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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 31322
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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I carry all of my stress in the muscle that runs across the

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I carry all of my stress in the muscle that runs across the back of my neck and shoulder blades, and it has been very aggravated the past couple of days because I am in a very stressful situation at the moment. There is a small, hard nodule at the base of my neck, to the right side, on top of that muscle that has been there for several months and today I am having pain not only in that muscle but running up the right side of the front of my neck, right across the location of the jugular vein. Is this just pain stemming from those aggravated muscles or is there something else I should be considering?
I am Dr. Arun and will be helping you today.

It is stemming from the aggravated muscles. This is called as myofascial pain syndromes. Muscles of the neck and shoulder girdle, namely; trapezius, scalene, sternocleidomastoid, levator scapulae etc can develop myofascial trigger points. These are hyperirritable tender spots in palpable tense bands of skeletal muscle that refer pain. This can be associated with degenerative disc disease in neck causing pinched nerves. Trigger points may develop after an initial injury to muscle fibers, or due to stress, tension, over work of muscles. This injury may be a noticeable traumatic event or repetitive microtrauma to the muscles. The trigger point causes pain and stress in the muscle or muscle fiber. As the stress increases, the muscles become fatigued and more susceptible to activation of additional trigger points. The treatment is following;


1) passive stretching of the affected muscle after application of sprayed vapocoolant.

2) physical therapy; simple muscle stretch, augmented muscle stretch, post-isometric relaxation.

3) deep electrotherapy; iontophoresis, phonophoresis, short wave diathermy, electrical stimulation, high voltage galvanic stimulation, biofeedback.

4) local analgesic patch / ointment / spray

5) anti-inflammatory analgesics; Ibuprofen (Motrin / Advil)

6) ischemic compression therapy; pressure on the points

7) massage

8) steroid shots

9) acupuncture

10) Neck traction


Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

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Customer: replied 3 years ago.

Thank you so much. I worked in the chiropractic field for many years, and I felt like that was what was happening, but I just wanted a second opinion. It really is amazing what effect stress can have on the body and this week has just been a rough one. Thank you again!

You are very welcome, Michele.

Stress and anxiety can cause may physical symptoms too, as you know.

Take good care.

My Best