Chapter 895 - 436: Three Causes of Stiff Neck and New Auscultation Techniques

Chapter 895: Chapter 436: Three Causes of Stiff Neck and New Auscultation Techniques

Stiff neck is extremely common, and both adults and children can experience it.

After a stiff neck occurs, it becomes very uncomfortable, and there is significant pain when trying to turn the neck. Out of instinct for self-protection, patients will try to keep their necks still to avoid pain.

This condition is self-limiting and can recover on its own in just a few days if it’s quick.

If it’s slow, it can also self-recover in about a week.

Most people choose to buy a plaster from a clinic or pharmacy and apply it to the neck. It has some effect in alleviating symptoms and also provides a certain level of psychological comfort.

Li Jingsheng is now renowned and has become a well-known bone-setting doctor in Jiangli City.

Some patients with stiff necks, who are financially well-off, are willing to pay him for treatment.

Through massage therapy, he can indeed help patients quickly relieve symptoms and significantly shorten recovery time.

Originally, it would take a week of pain, but after his treatment, one can generally recover by the next day.

It is precisely because his post-treatment results are remarkable that more and more people are seeking him out for treatment.

Such things spread easily from one to ten, then ten to a hundred.

Additionally, people often leave messages on his Douyin videos, and when these comments receive likes, they get pushed to the top.

This lets more people know what bone injuries and conditions he can treat.

"Does it hurt right now when you turn your neck?"

Li Jingsheng asked.

"Yes! As soon as I turn my head this way, the neck hurts a lot. It feels like a knife is constantly cutting into my neck, it’s really too painful."

The patient didn’t dare to demonstrate by turning her head but pointed to the right with her hand.

"Is the pain on the left side or the right side?"

"It seems to be here. Anyway, it’s just in this area."

The woman pointed to the left side of her neck.

When turning the head to the right, the left side of the neck was in pain.

This is indeed one of the most common typical symptoms of a stiff neck.

"Are there any other symptoms like dizziness, nausea, or vomiting?"

Li Jingsheng further inquired about the patient.

"No, not these. Just a bit of a headache, feeling uncomfortable."

"Did it start this morning?"

Li Jingsheng carefully asked about the patient’s medical history.

This is very important for diagnosis.

"It seemed to hurt a bit a couple of days ago, but it wasn’t serious then. I didn’t pay much attention to it. This morning, it hurt particularly badly. I happened to know you could treat this condition. A friend of mine had a stiff neck last time, and after treatment here, it almost didn’t hurt on the same day, and it was completely healed the next day. So I hurried over to line up."

The woman seemed very envious as she spoke about her friend’s treatment experience.

Her symptoms are very severe now; she just wants to get better as soon as possible.

Because it’s really too uncomfortable.

"Alright, I’ll examine you first. You can just sit; I will check your neck muscles and bones to see if there’s a sprain. If massage therapy can help you, I will definitely treat you. Also, there will be a plaster to relax muscles and improve circulation, which, when applied, generally allows recovery by the next day."

Li Jingsheng’s plasters are sourced from Jinkui Clinic.

Now, Ye Hui has become his apprentice, and Ye Hui is Boss Ye’s sister.

With this connection, Boss Ye is particularly friendly to Li Jingsheng.

Whenever Li Jingsheng asks her for bone injury medicine or circulatory plasters, she always prioritizes high-quality supply for him.

He tried to examine the woman’s neck. Since it was quite cold, he didn’t rush to put his hand on her neck.

Instead, he warmed his hand in front of him for a moment, and after it got a bit warmer, he then touched her neck.

Even such a small gesture made the patient feel very warm.

"Oh, what’s this lump here?"

After examining her bones, Li Jingsheng did not find any neck vertebrae damage, and the muscles felt okay.

There wasn’t any obvious sprain either.

Considering the cold weather, it was possible her neck had been affected by the chill, causing the stiff neck and pain.

However, he quickly ruled out the cold as the cause of her stiff neck.

Because he felt a lump on the left side of her neck.

If not in this profession, it would be hard to detect anything abnormal by touch.

Li Jingsheng’s touch is now very sensitive, even able to sense the condition of blood vessels under the skin.

He can detect whether superficial blood vessels have any abnormalities.

"Is it swollen?"

The woman immediately became a bit nervous upon hearing about the lump.

Nowadays, with high incidences of cancer and malignant tumors appearing in abundance, even doctors find it hard to guard against.

Many malignant tumors are simply incurable.

Currently, in medicine, most cancers remain an unsolved problem.

When hearing about lumps or swellings, people’s hearts tend to skip a beat, immediately associating them with dreadful cancer.

"It doesn’t seem like a simple hematoma or subcutaneous emphysema. Have you ever noticed a lump here while washing your face or taking a bath?"

Li Jingsheng asked the patient to feel it herself.

"I haven’t really noticed it before! It did feel a bit painful when I touched it here in the past, but I always thought it was normal and didn’t pay attention."

After feeling it, the woman also touched the other side of her neck and didn’t find a similar lump.

"Is this lump serious? Is it the reason for my neck pain?"

She was clearly a bit flustered.

