Question
I woke up a few days ago with a "kink" in my neck... yesterday it got so bad my entire left side was swollen, and I couldn't do anything; I essentially cried all day and was unable to care for my children (which my mom had to do for me). I went to the ER and was told I have a strained trapezius muscle, and was prescribed some valium to relax the muscles and reduce the spasms. My neck still hurts, however, and seems to be confined to the base of my skull and the top edge of my shoulder blade, all on the left side. What can I do to ease the pain while taking the Valium? i have tried both heat and ice, to no avail. Is there any stretches that will ease the pain some? I have a 2 year old and a 9 day old, and I need to be able to care for them. Will neck massages help or hurt, and if they help, is there a specific are that should be rubbed?

Answer
Dear Kelly,

The trapezius is the likely source of your pain, but you also need to consider the levator scapulae muscle and the posterior scalene muscles as they are all in the same location, attach to the base of the skull and the top cervical vertebra, and can be the sources of significant pain when acutely inflamed.

Either way, gentle stretching of the area will help to alleviate some stress in the area, but is unlikely to completely resolve the issue.  You should be using ICE for pain and inflammation, not heat as it can actually increase pain levels due to inflammation.  If you wish to use some heat, never use dry heat such as a heating pad...a hot shower is okay, if you stretch the area afterward for 5-10 minutes, but you should then use and ice pack for 20 minutes in the same area.

When this occurs in patients I see in my clinic, I immediately start them on a course of therapeutic ultrasound for this acute phase.  Basically, I use the ultrasound in the non-thermal range, which means that it is placed on a pulsed setting rather than a continuous setting, and used directly over the sore muscle for about 10 minutes. The effect in the tissue is called micro streaming and cavitation.  I prefer 1.3 to 1.5 watts per square cm as the setting for the first 4 days.  As the swelling and pain reduce, I switch to a continuous setting to create some heat in the tissue so that I can perform PNF stretching with the patients and work on increasing the functional range of motion.  The stretching is most effective when performed immediately after the ultrasound. This protocol works best if done daily for 1 week then reduced according to recovery and the patient's need for follow-up.

I would recommend that you find a local chiropractic physician in your area and get some ultrasound to the area.  It is very effective at reducing inflammation, and aiding in the early stages of tissue healing.  They may also want to utilize interferential current to stimulate the lymphatic channels and aid in further inflammation reduction while attaining more pain control.  Sometimes I will utilize these modalities together depending on the severity of pain and dysfunction.

Good Luck Kelly.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net