Neck Pain

Neck pain is often due to overuse of the muscles and ligaments in the neck, but it may also be due to stress, trauma, injury, or illness. It is characterized by tightness, a knot, or severe pain in the neck and upper back. Neck pain can be acute or chronic.

Acute Neck Pain - Acute neck pain is often due to daily activities such as poor posture, sitting all day, looking at a television or computer screen for long periods of time, or sleeping in the wrong position. Sudden onset of severe neck pain may be due to trauma to the bone or nerve structures in the neck. Sometimes acute trauma leads to chronic neck pain.

Chronic Neck Pain - Chronic neck pain occurs when the pain in the neck lasts greater than two to three weeks. If you have chronic neck pain, it’s important to see your physician for an evaluation. You may need diagnostic studies such as an x-ray, CT scan or MRI to rule out serious injuries that can lead to permanent damage.

Some medical conditions that cause neck pain include:

• Cervical disc herniation
• Degenerative disc disease
• Pinched nerve
• Spinal stenosis
• Spinal tumor
• Spinal infection

Home remedies for neck pain include:

• Take anti inflammatory medication (Ibuprofen, Advil, or Motrin) to decrease inflammation and Tylenol (acetaminophen) for pain relief
• Apply ice to the area for the first 48-72 hours to decrease the initial inflammation and swelling, then after that apply heat (warm compresses or heating pad) to increase blood flow and speed healing
• Reduce activity level to allow time for healing, but avoid extended periods of inactivity which can prolong recovery

If your neck pain persists for longer than 5-7 days, contact your physician for an evaluation.

Thyroid Problems

The thyroid is a butterfly shaped gland located at the base of the neck. They thyroid helps to regulate metabolism, body temperature, and the functioning of organs and muscles. If the thyroid is not functioning properly, it can over or under produce thyroid hormones causing imbalance in the body.

Hyperthyroidism

The thyroid produces thyroid hormone, which controls metabolism, body temperature, and muscle and organ function. Hyperthyroidism involves the overproduction of thyroid hormone, causing the body’s metabolism to become overactive. Some of the symptoms of hyperthyroidism include:

• Racing heart
• Tremors
• Shakiness
• Anxiety
• Over heating
• Unintentional weight loss
• Insomnia

A blood test is used to diagnose hyperthyroidism. The causes of hyperthyroidism include Grave’s disease, which is the overproduction of thyroid hormone, growths on the thyroid, inflammation of the thyroid gland, thyroid cancer, or pituitary gland malfunction.

Hypothyroidism

Hypothyroidism results when the thyroid does not produce enough thyroid hormone. This causes the body’s metabolism to become underactive. Some of the symptoms of hypothyroidism include:

• Fatigue
• Weakness
• Depression
• Low levels of energy
• Dry brittle hair and nails
• Dry skin
• Constipation
• Memory loss
• Feeling cold most of the time
• Heavy or irregular menstrual periods

A blood test is used to diagnose hypothyroidism. The causes of hypothyroidism include an underproduction of thyroid hormones (Hashimoto’s thyroiditis), high amounts of iodine exposure, high lithium levels, and surgical removal of the thyroid gland.

Goiter

A goiter is a swollen, enlarged thyroid gland. A goiter can develop due to thyroid nodules, hyperthyroidism, and Graves’ disease can all lead to the development of a goiter. Lack of iodine in the diet can also lead to the development of a goiter, however this is rarely a problem in the United States since iodine is added to salt. As a goiter enlarges, it can put pressure on the organs in the throat and cause symptoms such as:

• Trouble swallowing
• Trouble breathing
• Pressure in the neck
• A choking sensation
• A lump or mass in the neck

Multiple tests can be used to diagnose a goiter, including blood tests and imaging studies. If there are nodules present, sometimes a fine needle biopsy is needed to determine if the nodules are benign or malignant.

Thyroid Cancer

The thyroid is a gland in the front of the neck that is butterfly shaped and produces thyroid hormone, which regulates metabolism, body temperature, and the functioning of organs and muscles. When present, thyroid cancers are often found in nodules on the thyroid gland that can sometimes be felt or may show up on an imaging study. Thyroid cancer is diagnosed with tests including ultrasound, fine needle biopsy, nuclear medicine study, or CT scan. Many patients do not have symptoms, but it’s possible to have the following indicators:

• Trouble swallowing
• Trouble breathing
• Feeling of a lump in the throat
• Voice changes
• Cough
• Swollen lymph nodes
• Weight loss

There are several types of thyroid cancer including:

Papillary - This slow growing form of thyroid cancer is the most common and has a good prognosis.

Follicular - This is the second most common form of thyroid cancer. It frequently invades vascular structures within the thyroid (veins and arteries). It is more common in older people and generally has a good prognosis.

