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Pain Management

Constant Tightness and Pain

02/12/2008

Question:

About a year ago I had benign positional vertigo which made me very dizzy and made walking very difficult. I am a 45 year old woman. My neurologist did many tests MRI, hearing tests which came back normal and treated the BPV. My problem is that I now have constant neck,jaw , shoulder tightness/spasms which still causes dizziness and spasms and sleeping difficulties. I've had a CT and X-ray , X-ray shows a slight loss of lordosis which they think is postural. My physiotherapist thinks the lordosis is due to muscle spasms. My neurologist mentioned that most of his dizzy patients suffer from neck tension from being too afraid to move freely. I also suffer from anxiety and when my muscles are extremely tight, I feel I am going to have a stroke or heart attack. My question is why do I get the feeling of doom when the muscles are tight, I constantly check my pressure when this happens. (I've been told to stop checking but have difficulty resisting this compulsion when the muscles are extremely stiff)

What is going on with me and what treatment is best?

I've been to a pain management clinic to access the jaw function and they the problem is the neck and anxiety. I am fed up with all this and it is stressing me up as I want to get back to work but it is a constant daily battle.

My posture is bad but that is how I can hold myself at times.

Please help.

Answer:

Most likely you need to be seen by a pain psychologist to help you with cognitive behavior and to teach how to control your muscle. At the same time you may need to have a special physical therapy program including swimming. I am not sure where you live, but I would be happy to help you.

From what I gather, the worst will be if you start taking opioids or narcotics. You should try to stay away from this type of medical therapy.

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Response by:

Hammam  Akbik, MD, FIPP Hammam Akbik, MD, FIPP
Formerly, Assistant Professor of Anesthesia
College of Medicine
University of Cincinnati