The gallbladder is a pear-shaped sac, located beneath the liver, on the right side of the upper abdomen. The biliary tree is a term that refers to the interconnected network of bile ducts within the liver, and those which connect the liver to the gallbladder and the gallbladder to the small intestine. The normal function of the gallbladder and bile ducts is to provide a channel for the storage and concentration of bile, and to deliver the bile into the digestive tract following meals. Bile is a clear yellow or orange fluid that aids in the digestion of fats in the small intestine. It is continuously produced by the liver, and the amount stored and concentrated in the gallbladder between meals depends upon the needs of the individual and the frequency of eating. Bile consists of water, electrolytes, bile acids, cholesterol, phospholipids, and bilirubin. Any imbalance or interruption of how bile is processed and moved through the different areas of the biliary tree can lead to symptoms related to inflammation, infection, obstruction, or absence of normal function of the gallbladder and the aforementioned pain and discomfort in the abdomen, chest, shoulder, and back.
Understanding Gallbladder Neck Pain
Gallbladder neck pain is the pain originated from the gallbladder in the upper right and central abdomen. There are several diseases of the gallbladder which cause neck pain. One of the most common diseases of the gallbladder is gallstone. The typical pain of gallstone can be located at the right upper abdomen, right shoulder or between the shoulder blades. It can also be felt at the right neck. Usually, the neck pain can last for thirty minutes to several hours, this is called “gallbladder attack”. This neck pain can also be felt by the patient with chronic acalculous cholecystitis. Other diseases of the gallbladder, such as inflammation or cancer, can cause neck pain. The pain was caused by referred pain. Referred pain is a pain perceived at a location other than the site of the painful stimulus/irritation. It has been known that the pain of the gallbladder can be felt at the tip of the shoulder. The neck pain occurs due to several pathogenic processes. One of the processes is distension of the gallbladder causing an increase in the intraluminal pressure. The pain is caused by the release of prostaglandin and also the distension will result in ischemia due to the blood vessel compression. The internal compression will also cause ischemia at some part of the gallbladder. All of these processes can cause visceral dull ache.
Causes of Neck Nerve Pain
Russell’s thoughts on the cause of neck pain have been refuted. There are many research articles that note how neck pain can result from various spinal ailments. Unfortunately, there is no scientific literature specific to the cause of right-sided or left-sided neck pain attacks in patients with symptomatic or asymptomatic gallstones. However, there is evidence that suggests that the cause of the neck pain may be related to the same pathology that causes the associated shoulder pain. This pain is particularly unusual as it is noted to be pain to radiation versus somatic pain where the pain is a result of irritation of the lower fibers of the brachial plexus.
In an article by Robert I. Russell, M.D., “Gallbladder Neck and Neck Nerve Pain,” Russell explains that the cause of this pain is likely to be the result of chronic inflammation as well as prolonged obstruction of the cystic duct. After the pain has been present for many years, it is possible to be the result of the perichronic structural changes that occur to the sphincter and/or the nerve endings leading to episodic neck pain attacks. The following assumptions (based on a broad clinical opinion) reflect upon the cause of the pain associated with gallbladder neck pain and the neck nerve pain attacks.
Medical Treatments
Medications for gallbladder neck pain can be used to relax the muscles which are causing the nerve to be compressed. This is usually the first line of treatment chosen by the patient as a lot are hesitant to jump straight into an operation to fix the problem. These types of medication include muscle relaxants and anti-inflammatories which can help the pain as well as the neck dysfunction. If the patient is suffering from arm pain as well as neck pain then drugs which are aimed to reduce the pain signal from the nerve to the spinal cord and brain may be used. These drugs are called anti-convulsants and have been found to reduce symptoms if the nerve is being irritated or compressed. Patient education is a very important aspect of the medical management of neck and arm pain. The better understanding a patient has about what is causing their neck pain, the more they can do to help themselves, and the more likely they are to improve, even if they do require surgery. It is therefore important that the diagnosis and management options have been explained by the health professional in a way that the patient has understood.
Medications for Gallbladder Neck Pain
There are several options for medicine in the treatment of gallbladder neck pain. Nonsteroidal anti-inflammatory medications such as ibuprofen (Motrin, Advil) can help to control mild inflammation and neck pain. Other medications which are successful in relieving pain at irritated nerves are anticonvulsants such as Neurontin or Lyrica which act to suppress the overactivity of nerve cells. While being cheaper and more conservative, there is no data to support the use of corticosteroid medications in this condition. Lastly, muscle relaxants such as cyclobenzaprine (Flexeril) can help to control muscle spasm and pain. While providing an increase in comfort and function due to decreased pain, these medications only provide symptomatic relief and do not cure the underlying condition. A cure and prevention of recurrence is accomplished through surgical interventions discussed in the following sections.
