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  1. #1
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    Brief Medical History Overview

    Age: 26, Male, Presenting Problem Since: 9-12 months, Symptom Behaviour: Remaining Constant, Symptoms Worse (24hr Behaviour): Worse during the day, they improve in bed and seem fine upon waking, Aggravating Factors:: Generally being awake, Easing Factors:: Chiropractic adjustments, positive thinking, hot baths, Investigations: MRI shoulder, MRI Arthrogram shoulder, X-ray shoulder (all pre-op) X-ray of back, neck, MRI of neck (all post-op), No Diabetes, No history of High Blood Pressure, Medications: Naproxen, Co-dydramol, tramadol, No Osteoporosis, No Hx of Cancer, No Unexplained Weight Loss, No Bowel/Bladder issues, Other Info: Not that I can think of!

    Major problem / Symptomatic Areas

    Head, Neck - Posterior

    Head, Neck - Anterior

    Thoracic Spine

    Horrific pain in upper back / neck

    Physical Agents In Rehabilitation
    Now for the sob story of the year. Apologies for this being my first post, these initial one-offs probably annoy you all but I really need some advice. Any help on this would be greatly appreciated as I'm suffering a lot and am very close to giving up..

    About a year ago I damaged my right shoulder doing front-deltoid raises with admittedly poor technique (all about the front, not much attention to strengthening back muscles, always had poor posture, 6'2", work on a computer all day). First port of call was rest, ice/heat, ibuprofen and then gentle rehab. After a month of this I wasn't making any progress so the doctor gave me some stronger pain meds, some Diclofenac and a referral for physio (a month waiting list). I also had an MRI which diagnosed subacromial bursitis.

    Despite staying out of the gym for a further month and making effort to correct posture / use up all my meds the pain was getting worse. Gentle physio didn't seem to work and after 3 sessions and some recommended home therapy (stretch bands, all the scapula / rotator cuff stabalisation exercises etc.) a month later and no progress. I was then given a steroid injection by one of the top shoulder surgeons at my own expense (no ultrasound used?) - It was wondrous, my pain had gone and I was sent home ecstatic. 2 or 3 days later the pain returned with avengeance - I guess it was just the anesthetic. At this stage I was swiftly losing my gym gains and as quite an insecure person I was starting to lose a lot of confidence, especially as I had just met my current girlfriend at this time and really wanted to be myself w/no pain.

    I took it all in my stride and accepted that pain management was more important and that getting my body back came second, life has ups and downs etc. 5 months since the initial injury I had had enough - the pain was radiating into my neck (scalene's) and my upper back between my scapula and spine - a trigger point - and also the back of my neck - all on the same side as my damaged shoulder. I paid top whack for a subacromial decompression. Despite being very painful afterwards the radiating pain had stopped so i was happy to cope with a healing pain as opposed to a 'something is wrong and i don't know what' pain.

    Sadly, a month or so after the op my radiating neck and back pain came back - especially in my scalene connecting to my clavicle - causing bad pec minor pain. My surgeon said it's likely to be caused by weakened muscles on the right side causing stress on the left - lack of symmetrical muscle strength causing instabilities basically and that I should stick at physio.

    It's now been almost a year and almost 3 months since my surgery. The initial shoulder pain has pretty much gone although my ROM is not quite there yet. I cannot get rid of the pain in my scalenes / back - it's ruining me. I've tried rest, ice/heat, nSAIDS, physio, sports massages and now I've been going to a chiropractor - the pain relief was really good but it's short-lived and expensive. He also thinks the instability has pulled my neck vertebrae out of alignment so he's been clicking my neck / putting electrode suction pads on my back - genuinely feels so good and sends me home smiling and pain free but it doesn't last.

    This ordeal has taken everything from me - My confidence, my passion (I'm a pianist and budding musician but can't sit at a piano without pain, also a writer but can't concentrate to get inspired, can't concentrate at work) and I know my girlfriend wouldn't leave me over this but I feel as though my pain is vastly affecting my mood and tolerance and I'm dying to show her the real me as this has changed me so much and all I want to do is get my life back, my personality - I don't want to bore her but I can't go on holiday because I wouldn't enjoy it with the pain, I can't get myself out of the house very much - I'm surprised she hasn't ditched me already! She is very understanding but it's more about me - I'm very unhappy, unstable, uninspired and although I never thought I'd admit this - the mass amounts of opiates, drinking to mask pain and lack of physical activity has left me with somewhat suicidal tendencies. Brought a tear to my eye to just write that.

