OpenHealth Q&A

38-Year-Old Male – Persistent Left-Sided Chest, Neck, and Head Pain with Internal Discomfort Following Cannabis Use Five Years Ago

**Demographics:** 38 years old, Male **Symptom Duration:** 5 years (constant, day and night) **Affected Areas:** Left side of the chest (precordial region), clavicle, shoulder, posterior neck, and left hemisphere of the head. **Current Medications:** Quetiapine 25–50 mg nightly. **Previous Medications Attempted:** Pregabalin, duloxetine, mecobalamin (Vitamin B12), eperisone, magnesium. **Medical History:** No formal diagnoses offered so far. Non-smoker; does not currently consume alcohol or drugs. --- 🔍 **Main Concern:** For the past five years, I have been enduring a persistent dull ache along with a profound sensation of internal swelling that affects my left chest, collarbone, shoulder, back of the neck, and the left side of my head. This distress initiated after a significant episode during a depressive period when I was excessively using cannabis. The incident involved severe, piercing chest pain alongside palpitations, and an uncomfortable burning sensation, which then radiated to the left shoulder, neck, and head, resulting in a feeling of impending catastrophe. Since this frightening episode, the discomfort and sense of swelling have remained constant without any change. 🧪 **Diagnostic Assessments and Treatments Undertaken:** **1. Cardiology:** - A 24-hour Holter monitor revealed a first-degree AV block and a second-degree Mobitz I AV block during sleep episodes (lowest heart rate recorded 30 bpm). - The cardiologist attributed these findings to benign vagal hyperactivity. - Other cardiological evaluations, including echocardiograms and lab tests, yielded normal results. **2. Neurology and Imaging:** - Comprehensive MRI and CT scans of the brain and spinal regions (cervical, thoracic, and lumbar) indicated no notable abnormalities. - Attempted mecobalamin (B12) for treatment; while it provided slight pain alleviation initially, it later resulted in additional pain points and twitching, leading to its discontinuation. - Pregabalin and duloxetine offered minimal relief, with symptoms re-emerging post-treatment. - Eperisone, a muscle relaxant, reduced pain by approximately 30%, yet the swelling persisted, and I experienced a pulling sensation in affected areas when treatment stopped. - Magnesium (350mg elemental): Helped somewhat with mood stabilization but induced tightness in the chest, dizziness, and fatigue, and significantly lowered my heart rate compared to my baseline (approximately 80 bpm). Additionally, it triggered a sensation of nervous hyperactivity from my chest radiating to the left side of my brain, necessitating its cessation. **3. Sleep Disturbances:** - Natural sleep eludes me due to ongoing nervous inhibition in the precordial area. I am currently dependent on quetiapine (25–50 mg) to help induce sleep. **4. Conventional Therapy:** - I have attempted a “small-needle knife” fascia release technique (from Traditional Chinese Medicine) which provided slight superficial relief; however, deeper pain points in the chest and cranial regions could not be treated safely. - The practitioner noted the tissue in these areas is extremely tight and firm. 📉 **Symptom Characteristics:** - Continuous dull ache and a sensation of internal swelling. - Triggers include: - Nervous system stimulants (caffeine, green tea, chocolate, levofloxacin). - Physical activity or pressure on affected areas. - Low-frequency sounds or music with heavy bass. - Slight improvement with: - Resting, applying warm compresses, and gentle, non-invasive manipulation (though benefits are temporary). ❓ **Inquiries:** 1. Could my condition be linked to central sensitization, autonomic dysfunction, or a potential undiagnosed nerve entrapment or fascia issue? 2. Are there safe imaging techniques or treatment options available for deep fascial nerve swelling or irritation, particularly in areas difficult to access through standard dry needling? 3. Would pursuing advanced imaging methods such as MR neurography, functional MRI, or ultrasound-guided fascia assessment be beneficial? 4. Are there non-invasive methodologies available for addressing nerve hypersensitivity that may be kinder to fragile or overly responsive nerves? Thank you for taking the time to read this. This condition has profoundly impacted my daily existence and mental well-being, and I am eager to receive any medical insights or suggestions for further exploration.

Answers (1)

7/6/2025, 1:31:00 PM

OpenHealth AI

Your persistent left-sided pain, discomfort, and sense of internal swelling indicate a complex and prolonged condition, likely influenced by various factors, including possible stress responses following the initial episode. Given your extensive evaluations and treatments so far, let’s focus on your concerns about potential underlying mechanisms and management strategies.

Main Points:

1. Your symptoms may be associated with central sensitization or increased nerve sensitivity.
2. Exploration of advanced imaging could be useful, but practical treatments should be prioritized.
3. There are non-invasive approaches to help manage nerve hypersensitivity.

Explanation:

Your history suggests a possible link between your symptoms and central sensitization, which occurs when the nervous system becomes overly responsive to stimuli. This can happen after stress or trauma, like your experience with cannabis and the subsequent panic-like symptoms. Given that conventional treatments have provided limited relief, it's essential to evaluate alternative strategies to ease your discomfort.

Next Steps:

1. Consider Non-Pharmacological Approaches:

   • Physical Therapy: A therapist familiar with myofascial release techniques may aid in manipulating tight tissue and relearning movement patterns to reduce discomfort. Combining gentle stretching, stabilization exercises, and relaxation techniques may enhance results.
   • Cognitive Behavioral Therapy (CBT): Working with a mental health professional can address anxiety related to your symptoms, promoting coping mechanisms that help mitigate stress-induced exacerbations.

2. Evaluate for Nerve Sensitivity Management:

   • Transcutaneous Electrical Nerve Stimulation (TENS): This technique uses low-voltage electrical currents to relieve pain and may work by disrupting pain signals.
   • Mindfulness and Relaxation Techniques: Practices like yoga, meditation, or guided imagery can help improve pain management and stress resilience.

3. Consider Advanced Imaging Techniques:

   • While MR neurography or ultrasound can potentially provide insights into nerve entrapments or fascial issues, they may not always yield actionable treatment pathways. Discuss these options specifically with a healthcare provider to assess their necessity based on your situation.

4. Track Your Symptoms: Keep a symptom diary noting triggers, pain intensity, and associated activities or foods. This can help identify patterns that may guide temporal management.

5. Social and Support Networks: Engaging in support groups or forums where you can connect with others experiencing similar issues can offer emotional support and practical coping strategies.

While your symptoms have been debilitating, continued exploration of treatment options and support systems aimed at managing both physical and psychological components can lead to improved quality of life. If you need further clarification or have any more questions regarding specific treatments, feel free to ask.