• Is the pain burning, stabbing, sharp, shooting, dull, aching, electrical, gnawing or pins and needles? I have pain in my neck and at the base of my skull. It is always there. Either dull or more prominent ache which gets to a point of causing nausea. It spreads up the back of my head and on the sides of my ears. I feel pressure as though someone is strangling me. I get a strange sensation in my neck when I swallow – not pain but feels a little constricted.
• Does the quality of pain change with activity? The pain gets worse as the day goes on regardless of what I am doing. Sitting and standing make it progress faster.
• Is the skin hypersensitive to touch? no
• Are there associated skin changes like thickening, color change or nail changes? This is important in the shoulder, arm and hand. no
Percentage of Pain by Location
• What is the percentage of pain in the neck vs. shoulder and arm? 60% neck 30% base of skull and 20% from the inside of the elbow down to the wrist. My wrists become painful when I hold things and they are weaker than they used to be. For example, I cant take a baking pan out of the oven with one hand anymore. Its very painful and my wrist strength won’t support it.
Intensity of Pain
• Pain started at a zero in January and progressively got worse over the last few months. It ranges from a 1 usually in the morning to a 5 in the evening every day. Only once I had a pain that went to an 8, it was a about a month ago. The pressure in my head was so severe I debated going to the hospital. The pain in my lower arms and wrists is only when I use them and it’s a 3.
• Is there weakness associated with the pain? The weakness occurs only in my wrists and forearms. I get a numbness down my left leg into my pinky toe occasionally. I’m not sure what triggers it.
• Is the weakness due to pain inhibition (the muscle is weak from use due to pain) vs. neuropathic weakness (is muscle is weak because the signal from the brain is interrupted due to a pinched nerve)? I don’t feel like any muscles are weak. It seems like its neuropathic weakness. I am extremely clumsy with my hands also.
• Is there now an inability to lift the arm due to pain or to weakness? no
• Are certain activities more problematic like pushing away or throwing (due to weakness and not pain- such as a weak triceps muscle) or lifting due to a weak deltoid or biceps muscle? Just my forearms have limited strength with pain.