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Dr Basu
Dr Basu, Experienced Specialist
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I have a burning pain down the front of my neck that feels

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I have a burning pain down the front of my neck that feels like a sunburn. I've had the tingly pain for about three days and it makes its way to my chin and the left side of my ear.

Went to emergency two days ago, and they did a brain CT that was normal, I also happened to have an EMG on Wednesday that was normal. I am recovering from a neck/shoulder issue that had radiating pain down my arm. Most of all that is done as I was in PT for 3 months.

The ER doc suggested shingles, but said since it was mostly down the middle of my neck, that it could not be. I was not given any dx, nor any medications. I have not had pain in the front of my neck/throat before.

Should I return to a medical center to check for shingles?

mysticdoc :

The views expressed by me are for educational purposes only and do not establish a doctor patient relationship.

mysticdoc :


Hi there,



I am Mysticdoc, experienced Internal Medicine Specialist.



I am here to help you with your concerns.


mysticdoc :

How long you have these symptoms?

Customer:

Three days

Customer:

I'm not sure what it is, but if it is shingles, isn't early anti-viral the best bet?

mysticdoc :

good concern.

mysticdoc :

did you have shingles before?

Customer:

no

mysticdoc :

Does the pain radiate from your upper back to the upper arms?

Customer:

no, but I have some pain in my shoulder blades. I doesn't really radiate, its tingly and burn like on the front of my neck. Mostly the left side, up to my ear.

Customer:

It goes into the front part of my chest. It burns most on the small of my neck, and the rest is tingly.

Customer:

When you have puzzling pain symptoms, it makes one hypersensitive I think, so I don't want to overreact.

mysticdoc :

Ok I understand.

mysticdoc :

See, in case of shingles, the rash should have appeared by now.

mysticdoc :

However, in small number of cases, the rash may not appear.

mysticdoc :

In that case, the treatment with valacyclovir will prove if you do have shingles or not.

Customer:

Hmm. So the only way to know is to try the antiviral?

mysticdoc :

yes correct

Customer:

So, if its not shingles, what could the pain be?

mysticdoc :

another possibility can be the nerve compression at the cervical spine.

mysticdoc :

This can be checked by the MRI of the cervical spine.

Customer:

Really? The front of the neck can be affected?

mysticdoc :

yes correct

mysticdoc :

the nerves originate from the cervical spine

mysticdoc :

In that case, physical therapy will be helpful.

Customer:

I was referred for an MRI for my neck issue, so that will happen soonish.

Customer:

what do you think about IMS treatment for the neck issue?

mysticdoc :

That may be helpful as well if this is indeed nerve compression related.

Customer:

I had pain radiating down my right arm that started May 24. Most of that has pulled away and I have tingles down my arm (very minor now).

Customer:

It seems that IMS flares the pain. I wondered if it was just not indicated.

Customer:

My EMG was normal, the physiatrist told me its not compression.

mysticdoc :

ok -- in that case IMS can be avoided.

mysticdoc :

Still, a MRI spine is more definitive test.

mysticdoc :

Normal emg at least rules out other serious conditions like autoimmune disorders damaging the nerves.

Customer:

OK, thanks. You've been really helpful. I have amytryptaline at home, it was prescribed for my arm pain but I am really against medications so after the RX I gave it a week to settle before trying it. The pain settled, and I never started it.

Customer:

Is it worth a try now?

mysticdoc :

yes amitriptyline also may help with the nerve related pain.

mysticdoc :

Worth a try.

Customer:

Ok, thank you. It takes a while to work though does it not? Should I wait another day for the rash, and then take it? As you can see, the thought of taking meds makes me feel a little defeated. If I knew this was shingles, I would wait out the pain.

mysticdoc :

You may wait if this is not too bothersome.

mysticdoc :

And amitriptyline will not affect shingles.

mysticdoc :

The rash will come out even with amitriptyline.

mysticdoc :

Also get checked other possibilities like B12 deficiency, thyroid disorder, diabetes.

Customer:

Amitryptaline is not fast acting though... and how are the side effects? I have two small kids and cannot be a zombie.

mysticdoc :

taken usually at bedtime to avoid the drowsiness, dizziness.

mysticdoc :

no it is not.

Customer:

oh, ok. if I try it, I will take it at bedtime. Good idea. Thank you!

mysticdoc :

very welocme

mysticdoc :

very welcome

mysticdoc :

It was my pleasure to help you today.
Best wishes,
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Customer:

Thanks very much. I appreciate it.

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