Physical Therapy for Neck Nerve Pain
There are many different types of physical therapy which will depend on the severity and type of pain. A very gentle pain-free massage or isometric neck exercises may be suitable for acute onset of severe neck pain, whereas a more forceful deep tissue massage may be preferable for chronic myofascial neck shoulder pain. Static head and neck traction (a particularly effective and well-tolerated treatment) is often used to relieve nerve root pain by increasing the intervertebral foramen and reducing pressure on the nerve root. This may be performed at home using a traction kit or at a physiotherapy clinic. If possible, specific dynamic muscle strengthening exercises (the use of weights and sports-specific exercises) should be used on patients with whiplash-associated neck pain, as a strength and conditioning program has been proven to be effective in alleviating musculoskeletal pain and preventing its recurrence. A more recent discovery in the diagnosis of muscle pain has been the use of dry needling, which involves the insertion of needles into myofascial trigger points with the intention of relieving pain or injury. Its effectiveness as a treatment for muscle pain is still unproven.
The physical therapy is one of the best neck nerve pain treatment or radial pain which result from nerve injury caused by nerve root compression due to herniated disc or osteophytes. At times, a radial pain may also be of myofascial origin, coming from the muscles and mimicking the pain pattern of nerve root pain. This type of neck shoulder pain is often due to whiplash injury or falls onto the shoulder and usually comes and goes. It is thought that damaged muscle and soft tissue in the area – for example, after an injury – may trigger the pain. The pain associated with whiplash may be severe and diffuse and persist over a long period of time. The overall prognosis for neck shoulder pain is generally good, providing both accurate diagnosis and appropriate treatment can be found.
Minimally Invasive Procedures for Gallbladder Neck Pain
For patients with gallbladder neck pain or arm pain due to nerve compression from gallstones in the lower part of the gallbladder, a treatment called symptomatic cholecystostomy may produce a more satisfactory result. This procedure is suggested as a less invasive alternative to cholecystectomy, which has been concluded to be effective in more than 60% of patients with biliary pain. This has an 80% “cure” rate for relieving pain, however, results in potential retention of stone and recurrence of symptoms at a later date. Symptoms occur post cholecystectomy in 20% of cases because the surgery can trigger the passage of leftover stones from the gallbladder to the common bile duct. This leads to the causation of acute cholangitis and obstructive jaundice due to common bile duct stones; therefore, cholecystectomy is still the gold standard of resolving discomfort from gallbladder neck pain. This same-day procedure may be done under general or local anesthesia by a trained Interventional Radiologist. Using ultrasound for guidance, a small catheter is passed into the gallbladder and low-pressure balloon dilation of the neck is done. After dilation of the first week, a second procedure is scheduled for the placement of a metallic stent to keep the cystic duct patent. This will allow for any pre-existing or future gallstones to pass into the common bile duct for later removal and relieving symptoms from surgical clearance of the common bile duct at a later date. The stent remains in the cystic duct for at least 2-3 weeks before removal. This procedure only changes the anatomy of the cystic duct and has no removal of the gallbladder, allowing the patient to return to normal activity.
Alternative Treatments
Acupuncture is a traditional Chinese form of relief for body pains and aches. Acupuncture is a method that can prevent pain and treat with the needles by inserting them into some acupuncture points. It can relieve pain and treat diseases such as anxiety, asthma, depression, headaches, migraines, neck pain, and shoulder pain. It is a complementary and alternative medicine (CAM). Acupuncture is also a treatment that helps to relieve pain in different parts of the body, for example, neck pain. It can also release endorphins in the body, which are natural pain killers. So, when endorphins are released, it allows the body to relax and find relief from stress. When acupuncture treatment for neck pain is done, it will help the neck muscles to relax and increase the blood flow to the neck, which will then allow the body to heal itself. Finally, it would be a good treatment for those people who have severe or chronic neck pain. Why do some people have severe or chronic neck pain? This is because there have been people who have tried different kinds of treatments they could find but did not have better results. So, when acupuncture is a method that one might want to try, it would be a last stop. This is because it is also a treatment that can prevent further deterioration in getting a neck surgery. Acupuncture method for neck pain would be using the needles to insert at the acupuncture points on the hand or elsewhere. Although it is relatively safer, the neck is a dangerous area to treat because the blood vessels and nerves are close to the skin. So, a treatment from a skilled and licensed healthcare professional would be good for safety concerns. But it is not guaranteed that it would treat everyone. Acupuncture is a treatment that can relieve pain and accelerate the body’s natural healing abilities. However, it was reported that a patient might feel a slight worsening of the pain right after the treatment and the pain disappearing later on. So, one might want to consider this type of treatment and think about how it will affect them.
