Expert: Dr. Victor Dolan, DC, DACBSP - 10/2/2009

Question
Hello. I am having severe back pain around my left shoulder blade in one aream I've seen my pcp who thinks it muscle pain. She gave me naproxyn and valium which have done nothing. Will a chiropractor help?

Answer
Back pain,  severe back pain,  shoulder blade pain, Staten Island Back Pain, pain medications,






Hello Jennifer,

I am sorry to hear of your pain.

How did you hurt yourself?  Did you have a slip/ trip/ fall?,  Did you lift something heavy?,  Did you have a car crash?,  Did you wake up with this pain??

Pain is your body talking to you.  Where is the pain coming from?- Is it possible to be a heart pain (left side, left shoulder blade)?, Is it possible to be a Gall Bladder referral pain?
              Pain is your body talking to you.  Depending upon a more thorough examination, your doctor can make better decisions.

You saw your Medical Doctor PCP.  Good.  I am sure she knows your history, has ruled out the less probable causes of your complaints, and come to a good medical diagnosis of 'muscle spasm', muscle pain'.

Chiropractic Doctors may work similarly in the diagnostic portion, the examination portion of the evaluation.  First rule out the more serious, less likely conditions- Heart, Lung, Gall Bladder.  Move on to the more probable, and less serious:  pulled muscle, tendinitis, 'pinched nerve', vertebral subluxation, stiff neck,,,,
              The Doctor of Chiropractic would treat differently then the Doctor of Medicine.
Depending upon the findings, perhaps a Chiropractic approach could be helpful.

What caused that muscle pain?- did you sleep wrong, is it related to your cervical or thoracic spines?, a 'pinched nerve' in your t- or c- spine??  Did you lift something heavy, have a trauma??  Again, the pain is your body talking to you.  You can shut the body up with a pain killer or muscle relaxer,,, but is that wise?- what is the cause?

I have informative handout sheets that I give to my Staten Island back pain patients,  I think this may help explain what is possible with your complaints:




PAIN           

Pain  is a  ‘red light on the dashboard’.
 
Pain is your body telling you that something is wrong.

That RED LIGHT on the dashboard of your car-
-- do you ignore it until the car breaks down,
or do you get it checked and correct the problem?  

Pain,
pain in your body-
-- do you ignore it until your body breaks down,
or do you get it checked and correct the problem?   

Pain,  
do you cover up the pain by taking a painkiller?  
Take a painkiller,
mask the pain,
and allow a problem to progress in your body?

         NOTICE  ON  PAIN  RELIEVERS:
 
Label changes ORDERED by FDA;  the FDA announced proposed label changes for OTC over-the-counter pain relievers to  include the potential for stomach bleeding and liver damage (FDA news  206- 207;  12-9-06) ;

The  American Heart Association issued a scientific statement   recommending medical doctors change the way they prescribe OTC pain relievers from a first choice    to an alternate of recommending non-pharmacologic treatment (AHA statement  2-26-07).

NSAID Acceleration of ARTHRITIS; an important side effect of Aspirin and other NSAIDS is that it will inhibit cartilage repair and accelerate cartilage  destruction ( Journal of Rheumatology, 1982; 9: 3- 5 ).   Many times people take NSAIDS  for  the pain of Arthritis,  not realizing these drugs may make the underlying condition worse.   These medications  cover  up  the  pain,  and  cause  the  problem  to   worsen.


Pain  can  often  be  the  result  of  the  Vertebral  Subluxation  Complex.

Vertebral  Subluxation           (  ‘VSC’ ,    ‘subluxation’   )
Vertebral Subluxation  is  actually  a  quite  common  condition.   Doctors of Chiropractic look for pathological conditions which may require referral to other specialties,   and also look for ‘Subluxation’. Other disciplines look for pathology, but overlook the importance of alignment and movement in the spine which affects our nervous system  (the master control system- ALL health disciplines learn this).  VSC- ‘Subluxation’ – can be the cause of many symptoms and conditions.



Only  a  Doctor of Chiropractic  will  evaluate  and  treat  for  VSC,   as  well  as  other  pathology.



The course of VSC is highly variable.   Some patients with VSC literally cannot walk, yet other patients with similar test findings may be able to run marathons or lift heavy weights.    Some patients immediately develop symptoms related to the VSC,  some patients take years to develop symptoms.  Some people suffer for only a few days with pain and symptoms, some people suffer for months.  Some people recover in days, some take months or years, depending upon severity of the condition.

