Hello Dr Mariano,

I haven’t posted here before but was hoping you can provide some insight. I am not looking for diagnosis but possible causes to search for.

I was healthy as a horse in 2009 until I overexerted myself at the gym. I felt some pinch in my neck and dull tense pressure in the head followed. I have no pressure in the head/neck now but continue to have issues with mildly shaky extremities, fatigue, apathy, fear, insomnia, nervousness, tingling sensations with the upper body (esp fingers) and anxiety during the daylight hours, being worse in the AM. I have no shooting pain. At times I feel totally flattened. I have no real weakness but my muscle mass has decreased probably from being sedentary since the incident. Imaging studies have been negative.

My question is related to a constant pattern here–all symptoms seem to get much better towards the evening, but not completely. I get to sleep between 10-11 but wake up around 3 or 4 and cannot fall back asleep. Does the fact I get better towards evening mean anything concrete?

I am in my late 30s, never took any drugs, supplements, medications and have no mental history including anxiety. I used to sleep like a rock. I am not taking anything.

I appreciate any feedback you can provide.