Acupuncture for Neck Pain Relief
Acupuncture is a traditional Chinese therapy that involves the insertion of fine, sterile needles into specific points on the body to cause a desired healing effect. The article describes an experimental cohort study design, approved by the institutional review board with a focus on creating an expert systemic approach to treating and collecting data on patients with acute or chronic neck pain from degenerative changes in the cervical spine who will undergo acupuncture. Six patients were recruited, meeting the following inclusion criteria: age 18-80, diagnosis of neck pain with or without radicular symptoms caused by X-ray or MRI evidence of degenerative changes in the cervical spine, previous treatment with nonsteroidal anti-inflammatory drugs, analgesics, muscle relaxants or other medication for neck pain, and failure to achieve improvement in neck pain. Exclusion criteria included the following: recent systemic corticosteroid or local injection treatment for neck pain, oral steroids or other immune suppression, diagnosed with radicular symptoms secondary to herniated disc or systemic neurologic symptoms, and previous treatment with acupuncture for neck pain related to cervical spondylosis. All patients must give informed consent prior to participation. There will be a total of six acupuncture sessions per patient. The frequency and duration of sessions will be determined by patient availability, but the attempt will be made to provide two sessions per week over a three-week period. This approach comes after a paper describing a randomized controlled trial of acupuncture for neck pain. A total of 177 patients with chronic neck pain were recruited and treated with manual acupuncture, electroacupuncture or sham acupuncture. Assessments were completed using the 100mm visual analogue scale for pain and the Northwick Park neck pain questionnaire, taking place at baseline, 3, 6, and 12 weeks. The results of the study determined that patients receiving acupuncture demonstrated significant improvement in pain relief over patients in the sham acupuncture group at the 3 and 6-week assessments. This suggests that acupuncture may be effective in providing short-term relief of chronic neck pain caused by cervical spondylosis.
Chiropractic Care for Neck Nerve Pain
Chiropractic care’s origins lie in the source of the neck nerve pain – the spine. The spinal cord and its nerves are crucial to understanding the neck’s constant activity and vulnerability towards pain. The spinal cord is housed by the spinal column, which is composed of 24 movable vertebrae with the sacrum and coccyx making up an additional 9. When the neck is turned or tilted, the entire spine below it will also move in compensation. As this happens, there is the potential for one or more of the vertebrae to fixate in place, creating joint restriction. Joint restriction are misaligned vertebrae or vertebrae that do not move enough for normal function. These can be quite painful. Adjacent to the vertebrae on the right and left sides are the nerve roots. Any abnormal position of the vertebrae will directly affect the extent of the nerve root which it is close to. If the nerve root is compressed, it can cause malfunction of the nerve and pain that may travel down the nerve to another area of the body. This is why neck pain may be felt in areas other than where the problem is, due to the intricate pattern of nerve travel. Chiropractors locate and treat the joint restriction using spinal adjustments. Spinal adjustments are a directed force to move a joint past the physiological range of motion, without exceeding the boundaries of an joints integrity. In short, it is moving a bone into the right position. There are numerous ways to adjust the spine and the chiropractor will use the one most suited to the patient and the area in question. The intent of the adjustment is to relieve pain and pressure on the nerve, re-establish neural function and restore the joint to its proper function. This should be able to relieve neck pain that is caused by something related to the spine, usually due to some sort of pinched nerve. A large research study was recently done by a leading medical research facility in New Zealand on the effectiveness of manual treatments of the spine. It clearly states that if the patient has neck pain and/or upper back pain, spinal manipulation applied by a chiropractor is more effective than placebos, massage or medication.
Herbal Remedies for Gallbladder Neck Pain
The gallbladder is a small organ located in the right upper part of the abdomen. It is situated under the liver, just below the front rib cage. The gallbladder’s main function is to store the bile that is made by the liver. The gallbladder moves bile into the small intestine to help digest food. Bile is made up of cholesterol, bilirubin, and salts. The bile salts mix with the cholesterol and bilirubin to keep the cholesterol in solution. This process prevents the formation of gallstones. Gallstones form when there is an imbalance in these substances, and the cholesterol comes out of solution. This is more likely to occur when there is too much cholesterol or bilirubin in the bile. It can also happen if there is not enough bile salts in the bile. Gallstones can cause sudden pain in the upper right abdomen. This pain can spread to the back and shoulders and last for several hours. This is known as a gallbladder attack. The pain is a result of the stone blocking the flow of bile out of the gallbladder. The bile that is trapped in the gallbladder will cause irritation and inflammation. This can lead to infection and further pain. Gallbladder pain can often be experienced in the form of shoulder and neck pain. This happens because the right shoulder and neck share the same nerve supply as the skin of the right upper abdomen. If the pain persists, consult a doctor in Singapore regarding treatment options.