A subluxation interferes with the proper functioning of the nervous system (the master system which controls and coordinates all function within the body) and may cause various other conditions, symptoms and problems.


The Vertebral Subluxation Complex describes what happens when spinal bones lose their normal movement patterns and position.  When subluxated, joints are in a stressed, vulnerable, compromised condition.  Subluxation may cause Arthritis, Disk Herniation, or aggravate such conditions.
       Vertebral  Subluxation   cannot   be corrected through chemicals (medicine), stretching,  yoga,  vitamins  or  physical  therapy  alone.       Subluxation- a neuro/skeletal/muscular-    mechanical-    problem  requires  a    mechanical correction-  -  -    a manipulation,         best  performed  with  the  chiropractic  adjustment.

Dr. Victor E. Dolan,   Doctor of Chiropractic;   Diplomate, American Chiropractic Board of Sport Physicians; Diplomate, American Academy of Pain Management; Certified Clinical Nutritionist (IAACN); FIRST  Chief of Chiropractic  in  a  Hospital  in  New York State (DHSI);  As  Seen  in  PREVENTION  Magazine


You can see from the above that, in general, all drugs have intended effects and un-intended side effects, enough so that even the medical industry is concerned.

You state that you have taken "....naproxyn and valium which have done nothing...".
Let us look at the information on Naproxyn:
http://www.google.com/search?hl=en&source=hp&q=naproxen+side+effects&aq=1&oq=nap...

"......Naproxen is in a group of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). It works by reducing hormones that cause inflammation and pain in the body......
    Naproxen can increase your risk of life-threatening heart or circulation problems, including heart attack or stroke. This risk will increase the longer you use naproxen......
    Seek emergency medical help if you have symptoms of heart or circulation problems, such as chest pain, weakness, shortness of breath, slurred speech, or problems with vision or balance.
              This medicine can also increase your risk of serious effects on the stomach or intestines, including bleeding or perforation (forming of a hole). These conditions can be fatal and gastrointestinal effects can occur without warning at any time while you are taking naproxen. Older adults may have an even greater risk of these serious gastrointestinal side effects.
              Call your doctor at once if you have symptoms of bleeding in your stomach or intestines. This includes black, bloody, or tarry stools, or coughing up blood or vomit that looks like coffee grounds.
              Do not use any other over-the-counter cold, allergy, or pain medication without first asking your doctor or pharmacist. Many medicines available over the counter contain aspirin or other medicines similar to naproxen (such as ibuprofen or ketoprofen). If you take certain products together you may accidentally take too much of this type of medication. Read the label of any other medicine you are using to see if it contains aspirin, ibuprofen, or ketoprofen. Do not drink alcohol while taking naproxen. Alcohol can increase the risk of stomach bleeding caused by naproxen. Avoid exposure to sunlight or artificial UV rays (sunlamps or tanning beds). Naproxen can make your skin more sensitive to sunlight and sunburn may result.
. . . http://www.drugs.com/naproxen.html . . ."

That is some information on Naproxen (an NSAID).  Here is some information on Valium:
http://www.anxiety-and-depression-solutions.com/articles/conventional/pharmaceut...
".....Diazepam is indicated for the treatment of insomnia, anxiety, and symptoms of acute alcohol or opiate withdrawal......
               Diazepam has some off-label indications as well, including treatment of insomnia (short-term), treatment of tetanus – in conjunction with other measures of intensive-treatment, initial management of mania – along with first-line drugs such as lithium, treatment of stiff-person syndrome, treatment of painful muscle conditions, treatment of spastic muscular paresis, treatment of overdosage by hallucinogens or CNS stimulants and treatment of drug-induced seizures, among other uses......
               The most common side effects Valium include drowsiness, impaired motor functions, impaired coordination, impaired balance, dizziness, fatigue, depression, anterograde amnesia and reflex tachycardia. These symptoms are common with most benzodiazepines.
               Rare side effects can include nervousness, confusion, constipation, diplopia, dysarthria, headache, hypotension, incontinence, jaundice, changes in sex drive, nausea, changes in salivation, rash, slurring of speech, tremor, urinary retention, vertigo, irritability, insomnia, muscle cramps, and in severe cases, rage and/or violence. If these side effects develop, diazepam treatment should be discontinued.
               If Valium is given with other drugs, attention should be paid to the possible pharmacological interactions. Special care should be taken with barbiturates, narcotics, antidepressants and phenothiazines........"

