What Causes Lump Over The Base Of Neck After An Injury?

Posted on Fri, 24 Oct 2014

Question: I hurt the back of my neck on Sept 25, 2014 and would appreciate your opinion. I was in the hot tub with the hot tub cover half-open like in the attached photo. I jumped up and hit the back of my neck on the open edge of the hard cover (I was kind of bending forward). The edge of the cover hit the back of my neck in the center and slightly to the right (I'd guess between C5-T1). I iced it immediately. The area had moderate swelling the next day, no visible bruising. It still hurts. The swelling has decreased a little but is still swollen/puffy. I have iced the area often. I had thoracic and cervical (3 view) X-rays on Sept 30 - all normal. The neck pain is constant and quite localized and is a 4-5 on a scale of 1-10 (10 being the worst). I have full range of motion, and moving my neck does not affect the pain. I do not feel any tingling in my arms or shoulder. I do feel a little tingling in the fingers of my right hand at times, but I also have mild carpal/ulnar tunnel in my right arm which gives me occasional finger tingling, So I'm not sure if the tingling I am currently feeling in my pinky is due to carpal tunnel or my neck. I have taken 200mg of ibuprofen every other day since the injury occurred. I would take more ibuprofen, but I am on Zoloft and was told by my pharmacist not to take too much ibuprofen due to the risk of GI bleeding.

I attached a photo of my neck swelling.

What is my likely diagnosis?
Are any additional tests necessary, or do I just give it time to heal?
I am okay with the pain - I just want to make sure I'm not in any danger.

Thank you very much.

Answered by Dr. Richard Jackson (4 hours later)

Brief Answer:
No danger

Detailed Answer:
Hi,

Thanks for your query.

I don't really see any swelling. that lump over the base of your neck is normal and is the spot where your thoracic spine meets your cervical. if you touch it you can feel the tip of c7. the lump is accentuated by your neck flexion due to your pain and nothing to worry about. carpal tunnel shouldn't cause pinky numbness so this is likely a new symptom.

The first sign of a pinched nerve in the neck is pain between the shoulder blades. if the pinched nerve progresses you will feel it in your neck them shoulder and then arm and hand. it usually has a self limited course of 1-3 months and recedes in the same way it develops.

You can take more ibuprofen if you need it. the risk of ulcer bleeding while not something to dismiss is longitudinal. if you need ibuprofen then take it. you can also combine it with Tylenol which doesn't have risks for bleeding or switch to Tylenol so you can take it more often.

Please let me know if this applies to you and whether this answers your queation

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Richard Jackson (48 minutes later)

My husband says the area is definitely moderately swollen even though it doesn't show up very well in the photos. Maybe he is just seeing the accentuation from my neck flexion. If it actually is swollen, is that concerning in terms of a possible fracture that could have been missed by X-ray or anything else?

Any idea why I am in pain? Is it a bone bruise?

I have both carpal tunnel and cubital tunnel syndromes in my right arm, so I meant that I'm not sure if it's the cubital tunnel syndrome causing my pinky numbness or my neck. If it's the neck, it sounds like you're saying that will go away with time.

I don't think I have a pinched nerve from my neck given your description of how it will progress. Is that something that could still develop, or would I already be having the symptoms?

Many thanks for helping me on a weekend.

Answered by Dr. Richard Jackson (10 hours later)

Brief Answer:
Still not serious

Detailed Answer:
I still don't see much if any swelling even on the new pictures but I believe you that it is. it is unlikely that a fracture was missed on X-ray but it is possible. in this case it doesn't matter anyways because it would be on the dorsal spinous process and it will heal itself. there is really nothing back there that can be seriously injured or cause any problems so do t worry about it and just treat it symptomatically with ice and ibuprofen. you can get some pain patches too if it continues to bother you

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Richard Jackson (4 hours later)

Thank you - I really appreciate your feedback. I will do ice and Advil and give it time.

On a side note, my X-rays showed that I have mild scoliosis. I never knew about the scoliosis before and believe it is new. I've had past spinal MRIs (for a T9 thoracic disk problem) and was never told about the scoliosis before. I just took a photo of my back and can actually see the curve in my spine which I think I would have noticed in past photos of myself. What would be causing this scoliosis? Is mild scoliosis dangerous?The mild scoliosis is located in my mid-thoracic by the way. It's kind of freaking me out.

Thank you very much.

Answered by Dr. Richard Jackson (8 hours later)

Brief Answer:
Not dangerous

Detailed Answer:
Hi,

Nobody really knows what causes scoliosis which probably means there are multiple reasons. it usually gets worse with age but doesn't cause much problems other than arthritis such as aches/pains and bulging discs. it's also very common and may never cause you any problems especially if it's mild

Regards,

Above answer was peer-reviewed by : Dr. Raju A.T