I am sorry that your question was unanswered for long.
Her symptoms are most likely due to pinched nerves in the neck. Having said that, if she has following risk factors of the heart disease, she need to be evaluated by EKG and Troponin test (though these are not typical of angina / heart, but we work on the caution);
1) stress and sedentary life style
2) peripheral vascular disease (claudication),
3) previous stroke,
4) heavy smoking,
5) high blood pressure,
7) high cholesterol, and
8) a family history of heart disease
9) over weight.
Pinched nerves in the neck can be due to;
1) Herniated/degenerated disc in neck
2) Cervical spondylosis; bone spurs in the neck vertebrae pressing on the nerves.
Following investigations would be required;
1) X-ray of the neck spine
2) MRI of the neck
3) Nerve conduction velocity (NCV) study
4) Electromyography (EMG)
Following measures would be helpful;
1) Neck care in the activities of daily living.
a) No working on computer for more than half an hour in a single stretch. Same for TV.
b) Monitors and televisions exactly in front (180 degrees).
c) Contour pillow: Should fill the hollow when lying on back or straight. Available over the counter.
2) Cervical Collar or Brace
3) Cervical traction
4) Anti-inflammatory analgesics like Ibuprofen
5) Some physicians do give oral steroids in severe radiculopathy cases, in whom pain is quite significant.
6) Physical therapy: gradually increasing exercises from passive stretching to active against resistance regime.
7) Electrotherapy in the form of TENS, interferential and laser and ultrasound.
8) Hot fomentation
9) Local analgesic patch / ointment / spray
You can consult following specialists;
c) MD in Physical medicine and rehabilitation
This other likelihood of diagnosis can be myofascial trigger point. This can be associated with degenerative disc disease in neck causing pinched nerves. Trigger points may develop after an initial injury to muscle fibers. 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. When predisposing factors combine with a triggering stress event, activation of a trigger point occurs. Myofascial trigger point is a hyperirritable spot, usually within a taut band of skeletal muscle or in the muscle fascia which is painful on compression. The treatment is following;
1) passive stretching of the affected muscle after application of sprayed vapocoolant
2) physical therapy
3) deep electrotherapy; iontophoresis, phonophoresis, short wave diathermy, electrical stimulation
4) local analgesic patch / ointment / spray
5) anti-inflammatory analgesics; Ibuprofen (Motrin / Advil)
6) ischemic compression therapy; pressure on the points
8) steroid shots
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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