Medullary - This is a less common form of thyroid cancer that originates from the parafollicular cells of the thyroid. It almost never causes thyroid dysfunction (hypothyroidism or hyperthyroidism) and is usually found when a lump in the throat or neck is noticed by a patient or doctor. The prognosis of medullary thyroid cancer is not as good as it is with the papillary or follicular forms, but it is more curable than anaplastic thyroid cancer.

Anaplastic - This is the least common form of thyroid cancer which usually occurs in patients over the age of sixty. It progresses quickly, presenting as a rapidly growing neck mass. It is one of the fastest growing and most aggressive of all cancers.

Most thyroid cancers progress slowly and respond well to treatment which may include surgery, radioactive iodine, radiation, and/or chemotherapy.

If you think you have a problem with your thyroid, please contact our office and schedule an appointment with one of our otolaryngologists.

CANCERS

Head and Neck Cancers

Most head and neck cancers are preventable. They are highly curable if caught early. Recognizing the early symptoms and alerting your doctor of any concerning signs as soon as possible can save your life.

The symptoms of head and neck cancer include:

Neck mass - head and neck cancers typically spread to the lymph nodes in the neck before spreading to other parts of the body. If you have a lump in the neck that lasts more than two weeks, you should contact your doctor as soon as possible. There are other reasons to have a lump in the neck, such as an infection, however a physical examination should be performed to determine the cause and nature of the neck mass.

Voice changes - Although most voice changes are not due to cancer, the cancers that form in the voice box often cause voice changes. If you have hoarseness or the quality of your voice changes for more than two weeks, contact your doctor for an appointment. An ENT specialist can perform a quick and painless procedure to directly visualize your voice box to determine the source of your vocal changes.

Growth in the mouth - Cancers of the mouth or tongue often occur as a painless ulcer or sore that does not go away. As it progresses it may bleed, or it may be accompanied by lumps in the neck. Any sore or swelling in the mouth that does not go away within two weeks should be evaluated by your doctor. Your doctor will decide if a biopsy is needed, which will determine the nature of the growth.

Trouble swallowing - One of the symptoms of cancer of the throat or esophagus can make it difficult to swallow. Food may feel like it gets stuck in the throat, come back up, or take a long time to go down.

Coughing up blood - There are a few reasons you can have blood in your saliva or phlegm. Growths in the nose, mouth, throat, or lungs can cause bleeding. If you are bringing up blood, you should be evaluated by your doctor.

Persistent ear pain - Ear pain is not always related to a problem within the ear itself and may be due to a problem with the jaw, teeth, throat, or other surrounding structures. Constant ear pain with swallowing can be a sign of an infection or tumor in the throat, and if accompanied by voice changes, trouble swallowing, or a lump in the neck, you should be evaluated by a doctor as soon as possible.

Skin changes - Basal cell skin cancer is a very common type of skin cancer that frequently occurs on the head on sun exposed areas, such as the forehead, ears, nose, and face. It does not typically spread to other areas of the body, but it can cause local tissue destruction if left untreated. It usually starts off as a small pale or red patch that slowly gets larger. It can eventually look like an ulcer that doesn’t heal and may bleed. Other types of skin cancer, such as squamous cell or melanoma, also can occur on the head and neck. Squamous cell skin cancer may look like basal cell, or it can appear as a rough scaly patch. Squamous cell skin cancer often occurs on the ears and lips. Malignant melanoma is a dangerous type of skin cancer that usually has a dark discoloration, however any mole that changes color or size may be problematic. If a mole that is changing, bleeding, or nonhealing should be evaluated as soon as possible by your doctor.

Most of the time, head and neck cancers are preventable and associated with specific risk factors. The most common cause of the mouth, throat, voice box, and tongue are tobacco use and alcohol consumption. In adults who do not use tobacco products or consume alcohol, head and neck cancers can occur due to an infection with human papilloma virus (HPV). The number on cause of skin cancers is prolonged exposure to sunlight.

The symptoms listed above can occur without the presence of cancer and are often due to other conditions. However, an evaluation by a physician is needed to know for sure. If you have any of the warning signs of head and neck cancer, see your doctor for an examination immediately. Remember that head and neck cancer is often curable when caught early.

Listed below are some of the types of head and neck cancer:

Hypopharyngeal Cancer - This type of cancer occurs in the hypopharynx, which is located in the back of the throat, above and behind the voice box. These types of tumors can be challenging to diagnose and may not cause symptoms until they are advanced. Symptoms include hoarseness, throat pain, trouble swallowing, and ear pain. These tumors are diagnosed with a physical examination, biopsy, CT scan, and/or MRI scan. Treatment usually involves surgery, chemotherapy, and/or radiation therapy.