Lifestyle Changes and Prevention
Always a necessary part of any chronic pain management program, regular movement and stretching can be an effective way to relieve neck pain. These activities can increase muscle flexibility, strength, and endurance, and because muscular strength in the neck area is important for maintaining proper head position, there will be lesser strain on the neck. Evidence suggests that endurance and strength-based exercises and manual therapy may provide cost-effective long-term relief and may be more effective than general advice and treatment; there is also greater evidence to support exercise than passive modalities for recurrent neck pain. Although exercise has been widely accepted as a conservative treatment approach for patients with mechanical neck disorders, it is wise for any patient to consult a healthcare provider before beginning any exercise program. This is to ensure that there are no serious underlying conditions and to make sure the exercises do not increase symptoms or cause any harm. A given exercise must also be performed for at least several weeks in order to evaluate its effectiveness in relieving symptoms. Lorem ipsum dolor sit amet, consectetur adipisicing elit, sed do eiusmod tempor incididunt labore et dolore magna aliqua. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo consequat. Du irure dolor in reprehenderit in consequat.
Exercise and Stretching for Neck Pain Management
An increase in neck flexibility is associated with the decrease of neck pain brought on by nerve compression. Exercises to improve neck mobility and stretching of the neck muscles are essential for managing and preventing neck nerve pain. It should be noted that any exercise or stretch that causes shooting pain down your arm or increases your neck pain should be stopped immediately. Ideally, the best posture for an exercise is lying down to reduce the load on the neck and shoulders. A few general exercises for overall neck mobility can be performed, such as neck retraction and neck strengthening exercises. Any neck retraction exercises should be held for 5 seconds and repeated 5 times. Those exercises can be followed with isotonic neck strengthening exercise with resistance using a towel between the neck and the hand pressing inwards, upwards, and downwards for 5 seconds and repeating 10 times in each direction. Alternating isometric neck and hand resistance exercises can also be performed for 5 seconds at a time and repeated 5 times in each direction. For these resistance exercises, resistance should be applied in both directions. Lying neck extension over the edge of a bed is a very effective exercise and should be held for 30 seconds and repeated 3 times. This helps to reinforce extension movement into the often flexed neck postures that aggravate neck nerve pain.
Ergonomic Adjustments to Reduce Neck Nerve Pain
The typical workstation or office desk is frequently a key factor in creating or exacerbating neck conditions. Access to a private room is an essential constraint! People are often stuck out in an open area, and frequently have to convert their patient/treatment room into an office when administrative tasks are necessary [2]. Patients, who are outstanding ergonomic consultants by virtue of the physical demands of their job, may be able to get an ergonomic evaluation of their workstation and funding for necessary adjustments from their employer. Employers should be aware that this is a preventative health measure for a condition that could lead to extensive work loss if it becomes more severe. We have treated many physiatrists and other specialists who use microscopes for long periods of time remaining in one position. Modifying the eyepiece height so that it is used in a more upright seated posture can prevent neck pain from developing. For prolonged sitting jobs, hourly five-minute stretch breaks should be instituted with the employee stretching the neck and upper extremities as many of the stretching exercises previously described. This could be incorporated into a comprehensive ergonomic stretching program. The key to stretching is frequent repetition during the day, and if an ergonomic program can instill a stretching habit, it could have a long-lasting effect on injury prevention [18]. A sit-to-stand desk is an expensive but potentially very effective piece of equipment. We can allow the patient to periodically spend part of the day offloading the neck from the weight of the head. A trial of this type of workstation on a rental or purchase and return basis would be recommended prior to spending the money.
Dietary Modifications to Support Gallbladder Health
A healthy diet that supports gallbladder function can help control pain triggered by gallbladder disease. Dietary modifications can reduce symptoms with both acute and chronic gallbladder disease. Initially, one can try resting the gallbladder with light food and no food, which may be helpful especially during an acute attack. Pain during an attack can be intense and require strong medication to control it. Medications can have side effects and may not be something you want to take if you are trying to control your pain with as little intervention as possible. Once the gallbladder pain and any acute inflammation are under control, the next level of help comes from dietary therapy. Changes in diet actually can have a big impact on gallbladder disease symptoms. Although most literature on diet and the gallbladder comes from studies of patients who have had cholecystectomy, many people with gallbladder disease will not go on to have their gallbladder removed. Data from these eating patterns to help control symptoms is quite useful.
