Irritation and pressure inside neck and Ultrasound done

Dear M/26,

I have gone through the images . I have a few queries

1) Which side of the neck is the pressure / pain ? Is there a visible / palpable swelling seen over the area of pain in the neck.

2) Do u have any difficulty in swallowing solids/ liquids ?

3) Is there any history of injury ? thyroid disorder ? infection

Please let me know the answers to above to help you best.

Regards,
Dr. Rohit Malik

Hi, Dr.Malik.
I should have to write more about the background situation.
I had a really stressful experience two and a half months ago. And it was quite intense stress to me. After that, I've felt this stuffy feeling in my neck.
1) The spot in question is my left-below side of the neck.
2) I have no difficulty in swalloing solids and liquids.
(but if I tilt my head back I feel distinct difference between my
right and left side of the neck. Left below side is much more
tightening and suppressing.)
3) I had no medical treatment history about thyroid.

Actually, I've got some medical examination; laryngendoscope, gastroscope, another neck ultrasound examination in the ENT today.
And all the doctors after having examined said there is really not any problematic symptom at all.
They said to me that my feeling comes right from the psychological factors, which means vulnerability to stress.
(*The physician who examined my stomach, gullet,duodenum said that I 've got reflux esophagitis but he said my status is generally found and it is not serious at all.)
I now take the tranquillizers (Lexler;1/4size, Loravan 1/2 size)
from the department of neuropsychiatry.
What I am so curious about my feeling is,
Does really the psychological factor (stress) make me feel this
irritating and tighenting sensation in my left below neck?

Is there any chance of contracting neck muscle without my
perceiving it?

what is the possibility if carotid artery makes this feeling?

If I take the CT examination, do I have the most clear and
certain status in my neck?

How long do I have to take the tranquilizers?
Is it just safe to take them regularly without any other side
effects?

Is there, if any, a lot of cases like me of your patients?
(feeling of great irritation in the neck without any effective
medical evidence found in accurate and precise examinations)
What is your prescription and medical advice for the patient like
me?

Hello,

Thanks for your reply & answering my questions , they helped me understand the case in a better perspective .

1) The red circle in the USG pictures of the neck u sent me , most likley looks like a ligament which shows early strain pattern .

2) The commonest etiology for this is generally stress & anxiety related , which leads to involuntary strain & contraction of the neck muscles / ligament . The other reason could be reactive contraction & strain , secondary to reflux espophagitis .

3) This does not seem like a vascular phenomenon like carotid artery thrmobosis/ embolism or stenosis , because symptomatically that will present with more CNS related complaints.

4) Currently the treatment with tranquilors of anxiolytic drugs Like Lexar & Lorvan as mentioned by you seems the right thing to do, till your symptoms subside , continue at least for a week .....Of course u should NOT be taking these medications for long , as most of the neuropsychiatric medications have a small addiction potential & potential side effects on long term usage. So the idea is to wean of them at your earliest once your symptoms subside .

5) If despite the above treatment & also treatment for the reflux esophagitis , as prescribed by your doctor, u do not get relief from your symptoms , the in that case an MRI is a better modality to look for soft tissues of the neck , rather than a CT scan ......which I would advise SOS , if the current treatment doesn't seem to help .

6) Stress can present is various ways and yes we do see patients like you, Sometimes worse cases do present. SO keep the faith & take your medications regularly with good rest & use of relaxation techniques Like Yoga & breathing exercises as adjuvant therapy.

Hope I have addressed most of your concerns. Fell free to discuss further.

Take Care. God bless

Dr. Rohit Malik