Of course, these sources are from the medical industry, and this is self-reported.  Perhaps there may be other reactions as well- ascribed to other causes, perhaps there could be a reporting bias?


For my Staten Island Back Pain patients with muscle spasm I have another information sheet:




“Muscle  Spasm”,  Midback  or  Shoulder(s)

Sometimes  we  can  wake  up  with  a  muscle spasm,  tightness, ‘grinding’, stiff  neck,  or  pain in our neck,   mid back, or low back.... sometimes a slip, trip, fall, heavy lift, or even a motor vehicle accident can cause a problem in our neck, mid back or lower back.  Ultimately-  often  the underlying                

c a u s e       

of  the spasm and pain;  is a misalignment,  a  ‘kink’ in the neck or back- more properly termed a Vertebral Subluxation.

                Vertebral   Subluxation   Complex    (a.k.a.  ‘subluxation’)
The vertebral subluxation complex is the underlying cause of many healthcare problems.
A subluxation interferes with the proper functioning of the nervous system (the master system which controls and coordinates all function within the body) and may cause various other conditions, symptoms and problems.


This is a serious condition identified by its five parts:
      Spinal Kinesiopathology:
         This is fancy way of saying the bones of the spine have lost their normal motion and position. It restricts your ability to turn and bend. It sets in motion the other four components.
      Neuropathophysiology:
         Improper spinal function can choke, stretch, or irritate delicate nerve tissue. The resulting nerve system dysfunction can cause symptoms elsewhere in the body.
      Myopathology:
          Muscles supporting the spine can weaken, atrophy, or become tight and go into spasm. The resulting scar tissue changes muscle tone, requiring repeated spinal adjustments.
      Histopathology:
         A rise in temperature from an increase in blood and lymph supplies result in swelling and inflammation. Discs can bulge, herniate, tear, or degenerate. Other soft tissues may suffer permanent damage.
      Pathophysiology:
         The VSC contributes to OsteoArthritic degeneration.  Bone spurs and other abnormal bony growths attempt to fuse malfunctioning spinal joints. This spinal decay, scar tissue, and long-term nerve dysfunction can cause other systems of the body to malfunction.


The Vertebral Subluxation Complex describes what happens when spinal bones lose their normal movement patterns and position.
         Automobile accidents, improper lifting, improper posture, alcohol, emotional stress, chemical imbalances, and long periods of sitting can cause the Vertebral Subluxation Complex.
          Vertebral  Subluxation  cannot be corrected through chemicals (medicine), stretching, yoga, vitamins or physical therapy alone.  Subluxation- a neuro/skeletal/muscular- mechanical- problem requires a mechanical correction-  -  -    a manipulation,     best performed with the chiropractic adjustment.  For good health- Treat the   Cause,  not just the Symptoms.

Dr. Victor E. Dolan,   Doctor of Chiropractic;   Diplomat, American Chiropractic Board of Sport Physicians; Diplomat, American Academy of Pain Management; Certified Clinical Nutritionist (IAACN); FIRST  Chief of Chiropractic  in  a  Hospital  in  New York State (DHSI);  As  Seen  in  PREVENTION  Magazine


Finally you ask,  ".....Will a chiropractor help?.....".
Given your description, certainly a Doctor should perform a Chiropractic examination upon you.
The Chiropractic Doctor will be able to ascertain if a 'pinched nerve', vertebral subluxation complex (see above), intrinsic muscle problem, or if perhaps Heart/ Lung/ Gall Bladder (usually right shoulder), involvement exists.  If a CAUSE is found, then something more then SYMPTOMATIC treatment can be undertaken.

Will a chiropractor help?- given your description I would say yes.

Be careful of the drugs, be careful of the drug interactions.

If you need further information, please, do not hesitate to RE-contact me here
at your panel of experts!
http://www.allexperts.com/ep/965-100794/Chiropractors/Victor-Dolan-DC-DACBSP.htm
your Staten Island Chiropractic expert !!!

Thank you for this good question.

I wish you good luck in returning to good health- naturally!


Dr. Victor Dolan, DC
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