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QUESTION:
For some time now (about 6 or 8 months) I have had pain in my upper
right back, just next to the shoulder blade. I try stretching all ways
to try and releive the pain, but to no avail. The worst is of a
morning, when I wake up. Some times it is quite agonising to move. I
am hoping it is a muscular pain of some description that can be
rectified. I am posting in the hope (for want of a better word) that
someone else may have had similar troubles, before my trip to the doc.
ANSWER:
This sounds very much like what I have. The center of the pain is just
under the edge of the right shoulder blade (the rhomboid muscle), but it
tends to make surrounding muscles spasm as well. At its worst, it
affects most of my neck, as well, especially the left side. One
difference for me is that I am worst in the afternoon and evening, with
morning usually being the best. My problem has typically been referred
to as Myofascial Pain Syndrome (I've had all sorts of other diagnoses
that were eventually ruled out), and it is also related to headaches I
get that seem to be triggered by the occipital nerve. I don't want to
depress you, but my pain started in 1994 (no obvious cause - it just
started suddenly one morning).
The cause of my pain has been mostly mysterious, but a few years ago a
cervical MRI turned up some spondylosis that was in a position (C6-C7)
to explain some of it. Subsequent blocks of the facet were able to turn
it off like a switch, albeit for only a few hours. RF
rhizotomy/neurolysis was somewhat successful in reducing the pain for a
few months, and I will be trying it again. Trigger point injections are
sometimes helpful in knocking down the worst flare-ups.
In the course of trying to figure this all out, I spent much time
focussed on the shoulder joint itself, especially since there seemed to
be some impingement syndrome going on (I even tried surgery for that,
which did not help). Whatever you do, be VERY cautious about any
suggestion to have surgery, especially as a first course of action. When
the pain is bad, you may be tempted to do it, thinking that anything
would be better than doing nothing, but remember that you CAN make it
worse from surgery.
I am certainly not a candidate for surgery at this point, and I hope I
never am since I have great reservations about doing such a thing (I
ended up with a small amount of extra pain from the surgery and reduced
range of motion, but consider myself lucky). I have tried all kinds of
stretching and strengthening programs, TENS, accupuncture, etc. along
with the usual trials of all sorts of NSAIDs and such. The only things
that directly help are heat, rest, massage, muscle relaxants and
opioids. I am on long-term methadone along with zanaflex and lidoderm
patches (be sure to ask about those - they help me a lot with this
problem) in addition to meds for non-pain things.
I'm sorry you need to be here, but stick around and let us know how
things go for you.
I used a bathtub but a chair or couch arm will work. I would lean against
the bathtub with the lip just under my shoulder blades. Lock my fingers
behind my head with my elbows up and back. Then lean back as far as
possible. The point is to get the maximum curve. Keep your hips down and
head back. Try to touch your elbow behind your head and push with your hands
against your head as hard as you can. Lock your whole upper back muscles up.
I have found I can "pop" the ones between my shoulder blades this way.
Warning keep your head facing straight ahead. It is not very dangerous that
way. I found if I turned my head to the right I would throw myself all the
way out and spend a few hours on the floor. However when I turned my head to
the left I got this terrible popping and thudding like nothing I had ever
heard as things that had been out of place for years went into place. Warmth
and tingling would go through me. Turning the head and angle makes all the
difference. Listen to that inner voice before you do or else.
Also. You can do this on the tub arm of the couch or a on a stair. Lay on
one side or the other. I found it best with the edge of the stair in my
armpit with my arm hanging down. Then lay your head down as far as it will
go. Then with your upper arm push on the side of your head forcing it
further down. Keep you elbow as high as you can. Go for the curve. This
works differently depending on wether you are laying on your lower arm or if
you are laying on your side with the arm and shoulder hanging over the step.
On the other hand you can lay on your side with your head on your hand with
your elbow on the floor. Like you are reading. Let you spine curve into it.
Put your other hand on the outher side of your head. Keep the elbow up. Then
push hard with the upper hand. Be careful one way put me in and the other
put me out.
I got relief of muscle pain from massage. I go to a massage school for
$20/hr for Sr. Citizens and $25/hr for others. They are wonderful.
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