Still in extreme pain - Please help

[nikey2003]

Hi.  I have had a chronic pain in my neck for over a year.  I posted a previous question titled Acid Reflux issues on May 4, 2003.  The pain is so bad I can't concentrate on work or do anything.  I took the 24 hour ph test as you suggested last time.  They said my acid reflux was normal.  But they also took a motility test and they found too much pressure in my neck area and that is the area where the pain is. The pressure in that area they say is 118 and it is supposed to be 150 or maybe the numbers are the other way around. I do feel a tightening in that area too and I have trouble swallowing pills. And with the tightness and the pain together it feels really bad. I can't move or do anything. I can't go to work or function it is so bad.  It really just started acting up severely this week but the pain is always there and it gets severe all the time.  It has been over a year and I have been takin aciphex and nexium and nothin seems to cure it.   So anyway they claim that they don't know what causes the pressure in my neck and the nurse practitioner only had 6 people with the same problem this year.  So she says she treats this condition with high blood pressure pills to reduce the pressure. So I thought I finally had the answer. But after 3 weeks of the pills I am still in severe pain. I called the nurse back up(she works for the gastrologist I had been seeing) to see if there was anything she could give me to cure the pain. She said there wasnt much I could do and she said now that the pain I was experiencing had to do with acid reflux issues and that the pressure was a separate issue.  But my ph study was normal so why is she saying acid is the cause.  I can be in constant pain for days continually. It just doesnt go away.    I don't see how this is acid only. Why am I so unlucky to get this conition? What can I do to emliminate this pain for good. Can something be done surgically to remove the painful part or can I just have the nerves in that area destroyed so I dont feel anything.  I am willing to do anything to get rid of this pain.  The medications dont seem to cure me.  All I know is I am gonna see a second opinion now.  The nurse said they wont do an endoscope again to see if there are still problems.  She just says we dont do that.  What do you think this problem is?  I just want to be normal again.  I can't live like this. Please help.

[Kevin Pho, MD]

It would seem appropriate that you receive answers from the physician rather than the nurse, especially if the condition isn't getting better.  

With an abnormal esophageal motility test - any one of a variety of esophageal motility disorders can be causing your symptoms (i.e. achalasia or esophageal spasm).  

It is true that blood pressure medications are used to treat esophageal spasm.  Examples include nifedipine (10 mg) or isosorbide dinitrate (10 mg) just prior to each meal.  Another option would be long-acting diltiazem taken twice daily.

If you cannot speak to a physician regarding this, I would definitely suggest a second opinion.

I am also not aware of any surgical procedures to destroy the nerves to the area.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.