Doctors Lounge - Orthopedics Answers
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Forum Name: Spinal problems and back pain
|Shifty1985 - Fri Nov 07, 2008 3:51 am|
Its been ongoing for since last around last october. I have a burning sensation that gradually turns into a sharp pain inbetween my left shoulder and neck, i guess you'd say its on my back because its not ontop of the muscle inbetween the shoulder and neck. The odd thing is, i asked my fiance to feel if theres anything she could feel wrong with it and she was immediately able to find the spot without my help because she said the skin was really hot in the area. Theres no swelling or limitation of movement, and most of the time she's noticed that small veins appear in the area when it starts hurting. Its not brought on by anything that i've noticed and happens randomly during the day, usually several times. I went to a doctor, and the emergency room on seperate occasions, both gave me an x ray, neither opted for a MRI because my workers comp insurance wouldn't approve it. I've since left the job and discontinued use of the doctor they supplied because he seemed more happy to get me out than listen to the what i was actually feeling (had the same problem in the emergency room). He gave me a cortizone shot which didn't really allleviate the problem at all because he said it seemed that the cause would be a tightness in the muscle (i didn't think pulled muscles could last this long). I've use ice and heat therapy, tried physical therapy at the suggestion of my doctor (with some kind of shock pulse machine, and exercise), and it seems nothings working.
|Shifty1985 - Mon Nov 17, 2008 9:04 am|
just as lost as me huh? well thanks anyway.
|Dr. Safaa Mahmoud - Fri Nov 21, 2008 6:43 pm|
There are different causes that can give a clinical picture similar to yours. These include cervical disc problems, shoulder bursitis or shoulder tendinitis as well as muscle spasm or inflammation.
Cervical disc prolapse or herniated disc results in pain in the back of the neck, upper back, shoulder and can extend to the arm. Pain exacerbate after sitting for long time with bending forward or driving. MRI is the test of choice.
Shoulder bursitis is inflammation, and thickening of the tendons and bursa resulting in pain of the shoulder that exacerbate with movement (especially overhead movement). With direct examination, the involved muscles can make the diagnosis easier.
In these cases the pain is mainly due to muscle spasm and muscle rest for some time (24-72 hours) and pain medications are essential. Once the pain improves, other measures like physiotherapy and exercise can be started but it may take some time to reach a satisfying results.
It usually takes up to 4 weeks to get the pain completely relieved and to return back to normal activity. Steroid injections in the inflamed area are usually the next step to be used if these measures fail.
Avoiding positions that may precipitate the pain is essential. Also, try to regularly exercise as advised by your doctor.
When the pain is associated with numbness of the arm, it indicates nerve compression and your doctor should be informed to avoid complications.
Other causes like viral infections and improper positioning can causes muscle spasm that mandates following the same precautions.
In any cases if symptoms persist after these conservative measures, an MRI should be done and other investigations based on clinical examination. Orthopedic consolation is essential.
I would advise you to follow up with your doctor.
Please keep us updated.
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