"Don’t worry yet, let me take a closer look for you."

Li Jingsheng certainly wouldn’t give any answers before making a definitive diagnosis.

This is also being responsible to the patient.

He begins to make further diagnoses based on the medical history information provided by the patient, as well as the results of the examination.

"Siying, take the patient’s blood pressure, temperature, and heart rate!"

"Okay!"

Han Siying has matured gradually after studying with Li Jingsheng for so long.

She can execute various auxiliary tasks for handling diseases very well.

Li Jingsheng, however, is frowning in contemplation.

There are many causes for a stiff neck.

Poor sleeping posture alone generally doesn’t cause stiff neck.

It’s because there already exists a problem in the neck which, combined with poor sleeping posture, acts as a trigger, ultimately causing stiff neck.

The most common cause is muscle strain.

For example, during the night, poor sleeping posture with the head and neck excessively tilted for long periods, or a pillow that is too high, too low, or too hard, leading to overextension or overflexion of the neck.

All of these can cause muscle tension on one side of the neck, resulting in subluxation of cervical vertebrae joints.

Static injury may also occur, causing stiffness in the injured muscles and poor circulation of vital energy and blood, leading to localized pain.

Then, the neck movement becomes noticeably restricted.

Moreover, a sudden drop in temperature, or improper covering when sleeping, can cause the neck to feel cold, leading to stagnation of energy and blood in the back of the neck, numbness, and blockage of the meridians, also causing stiff neck.

Another possibility is that neck injuries, along with protective muscle contraction and poor sleeping posture, can trigger stiff neck syndrome.

No matter the cause of stiff neck, Li Jingsheng can identify it through examination.

With his current clinical diagnostic experience, he can tell if it’s a stiff neck just by feeling.

This female patient’s neck condition doesn’t match any cause of stiff neck.

This indicates it’s not a stiff neck.

The location of that lump is precisely where the richest neck vascular group is.

"Seems like the blood pressure is a bit high, her diastolic pressure is 97, systolic pressure 130mmhg. Heart rate is slightly fast, temperature is normal."

Han Siying now also has a certain level of insight and experience in physical examination.

"Diastolic pressure is high while systolic pressure is still normal. Let me listen to the heart sounds."

Li Jingsheng immediately becomes highly alert about the patient potentially having cardiovascular diseases upon hearing about the hypertension symptoms.

Hypertension itself isn’t a big issue.

The danger mainly lies in the series of chronic changes and complications it causes.

Over time, the main issue is plaque and hardening in the blood vessels.

This further exacerbates hypertension.

Once the blood vessels have issues, the risks of cerebral infarction, myocardial infarction, and vascular rupture increase.

Li Jingsheng hands over the probe to Han Siying with a serious expression.

He doesn’t dare press it directly onto the female patient’s chest.

Because there have been more than one or two doctors slapped by female patients for such actions.

If this woman slaps him in public and calls him a hooligan, regardless of whether he is right or not, today’s clinic sitting would be severely affected. It might even be stopped.

Thus, he is extremely careful about these details every time.

Especially after being stabbed by a psychiatric patient last time, he’s become even more cautious in practice.

Listening to the patient’s heart sounds, it seems fairly normal.

Generally, high diastolic pressure while systolic pressure remains normal indicates hypertension is still in its early stage.

At this point, reasonable healthy diet, routine, and exercise can possibly improve the hypertension, eventually restoring normal blood pressure.

It also needs to be mentioned that hypertension in pregnant women falls outside this theoretical scope.

Gestational hypertension occurs within a specific time period.

Usually, it can resolve on its own after childbirth.

However, gestational hypertension is extremely dangerous, far more so than ordinary hypertension. Medication control is essential.

As the pregnancy progresses, hypertension becomes more severe in late pregnancy.

If one is skeptical, doesn’t control blood pressure, or is worried about lifelong medication, and chooses not to take medication, it gravely threatens maternal and fetal safety. The fatality rate is very high.

For example, eclampsia easily triggered by gestational hypertension syndrome.

The patient’s heart sounds are normal, but she has hypertension symptoms, and also felt a lump at the location richest in neck vasculature.

Moreover, the lump is not hard.

Li Jingsheng almost instinctively suspects the patient might have a vascular tumor.

Under normal circumstances, the most common in clinical practice is arterial vascular tumors.

This is determined by its characteristics.

Strokes from ruptured blood vessels due to hypertension are generally arterial ruptures.

"Let me feel it again."

After notifying the patient, he feels the lump on the neck again.

It feels like the diameter of this lump isn’t particularly large.

This is relative to tumors.

If it’s truly an arterial vascular tumor, it is possibly an aortic aneurysm.

A rupture in a major artery can lead to rapid blood loss, causing swift death.

There wouldn’t even be a chance for rescue.

However, his clinic doesn’t have imaging equipment like CT, so there’s no way to directly perform an imaging examination on the patient.

If it’s truly a carotid artery aneurysm, it should be detectable through auscultation for some abnormalities.

Li Jingsheng’s medical skills are becoming increasingly advanced, his experience richer, and his diagnostic methods more effective and skillful.