Chronic Neck/Shoulder (trapziues?) Pain.

Hi for the past almost year now i have had chornic neck musclelar pain and i cannot seem to get it to heal or fix it always seems to get worse and never goes away, i have been to physio tons of times and they give me stretches like side to side roatation, ear to shoulder, cat camel exercise. But these usually just make the pain worse, for exmaple when i do the roatation side to side or ear to shoulder it will feel almost like a tearing burning pain/sensation and it may go away after about 15 min but then a couple hours later my neck/shoulder/between shoulder blades will be excruating pain. Every stretch i seem to do makes it worse, i have had xrays, MRIs, Bone scans and all have came back negative. I think it all started from years of sitting infront of a computer with bad posture, i used to be obese so i was pretty lazy and just sat all day pretty much and in the last year i lost alot of my weight, i just want to get better but everything seems to make it worse and no one seems to be able to help me or tell me whats wrong. In my opinion it seems like chornic trapzius damage but im not a specialist its just my opinion. Ill show you where the pain is mostly. I cannot even look down without pain in the area, i wear a cervical collar if i have to do anything that involves looking down to keep it from getting to bad.


http://img804.imageshack.us/img804/3639/painl.jpg

The green area is where i feel most of my daily pain. When i do the cat/camel exercise when i go upwards i feel burning/tearing all in my neck/shoulders. Im really stuck im trying to get better but all the stretches make it worse it seems. I bought a cervical pillow to sleep on to help and i cannot even lie on my back with one it will pain in that area. Any ideas?

Hi
Is there any reffered pain, any local tendeness over shown area?
has ur physio ruled out for intervertebral discs? Facet joints?
for forward head posture?
Trigger points?
Has ur physios tried anything else than stretching exercises?

Hi thanks for the reply, im not sure about intervertebral discs or Facet joints but i had an MRI and Xrays and it didnt show anything that would be causing my pain. And for trigger points my physio said i have some in my neck but im not sure what to look for to find them, but i dont think i have reffered pain when pressed on them in the neck, the tissue in my neck/area thats highlighted green has quite a few very sore tender spots that hurt alot when pressed along sides of the spine and about an inch outwards is pretty tender/sore to touch. And he hasent said anything about forward head posture i mentioned that i seem to lean forward alot but he didnt say anything. Also one thing i forgot to mention which is pretty big is it seems that using my arms to do anything brings it on and makes the pain worse for example if im slicing onions or gardening, it feels like its tearing in the back of the neck area when i bend over and let my arms hang or use my arms when bending over also. Also doing anything above my head with my arms like installing a ceiling fan KILLED so bad when i tried to do that about 3 months ago. Also today he gave me some stregthening exersies to work the muscles between my shoulder which is holding my arms out like a W and pulling backwards with a resistance band like 5 reps and 3 sets twice a day. What i cannot figure out is why the stretches/exercise exasterbate my discomfort so much. It makes it impossible to do any exercises without being in more pain. Im really losing hope my physio says to see him once more next week to see if any improvement its been about 6 weeks(6 sessions) with my current physio and almost no improvement so he says theres not much point in continuing to go if im seeing no benefit. My doctor cannot help me and now my physio cannot help me :(.

Thanks for the help!

Dear Dextah

From ur description it seems to me that you have built trigger points (TP) in ur trapezius.
As u mentioned that all your investigations are clear. Also taking ur aggravating and easing factors into account; Using ur arms brings u pain. The reason,when doing movements muscles contract that triggers the trigger points.Also you have got tender spots along sides of spine causes pain when pressed. TP are common in trapezius in people who use to sit hours in front of computer, which u used to do. Also u mentioned loosing weight by exercise and diet. Overdoing exercises can be responsible. If other muscles are weak, the trapezius will often try to ''help out'' even when it strains itself. Studies showed that poor nutrition also aggravates TP.
Having TP is an irritable and painful experience as I have experienced same in my own body.But I request u not to loose ur hope in physios.
TP can be treated by releasing them through massage(specific) followed by heat therapy. Some physios expert in manual therapy can do it with very positive results.Some physios use therapeutic ultrasound also. It can take a little long to get better and also TP release can be a painful experience.
As TP sometimes cause movements painful and thus restricted. So I suggest along with TP release massage, Mulligans NAGS and reverse NAGS for cervical and upper thoracic spine respectively, which gives wonderful results.
I suggest u some measures which could help:
Good nutrition like vitamins and minerals.
Use good body mechanics.Like when sitting at computer,make sure that ur chest is lifted and shoulders relaxed away from your ears.Keep ur head in line with the rest of ur spine.If ur head leans forward(as u mentioned) the trapezius muscle has to contract to counterbalance. When u use good sitting posture, the trapezius muscle can relax.
Smoking aggeravates
Being chilled can aggeravate, so stay warm.
Wear comfortable clothes. when the muscles of the top of the shoulder gets compressed by a heavy purse, or an ill fitted shirt or coat, they react by tightening.
Hope it helps...

Hi , I am just another fellow sufferer , you mentioned you find it difficult to use your arms overhead.
This is one of my symptoms as well as pain in all the places you mention , but it goes into my arms.
I have been told I have thoracic outlet syndrome , this can be caused by prolonged computor use.

Maybe worth looking into ?

Quote:

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Originally Posted by Dextah

Also today he gave me some stregthening exersies to work the muscles between my shoulder which is holding my arms out like a W and pulling backwards with a resistance band like 5 reps and 3 sets twice a day. What i cannot figure out is why the stretches/exercise exasterbate my discomfort so much.

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That's a pretty high load to start doing 'W's. It sounds like your getting your pain because your mid and upper traps are working to stabilise your shoulder blade, rather than lower traps and seratus anterior, which makes them over active and tight, linking in with previous comments re: trigger points. The idea of these exercises is that you're meant to use the smaller muscles of your back to stabilise your shoulder blade while you're moving. Doing them with a band straight off means you'll just use the muiscles that are already overactive, which just exacerbates the problem. try doing them without the band, and hold each rep for 5-8 seconds. You shouldn't feel like you're having to work really hard to stabilise. If you are, try doing the same exercise, but give your hands some support and just raise your elbows up.