Hello Anwesha, I understand your concern. This is some advise from my side, follow this and please report the results to me after some time, probably after 20 days, so here it is -
Please get these blood investigations done - CBC, FBS.
Lifestyle & Posture Correction - Avoid long hours with neck bent (phone/laptop). Small breaks every 30–40 min, gentle stretching. Use a supportive pillow (not too high).
Medications - Tab. Chlorzoxazone + Diclo + Pcm, twice a day × 5 days Tab. Multivitamin once daily × 3months And since you are already on duloxetine & nortriptyline, these also help with nerve and chronic pain.
Physiotherapy - Gentle stretching & strengthening (not traction if it worsens pain). Focus on isometric neck exercises rather than aggressive modalities.
Mind–Body Approach - Stress and depression can amplify muscle tension and pain. Relaxation techniques: deep breathing, yoga, meditation. Cognitive-behavioral therapy (CBT) can help in reducing pain perception. Kindly consider getting CBT done. It is very effective. Kindly consult a psychologist/ a psychiatrist for the same.
Feel free to reach out again.
Regards, Dr. Nirav Jain MBBS, DNB D.Fam.Med.
You have persistent neck pain after the episode of hair-pulling that didn’t respond to multiple conservative treatments and a normal X-ray, which suggests a soft-tissue/myofascial problem, occult cervical disc/nerve irritation (not seen on X-ray), or chronic pain/central sensitisation contributing to ongoing symptoms. Get a cervical MRI to look for disc, nerve root, or soft-tissue pathology, stop traction (since it worsened symptoms), and pursue a focused multimodal plan — supervised neck stabilization physiotherapy, graded exercise, targeted treatments such as trigger-point injections or image-guided nerve/root injections if indicated, and review neuropathic pain options and sleep/analgesic strategies at a pain clinic. Please consult a neurologist or pain-management (spine) specialist for MRI-guided evaluation and a coordinated plan, and ask your psychiatrist to review your antidepressant/psychotropic regimen because chronic pain and depression interact and medications may need adjustment; seek urgent care if you develop new limb weakness, numbness, loss of bladder/bowel control, or fever.
Hi Dear Anwesha , Pain in neck can also be due to Temperomandibular joint disorder Kindly have soft semisolid diet local hot fomentation TAB ZERODOL TH MAX 4mg 1-0-1 for 5 days CAP SOMPRAZ D 1-0-0 before food for 5 days DICLO Gel local application thrice daily for 7 days Avoid stress in any form avoid lifting weights kindly give rest take care
Hello dear See as per clinical history you are already taking medication But I think for depression or anxiety preventive measures can give better results Iam suggesting some tests and preventive measures Kindly follow them for atleast 2 months Do neck exercises like stretching Do meditation for mental health Engage in social activities for mind engagement Indulge in hobbies for emotional stability Take zincovit multivitamin therapy once a day for 1 month Take vitamin d sachets once a week for 2 months Apply diclofenac sodium gel twice a day for 15 days Take voveron xr 50 mg accordingly for 3 days In addition Please share results of following tests X ray Cervical spine xray Neck USG Crp level Esr In case of no improvement consult neurologist or spine surgeon for better clarification Please donot stop the current medication without consulting the concerned doctor Hopefully you recover soon Regards
Hello Anwesha, Your symptoms are consistent even after medications. Since your reports are also normal, I suggest you to visit PHYSIOTHERAPIST.
1. Regular Physiotherapy 2. Tab MYORIL 1 tab at night for 7 days 3. Avoid exercises involving neck 4. Maintain proper posture while awake and sleeping.
If there are any associated symptoms like giddiness, headache, vertigo, the consult an ENT specialist for further evaluation.
Take care
Given the persistence of your neck pain, it’s important to consider a comprehensive approach that addresses both physical and psychological factors. Your history of depression, combined with chronic body aches, suggests there might be a complex interplay between your mental health and physical symptoms. Neck pain that has not responded to conventional treatments and where diagnostics like the x-ray show no structural issues might often point to muscular involvement or a functional issue. Considering the stress and muscle tension linked with mental health conditions, your physiotherapist’s suggestion that muscle stress rather than injury might be involved seems plausible. An integrative approach could be useful here. First, review your current medications with a psychiatrist to ensure they’re optimized for your mental health conditions; sometimes adjustments or combinations may help improve both depression and chronic pain. Additionally, working with a clinical psychologist trained in Cognitive Behavioral Therapy (CBT) or mindfulness techniques could help manage stress and pain perception. On the physical side, maintaining gentle neck mobility through exercises might help. Consult a physiotherapist for personalized exercises that don’t exacerbate pain. Regular, low-impact physical activities like walking or swimming can also improve overall musculoskeletal health and mood. Consider trying a gentle yoga practice, focusing on relaxation and stretching, with guidance to avoid injury. Maintain good posture, and perhaps ensure your work and sleep environments support a neutral neck position. Importantly, if the pain escalates or significant neurological symptoms like weakness, numbness, or severe pain flare, seek medical attention promptly as further imaging or neurological evaluation might be needed to rule out other issues.
