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Old 9 February 2018, 10:27
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Who do I see?

I have a should issue but I donít know who to see, either a neurosurgeon or Ortho? I have constant pain in my shoulder made worse when I do a chest workout. I have huge knots in my back, but I get some relief when I roll them out. The pain is starting to radiate up my neck to the base of my skull. Sometimes my rotator cuff muscles wonít fire.

I was seeing a chiro about 6 weeks ago. Heíd adjust my neck, do some active release in my shoulder (which would give relief and my rotator cuff muscles would fire), and do 10 min estim. He mentioned I might have a C spine issue.

Insurance isnít the problem but I donít have the time to dick around ping ponging to different specialists. Iím guessing go straight to a neuro and get an MRI? Thought?
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Old 9 February 2018, 10:57
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IMO chronic shoulder pain can point to underlying liver/gallbladder issues (right shoulder) or heart issues (left shoulder). Rather than consulting a medical professional sometimes its better to consult people who want to help restore your health I've witnessed several instances of long term shoulder pain that got arbitrary "treatment" for ages until it ended in cardiac arrest or gallbladder removal
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Old 9 February 2018, 11:01
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I experienced similar symptoms you described and was ping ponged through the Army medical system. Did dry needling, shots, PT, meds, etc. It wasn't until I got an MRI that the root cause was identified. Though the dry needling helped tremendously with the knots in my back prior to the MRI, it wasn't until I did the dry needling post surgery based on the MRI results that the dry needling had the max results.

When I had similar symptoms years later in my left should, I didn't dick around and worked to schedule a MRI on it.

So, my non medical opinion is, MRI.
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Old 9 February 2018, 11:23
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So, my non medical opinion is, MRI.
+1. AFAIK, that's the only way to see what's happening structurally in your back/shoulder. I believe you should rule out any skeletal or muscular issues before you look down other paths.

What does your family/personal doctor recommend?
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Old 9 February 2018, 12:59
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Have you tried Motrin and changing exercises to rest the irritated areas? Since you state relief with rolling muscles, my $.02 is to find a Sports Med MD and then do physical therapy. May help to get a cortisone shot if you have inflammation. The Sports Med + therapy combination should be able to triage whether you need to strengthen the smaller supportive structures and muscles or refer you to Neuro if it's more complicated.
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Old 9 February 2018, 13:28
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Alright, dumbass. I'm going to tell you what every medic tells every team guy when said team guy says "Hey, doc, it hurts when I do this."

Stop doing that. Don't do that until the cause of the problem has been 1) identified, 2) treated, and 3) you have recovered from the treatment.

Dumbass SF guys...of course, when SF medics are hurt, they do the exact same shit as everyone else on the team, which is not #s 1-3 above. I managed to turn my shoulder injury, repair, and rehab into a much longer ordeal than it had to be because I was a dumbass.

Go get a referral from your PCM. Let a doctor examine you, and figure out who you need to see.
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Old 9 February 2018, 13:30
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Originally Posted by Godzilla View Post
I experienced similar symptoms you described and was ping ponged through the Army medical system. Did dry needling, shots, PT, meds, etc. It wasn't until I got an MRI that the root cause was identified. Though the dry needling helped tremendously with the knots in my back prior to the MRI, it wasn't until I did the dry needling post surgery based on the MRI results that the dry needling had the max results.

When I had similar symptoms years later in my left should, I didn't dick around and worked to schedule a MRI on it

So, my non medical opinion is, MRI.
Sounds about exactly what my issues are. What was the cause of your issue?
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Have you tried Motrin and changing exercises to rest the irritated areas? Since you state relief with rolling muscles, my $.02 is to find a Sports Med MD and then do physical therapy. May help to get a cortisone shot if you have inflammation. The Sports Med + therapy combination should be able to triage whether you need to strengthen the smaller supportive structures and muscles or refer you to Neuro if it's more complicated.
I’ve been resting it a month now with no relief. I will take Motrin when I remember as it is painful enough that sleep becomes an issue. Rolling gives me temp relief, I need the dry needling to really get those knots out. Chest exercises are the worst but now front sqt/back sqt are causing issues. I’m all about going to a sports med, but would I not see a neuro first for a MRI script and then a PT?

I don’t want to treat the symptoms but the cause.
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Old 9 February 2018, 13:35
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Go get a referral from your PCM. Let a doctor examine you, and figure out who you need to see.
LOL, my what?
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Old 9 February 2018, 13:39
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Old 9 February 2018, 13:44
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Are you in Cali?
PM sent
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Old 9 February 2018, 13:49
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When I was a team sergeant, my first team leader and I were talking one day, and he starts telling me that he is hurt, having XYZ issue, it ain't going away despite his best effort to, you know, PUSH THROUGH THE PAIN. I tell him "you dumbass, you know all those smarmy over-educated and under-utilized nonmilitary types drinking coffee over at the THOR3? Get over there and make them earn a paycheck!!!"

Off he goes, gets diagnosed, treated, all that go stuff.

Months later, I am sitting there, telling him I am hurt, having XYZ issue, and it ain't going away, etc.

He looks at me, with a deadpan expression, and says "I once had a team sergeant tell me something about this sort of thing..."
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Old 9 February 2018, 13:50
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I'd see a sports med or an ortho before you see a neuro. A MRI is the golden ticket; without it, everything else is just a guess.
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Old 9 February 2018, 13:56
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HM,
the pain you describe sounds muscular in origin and, based on all data you provided, may be your trapezius muscle, which originates at the base of your skull and inserts on your collar bone and shoulder blade. The shoulder pain that radiates to the base of your skull, which is made worse with lifting and better with rolling, describes a strain of this muscle.

