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The typical pattern: Location: Posterior neck, bilateral trapezius region, occasionally radiating to the base of the skull Quality: Dull, constant ache rather than sharp or shooting pain Timing: Begins 2 to 6 weeks after starting medication or increasing dose Duration per episode: 3 to 14 days at peak intensity, then gradual resolution Aggravating factors: Worse with head-forward posture, prolonged sitting, and during periods of active nausea Relieving factors: Heat application, gentle movement, lying supine The pain does not typically radiate down the arms (which would suggest nerve root compression), does not cause numbness or tingling (which would suggest neurological involvement), and does not worsen with specific neck movements in a dermatomal pattern (which would suggest facet joint or disc pathology)
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doi: 10.1002/(SICI)1096-9861(19990111)403:2 3.0.CO;2-5 141 MillerR
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