Female patient of age 28 unmarried

Female patient Chief Complaints Headach continous Pain and mild numbness in left hand since two days. Sleep decrease Appetite decrease History History of long screen time due to office work from home. Vitals Bp : 100/70 Pulse:80 Physical Examination On examination conscious Investigations I advice cbc and urine Rm Diagnosis Neuropathic pain?????? Management Need Precious advice!!!

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X ray cervical region, its case of cervical spondylosis

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Body want to rest for internal healing... continue work on desktop without comfortable posture due it...such diagnosis neuropathy because possibility median nerve involved to develop '' carrpal tunnel syndrome.'' Aslo develop stress of body - fatigue body... second due to bad dreams Nacroplexy. In this also develop vitamine B12 deficiency. D_ actue stress. So we need rest with medication... Amitriptyline 25 mg with NsAID pain killer and vitamine B12.... At Last steroids prednisolone...4 mg...

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X-ray Cervical Region----> AP & Lateral Views. Probably Cervical Spondylosis. If it is there, prescribe Pregabalin/Amitriptyline/Gabapentin in an appropriate dosages. Secondly she has low BP, Because she often forgets to drink adequate amount of water, due to prolonged screen time. So, ORS in a plenty of fluids for 2-3 weeks should also be administered, since Hypotension may be a cause of headache & dizziness.

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To me it appears stress related disorder ie constant exposure to screen . She needs some rest needs working counseling to identify the other reason if any.

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Advise her to maintain good posture. Use medical pillow to sleep . If severe, physiotherapy may help along with analgesics.

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Mri brain to exclude any organicity...if no treatment in line of CX spondylosis ... medications and physiotherapy must

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