Q: I have pain on the right side of my neck and the right shoulder. One doctor diagnosed it as thoracic outlet syndrome. The pain has been there for the past 1 year. I did some physiotherapy for the same (IFT, US, SWD) and felt better. But then suddenly I started getting dizziness and sleepiness. Then again I did physiotherapy and the body became alright. Now, I am experiencing headache on the right side of my forehead, which runs down behind the right ear and towards the right side of my neck. Is this headache also due to the problem with the neck/shoulder muscles? Is there a better cure for this problem, and some exercises to make me alright? If I do isometric exercises for my neck, within two days the pain increases. Stretching of the neck also causes pain.

A:Yes, your problem is partly due to your previous diagnosis and partly an occupational hazard. People working in your industry are prone to this kind of problem. Your x-ray report would show cervical spondylosis. I suggest, you go back to your physiotherapist and get yourself evaluated and the following regime would help you. 1. Follow the same postural guidance and avoid sudden extension and rotation of the head and learn graduated slow changing of posture, all with eyes open. 2. Use your collar while working. 3. Work for very short intervals in the beginning. 4. Thermotherapy modality for pain relief. 5. Learn exercises to improve the muscles of the whole arm and small muscles of the hand in particular. 6. Graded mobilisation by the therapist, if required. 7. Learn synchronisation of the eyeball movements of the hand.( eg. sitting on the chair and focussing on a finger, while turning your head from side to side.) 8. Take intermittent cervical traction in lying position (not sitting). 9. Avoid cycling, swimming, driving and carrying weights.