Nasopharyngeal Cancer - This is a rare type of cancer occurs in the nasopharynx which is the space behind the nose above the back of the throat. These types of tumors can be challenging to diagnose and may not cause symptoms at all. The symptoms may be similar to common issues, such as a head cold. Other symptoms that may occur include persistent cold-like symptoms, the feeling of something stuck in the throat, hearing loss, nosebleeds, snoring, headaches, or bloody sputum. These tumors are diagnosed with a physical examination and biopsy. A CT or MRI scan is used to assess the extent of the tumor and other areas of involvement. Treatment usually involves surgery, chemotherapy, and/or radiation therapy.

Laryngeal Cancer - This type of cancer occurs in the larynx, also known as the voice box. It is common in patients with a history of heavy tobacco and/or alcohol use. Symptoms may include hoarseness, trouble swallowing, ear pain, coughing or a lump in the neck. These tumors are diagnosed with a physical examination and biopsy. A CT or MRI scan is used to assess the extent of the tumor and lymph node involvement. Treatment is individualized and may involve surgery, chemotherapy, and/or radiation therapy.

Oral Cancer - This type of cancer, also known as oral cavity cancer or oropharyngeal cancer, occurs anywhere in or around the mouth. The most common oral cancers usually occur on the tongue, lining of the lips, or floor of the mouth. It can look like red or white patches, or it can have the appearance of an ulcer. Sometimes these types of sores or patches are precancerous lesions. The most common types of precancerous lesions in the mouth are:

Leukoplakias - These look like thick white patches that are usually on the tongue, cheeks, or gums.

Erythroplakias - These look like red raised areas in the mouth.

Leukoplakias and erythroplakias are diagnosed with a biopsy.

The most common types of oral cancers are squamous cell carcinomas. Squamous cells are thin, flat cells that line the lips and mouth. If the cancer spreads, it is most likely to go to the lymph nodes in the neck. Oral cancers usually occur in patients over the age of forty-five.

Risk factors for oral cancer include:

• Tobacco use (smoking or using smokeless tobacco)
• Heavy alcohol use
• Male gender
• Marijuana use
• Human papilloma virus (HPV)

Symptoms of oral cancers include:

• A mouth sore that bleeds or does not heal
• A white or red patch in your mouth or on your gums, tongue, or tonsils
• A lump or thickening on your lips, gums, or cheek
• Voice changes
• Trouble swallowing
• A sore throat or feeling of something stuck in your throat
• Numbness or pain in your mouth
• Dry mouth

If you have any of the symptoms above, contact your doctor or dentist for an evaluation. They will likely perform a physical exam to check for signs of oral cancer. If an abnormal lesion is found, other tests may be needed such a biopsy, x-ray, or MRI scan. If oral cancer is found, treatment will depend on the stage of the cancer and may involve surgery, radiation therapy, and/or chemotherapy.

If you have any of the above symptoms, please contact our office and schedule an appointment with one of our otolaryngologists

Thyroid Cancer - The thyroid is a gland in the front of the neck that is butterfly shaped and produces thyroid hormone, which regulates metabolism, body temperature, and the functioning of organs and muscles. When present, thyroid cancers are often found in nodules on the thyroid gland that can sometimes be felt or may show up on an imaging study. Thyroid cancer is diagnosed with tests including ultrasound, fine needle biopsy, nuclear medicine study, or CT scan. Many patients do not have symptoms, but it’s possible to have the following indicators:

• Trouble swallowing
• Trouble breathing
• Feeling of a lump in the throat
• Voice changes
• Cough
• Swollen lymph nodes
• Weight loss

There are several types of thyroid cancer including:

Papillary - This slow growing form of thyroid cancer is the most common and has a good prognosis.

Follicular - This is the second most common form of thyroid cancer. It frequently invades vascular structures within the thyroid (veins and arteries). It is more common in older people and generally has a good prognosis.

Medullary - This is a less common form of thyroid cancer that originates from the parafollicular cells of the thyroid. It almost never causes thyroid dysfunction (hypothyroidism or hyperthyroidism) and is usually found when a lump in the throat or neck is noticed by a patient or doctor. The prognosis of medullary thyroid cancer is not as good as it is with the papillary or follicular forms, but it is more curable than anaplastic thyroid cancer.

Anaplastic - This is the least common form of thyroid cancer which usually occurs in patients over the age of sixty. It progresses quickly, presenting as a rapidly growing neck mass. It is one of the fastest growing and most aggressive of all cancers.

Most thyroid cancers progress slowly and respond well to treatment which may include surgery, radioactive iodine, radiation, and/or chemotherapy.

If you think you have a problem with your thyroid, please contact our office and schedule an appointment with one of our otolaryngologists.