, even with 800mg. Other painkillers also didn’t do anything.
• Taking short breaks during work (5-15 mins.). The pain goes back in matter of minutes.
• Stretching the neck during work and changing sitting positions.

WHAT DID (AND DOES) HELP:

• Getting plenty of sleep always drastically reduces the symptoms, and if I got enough sleep (9-12 hours) usually I’m ok in the morning - the pain gradually starts appearing during the day.
• Not sitting in front of the computer (or sitting at all for prolong periods of time).
• Walking.
• When working - If I have a lot of work that involves looking at various corners of my screen (that’s just the nature of my work) that’s actually much more helpful and tolerable than just looking at one point in my screen (like when you’re reading something). Obviously, having my head in a constant movement helps a little bit, although the pain is still there and it doesn’t disappear like it does after taking a walk.
• Sleeping on my right side. It’s impossible for me to fall asleep by laying on the left side - the pain immediately and drastically increases. Although, I might wake up on my left side which means sometimes during the sleep the neck gets enough rest and it becomes tolerable to switch sides.
• Medications: “Lexilium” (Bromazepam - very similar to diazepams like Valium). I’ve been occasionally dealing with anxiety and I noticed that whenever I’d take this my symptoms in neck would drastically reduce. Before anyone suggests now that the neck pain could be stress related please note that this is not the case for many apparent reasons (I won’t go into details, but I can recognize stress very easily and I’ve been having neck issues even in most relaxing situations and periods). Later I actually realized (by reading the label itself) that apart from being anti-anxiety drug Bromazepam is also a muscle relaxant. Speaking of those, last year my doctor prescribed me a dedicated muscle relaxant called “Ortoton” (Methocarbamol) - these also help a bit, although not as much as Lexilium does, and they make me sleepy.

CONCLUSION FROM DOCTORS SO FAR:

MRI shows no problems with spinal cord, no pinched nerves, etc. The general consensus is that my cervical spine looks “ok” for my age. Of course, this is an opinion only from one doctor (and a very uninterested one I might add), so I’ll look for second opinion. I did an MRI last month (in December 2019) and that’s the one you can see here: [b]Link removed[/b]

I was worried about the appearance of discs in the neck - they are almost black (“Image 7”), but I was told by a doctor (an orthopedist) that that’s normal for my age (?). Is this really how it should be? Also, I have to mention this - I did an MRI a year ago and the discs weren’t dark like this, and this past year is also when I started getting those “clicks” and other unpleasant grinding noises in my neck - so, could the (suspected) degeneration of discs contribute to these audible symptoms (clicks and pinches in images 5 and 6)? I’ve been prescribed a new physiotherapy and that’s my next step, but as I said - I’m just afraid it’s going to be a dead end like before.

OPEN QUESTIONS:

Apart from trying to get a proper diagnosis obviously, my biggest question actually is: Is this pain related to problems with muscle tissue or bone tissue (spine)? I’m constantly suspecting that it’s related to muscle tissues because I already mentioned that muscle relaxant medications actually help with the symptoms. And IF it is muscle tissue then what exactly?? - Like, is there a specific part of a specific muscle (or other soft tissue like tendons, etc.) that’s torn, sprained, or something else. How to diagnose it properly?

I’m a little bit tired of being treated without a proper diagnosis and wasting time on all these appointments with doctors who are very uninterested in my case. If anyone has/had similar issues, or has an idea what to look for here specifically I would be extremely appreciated!

Thanks everyone, especially for the patience in reading this post!

With much respect,

Goran

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