Dexmethylphenidate has a 4â6 hour duration of effect (a long-acting formulation, Focalin XR, which spans 12 hours is also available and has been shown to be as effective as DL (dextro-, levo-)-TMP (threo-methylphenidate) XR (extended release) (Concerta, Ritalin LA), with flexible dosing and good tolerability.
1 Degenerative disc disease in the neck (cervical spondylosis) can cause local neck pain or radiating pain from disc herniation, causing pinching of nerves (cervical radiculopathy). 2  Abnormal conditions involving the spinal cord, heart, lungs, and some abdominal organs also can cause neck and shoulder pain. This can also cause muscle spasms in the neck and shoulder areas. 2  Tendonitis: The tendons connect the muscles to the bones. 3  With strain, the tendons can become swollen and cause pain. 4  This is also referred to as tendinitis. 5  Gallbladder disease: This can cause a pain referred to the right shoulder.
A stiff neck is often caused by factors that cause a strain of the neck or shoulder muscles, such as sleeping in awkward positions, poor posture, or strenuous activities. The levator scapulae muscle is located at the back and side of the neck and connects the neck to the shoulder.ibromyalgia (chronic condition that causes pain, stiffness and tenderness). Headache such as migraine. Heart attack. Infections such as influenza (flu), cervical spine infection, or meningitis (a serious bacterial infection of the membranes surrounding the brain and spinal cord).