You can confirm the diagnosis with two simple tests.
1. do some shoulder shrugs at 80% max. If it perfectly reproduces your pain, then it is the trapezius.
2. If you take motrin or advil, and it eases the pain, then your problem is very likely NOT a c-spine issue.

You need neither a neuro/ortho surgeon nor do you need an MRI right now. If the simple tests above confirm that, indeed, you have strained your trap, then you need to let it rest and heal. Your symptoms are classical for a strained trapezius. IF you HAVE to do shit for work that requires you to use your traps, you can ice it down afterwards and achieve quick relief. However, this delays the healing process, and the best practice is to skip lifting that exacerbates your pain.

Good luck, and feel free to PM any specific problems associated with your pain.

Danny

Edit: If you do a good job leaving your shoulder alone, expect recovery to take 2-4 weeks. They don't heal quickly.
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Old 9 February 2018, 15:50
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Originally Posted by Hot Mess View Post
Sounds about exactly what my issues are. What was the cause of your issue?
The causes of the pain I experienced as it was explained to me:
- SLAP tear in R shoulder (revealed by MRI);because I spent some time trying to gut through it and continued to exercise, some of the other stuff (tissue, muscles IIRC) around the shoulder area were strained and affected to the point they had to clean out the shoulder socket as well as dealing with the SLAP tear. It also had near bone to bone contact when the shoulder moved to certain angles which was fixed with surgery.
- Because those muscles also connected to some of the back muscles in/around the shoulder blades, they weren't worked as often as I had compensated due to pain. I would then over compensate with the left shoulder. All that resulted in upper back issues that felt some relief when I rolled it and more so when I got the dry needling.
- the neck issues was from a prior injury that again, I gutted through it only to result in continued pain, spasms, etc. I experienced severe headaches as well. A seperate MRI revealed that my neck was rather straight versus the curvature it was suppose to have.

So, my situation compounded over time and had couple incidents that caused it to worsen over time. The tear in the shoulder was where the Docs decided to fix first, build back strength, flexibility, and endurance followed by PT for the shoulder, back, and neck. It took some time from flash to bang but I feel those areas were/are much stronger now.

It's been a while since I've woken up from upper back/shoulder pain or experienced discomfort while doing PT.
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Old 9 February 2018, 17:18
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Had a similar problem in upper right arm and shoulder several years ago. Pain radiated to neck, causing constant headaches. All imaging came back negative. Vacation to Mehico comes around and about 1/2 way through it I realize I was in no pain. Went back to work and within a week it was back.

Turned out to be stress!

Not sure if you have considered stress being the problem. If not I strongly advise it. Good luck.
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Old 9 February 2018, 19:20
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Essential oils should fix it. (That’s what Instagram told me).

I had same exact symptoms. Finally went to doc and got an MRI. Years of abouse tore it apart. Surgeon repaired it and after letting it heal properly and getting myself back to 100%, I kick myself in the ass for not doing it sooner.

Go get an MRI. Be smart Ranger, not broken Ranger.
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Old 9 February 2018, 19:50
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I have constant pain in my shoulder made worse when I do a chest workout. I have huge knots in my back, but I get some relief when I roll them out. The pain is starting to radiate up my neck to the base of my skull. Sometimes my rotator cuff muscles wonít fire.
Will gladly defer DDx to the pros, but this cluster of symptoms may suggest thoracic outlet syndrome, which unfortunately seems to be pretty common in those of us with overuse or rapid deceleration injuries of the upper body. C-spine, shoulder damage, chest wall trauma, severe/repeated muscle strain - all causing inflammation and an imbalance in muscling and nerve/vascular entrapment.

Chesie and Godzilla hit on the stuff docs have told me over the years about ID of causes and mgmt. Still haven't had the shoulder rebuild (probably my original issue, way worse when I was climbing a lot) but have found the combo of meds, stretches and pressure points to resolve vascular restriction and mitigate the severity and windup if I'm paying attention.

Even doing a 'symmetric' activity like swimming I can run into issues.

Another vote for rest, stretch, roll; MRI with sports med doc if no improvement. And then essential oils and voodoo dolls and maybe spitting on chicken bones.
DaveP
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Old 9 February 2018, 20:24
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I’m all about going to a sports med, but would I not see a neuro first for a MRI script and then a PT?

I don’t want to treat the symptoms but the cause.
Depends partially on your coverage, e.g. if you have to pass through primary care to a specialist. If not can skip the middle person and go sports med. A sports med MD worth their salt will use all tools, including imaging to find cause. Amazing what appropriately used cortisone and PT can do. Will also pick up some good exercises to shore up supportive structures and help prevent future.

Agree with Gavin, "Stop doing that" until further medical guidance. Godspeed.
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Old 9 February 2018, 21:37
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Thanks everyone for your replies. Iíll search a sports doc in my AO and set up an appointment. Iíve tailored my work outs to things to that upset my shoulder gurdle as much, but not working out at all isnít an option.


LOL about the swimming. I havenít been able to swim in over a year without a bunch of pain
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Old 9 February 2018, 21:59
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Have you ever had Bursitis? It's a long lingering condition that is hard to heal. Like a hamstring or groin muscle.

Just a wild guess. But I had it re-occur in my shoulder muscle a couple of times. The knots in your back are mysterious though.

Agree with others, see your PCM and get referred to the correct specialists.


https://www.webmd.com/pain-managemen...ritis-bursitis
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