    Please - If anyone can help me figure out what's causing this pain, please just reach out and help because I am at my wits end with this and I can't take it any more. I hate to sound so emotional but it's destroying me. I've had X-rays, no abnormalities, 2 MRI's, having a neck MRI tomorrow - it's killing me.

    Cheers,


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  2. #2
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    Re: Horrific pain in upper back / neck

    Sounds fairly epic and you've been thro a few therapists. The chiropractor might have the point with the idea of instability. Your muscles are likely very out of balance and the function is no longer how it should be. The deep stabilising muscles versus more superficial muscles are likely not stabilising correctly. Adjustments from the chiropractor can't be maintained by the muscles. X rays may show no abnormalities as MRI may shown little or no structural abnormalities. These pictures are taken when you are not moving but your dynamic issues ie when you are moving every day are not in order. I'm suggesting a different approach as you mentioned music. Try to find a good teacher of Alexander Technique as they are often involved with musicians. London must have many Alexander Teachers and the Royal College of music could give info. If not go for a Kinetic Control approach that many physios do. Try to find someone well trained in advanced "Kinetic Control". It deals with muscle imbalance. (try Google and the name Mark Comerford as I haven't the link on hand )I have a sneaking suspicion that your shoulder injury was including a neck from the beginning..... Good luck and hang in there!


  3. #3
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    Re: Horrific pain in upper back / neck

    Quote Originally Posted by Judith Mollet View Post
    Sounds fairly epic and you've been thro a few therapists. The chiropractor might have the point with the idea of instability. Your muscles are likely very out of balance and the function is no longer how it should be. The deep stabilising muscles versus more superficial muscles are likely not stabilising correctly. Adjustments from the chiropractor can't be maintained by the muscles. X rays may show no abnormalities as MRI may shown little or no structural abnormalities. These pictures are taken when you are not moving but your dynamic issues ie when you are moving every day are not in order. I'm suggesting a different approach as you mentioned music. Try to find a good teacher of Alexander Technique as they are often involved with musicians. London must have many Alexander Teachers and the Royal College of music could give info. If not go for a Kinetic Control approach that many physios do. Try to find someone well trained in advanced "Kinetic Control". It deals with muscle imbalance. (try Google and the name Mark Comerford as I haven't the link on hand )I have a sneaking suspicion that your shoulder injury was including a neck from the beginning..... Good luck and hang in there!
    Thanks for the reply - much appreciated. I agree, logic is telling me that as the condition has been worse since my operation that it comes down to a deep instability / muscle compensation (Rhomboids / Scalenes) that can only really be properly addressed with proper stretching exercises and strength training - something I'd be doing more of for my shoulder had this ghastly neck / back pain not come into the equation.

    I've attached a picture of my Chiropractors diagnosis / treatment plan - do you think this all sounds adequate? It makes sense but I'd like to hear others gut opinions.

    10499476_10154409774625437_7007108781251952461_o.jpg

    Cheers x

    - - - Updated - - -

    Thanks for the reply - much appreciated. I agree, logic is telling me that as the condition has been worse since my operation that it comes down to a deep instability / muscle compensation (Rhomboids / Scalenes) that can only really be properly addressed with proper stretching exercises and strength training - something I'd be doing more of for my shoulder had this ghastly neck / back pain not come into the equation.

    I've attached a picture of my Chiropractors diagnosis / treatment plan - do you think this all sounds adequate? It makes sense but I'd like to hear others gut opinions.

    10499476_10154409774625437_7007108781251952461_o.jpg

    Cheers x


  4. #4
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    Re: Horrific pain in upper back / neck

    Aircast Airselect Short Boot
    the treatment plan sounds reasonable but of course hasn't got the details of what sort of exercises are to be taught. It indicates long term management and not a quick fix which is my opinion as well. I'm not sure what your idea of "with proper stretching exercises and strength training" is exactly but it is important that they are the proper ones! It's important to get the deep muscles working and that does not mean weightlifting turbo work and that's why my advice was the Mark Comerford direction. Unless there has been a big paradigma change since my courses ages ago stretching is not necc. the number one priority but does get dealt with along the (long) way



 
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