Expert: Dr. J. Shawn Leatherman - 8/29/2006

Question
I've had back trouble since I was 16. One particular place about the size of a quarter between my shoulderblades, right side. It used to "go out" and cause excruciating pain there. As years have gone by, it has changed in amount of pain and frequency and duration. Now it bothers me almost not at all. But I strained my neck dancing. It hurt just a little for 3 years. I'd notice it more riding long distances in a car, when it would start to ache. Mostly it didn't bother me too much. Recently the right side of my neck began to hurt more and more and both sides started popping all the time. The popping does not hurt but the muscle running down the back of my neck sure does. Some days it's worse than others. The bottom of my head on the right side, right where it joins my neck, seems swollen. I had headaches for a while but they stopped. I dont get alot of numbness or tingling. But sometimes if I play the guitar My right hand will go to sleep. If I don't elevate my arm at night when I sleep (the one I'm not sleeping on) my hand will go to sleep. That goes for either side.
Recently my left shoulder started hurting, worse than my neck. The muscle on top, the joint at point of shoulder in front, and my collar bone nearest my neck. The collar bone has become obviously enlarged right in front and seems to be sticking out more than the one on the right. If I push on it I can feel it all the way from collarbone to point of shoulder to rib and back to the old back injury or whatever it was. In other words, it all seems to be connected. If I get my back rubbed and the person doing the rubbing hits that small spot between my shoulderblades, it almost feels like a raw nerve and it makes my neck hurt. Otherwise that place between my shoulderblades has totally stopped bothering me after all these years...

I tried to be thorough. What do you think it is and what should I expect? Might a chiropracter help? I have not had the money to go to one in several years, but I may have to rob the bank... This pain is constant and I can not escape it. I can't roll over in bed at night without hurting bad, and I wake up so stiff in the mornings! The stiffness goes away to some extent when I move around and limber up, but the pain only subsides slightly. I still have all mobility, it just hurts is all.

Answer
Dear Earthmother,

From what you have described, I believe that all of your symptoms are inter-related because of the proximity of problems as well as the anatomical relationship of the tissues involved.  You definitely have musculoskeletal dysfunction...although to what extent, I would not be able to tell without a thorough examination and x-rays.

Nn regards to the symptoms in your arms and hands, this is most likely arising from the nerve roots and their anatomical courses from the neck.  Spinal positioning such as forward head posture creates increased stresses in the neck musculature, the upper back musculature, the shoulders, the disks between the vertebra, the ligaments, the nerves, the spinal cord and the brain stem.  All of these structures need to be considered in the examination of the upper part of the spine.  

Restrictions associated with the muscles of the chest (pectoralis major and minor), the collar bone (clavicle), and the front neck muscles (scalenes, sternocleidomastoid), also factor into possible nerve and blood supply issues into the arms and hands.  This should also be evaluated.

Realize that as these structures are placed under the physical demand of gravity as you move through your life and associated duties, the muscular system is where most of the compensation happens.  This is where we frequently notice pain and symptoms, although it may not be the cause of the problem.  The muscular strain is an easily documented result of the problem.

I definitely think that a chiropractic physician can help your problems, and that you should consult with a few and pick one that you feel the most comfortable working with.  Ask about their patient philosophy (how they treat), also about their credentials (do they have post doctoral education/certifications).  In addition, massage therapy would be a great adjunct to chiropractic care.  I send many of our patients to the massage therapist who can specifically address abnormal muscle contaractions, spasms, and adhesions...it is a big help with treatment.  If you do not know of a good massage therapist, many chiropractors will have them on staff or will know where to refer you.

If you have friends, family, or co-workers who utilze a  chiropractor, ask them for a referral and about their experiences.  If you need help finding a good chiropractic physician, check out my website, www.suncoasthealthcare.net , go to the links button and it will send open up a page with information to help you find a doctor.  If you have any further questions or comments, please feel free to contact me.

Respectfully,
Dr. J. Shawn Leatherman