Chronic Pain and Inflammation: Shoulder and Neck Issues

Inflammation

Hello, doctor...
I would like to ask a few questions...
My shoulders and neck have been sore for many years (I can't even count), and my arms down to my fingers often feel numb and occasionally twitch lightly.
I struggle to exert strength, and the pain on both sides of my neck is constant, radiating down towards my lower back (mainly the upper back).
This year, it has worsened, and sometimes when I wake up, my neck feels like it's locked, making it difficult to turn, which makes my daily life very challenging.
I am a repeat exam student...
this condition prevents me from maintaining a seated position for long periods.
I used to play basketball and have had two significant falls on my spine; although I was able to stand up at the time, it was quite painful (about five years ago).
I didn't see a doctor then, but now I find that standing for too long easily makes my lower back sore, and lifting heavy objects (which others find light) is very strenuous for me, causing back pain as well.
Earlier this year, after playing basketball, I returned home to eat, but I couldn't even hold chopsticks properly (during the worst times, my hands would shake continuously).
This situation has persisted...
I have temporarily stopped playing basketball, and I have a habit of using the computer.
I used to sit in front of the computer for long periods, but I have reduced my computer time over the past six months.

Key point: I have been seeing a rehabilitation specialist for two years and have also consulted traditional Chinese medicine for about two to three years...
but my condition has not improved despite ongoing rehabilitation.
Recently, I visited the orthopedic department at Linkou Chang Gung Memorial Hospital, but as soon as I mentioned using the computer, the doctor said it was muscle inflammation and prescribed muscle relaxants, which had no effect at all.
I heard that the medication might make me a bit sleepy, but that wasn't the case; I felt very alert (and in pain).
Returning to my previous point, the rehabilitation doctor said that both my shoulder muscles and nerves are inflamed, and there is poor blood circulation...
I have undergone neck traction, electrical therapy, ultrasound, and more...
for two to three years...
yet there has been no improvement, and my fingers continue to feel numb.
Additional question: When I was 7 years old, I fractured both of my arms (each from different falls).
The X-rays showed a clear separation of the joints, but later, Western medicine managed to fix them.
Given the severity of the injuries at that time, could this have led to my current inability to exert full strength in my arms? I struggle to lift heavy objects (about the weight of a computer monitor), and each time I try, it takes a lot of effort...
Thank you for your answers.

deicide, 10~19 year old female. Ask Date: 2001/02/02

Dr. Pan Yingda reply Rehabilitation

I personally believe it is a cervical spine issue, possibly related to your injury, and likely less connected to your fractured arm.
Testing the tendon reflexes (like how doctors tap the patient's knee on TV...) can indicate if there is an increase in reflexes, which may suggest spinal cord injury, necessitating further examination.
Maintaining proper posture is crucial, especially for you; when stretching your neck, keep your spine straight, slightly lean forward, lift your neck, tuck your chin, and relax while allowing the machine to pull without resisting.
In fact, there is no need to pull too hard.
I genuinely want to help you, it's just...

Reply Date: 2001/02/02

More Info

Chronic pain and inflammation in the shoulder and neck can be debilitating, especially when it affects daily activities and overall quality of life. Based on your description, it seems that you have been experiencing persistent pain and discomfort in your shoulders and neck for several years, along with symptoms like tingling in your arms and fingers, muscle spasms, and difficulty with strength and mobility. This situation is understandably distressing, particularly as you are preparing for important exams.

From a medical perspective, there are several potential underlying causes for your symptoms. Chronic pain in the neck and shoulders can often be attributed to a combination of factors, including muscle strain, poor posture, previous injuries, and nerve involvement. Given your history of significant injuries, such as the falls while playing basketball and the fractures you sustained at a young age, it is possible that these incidents have contributed to your current condition. Injuries can lead to long-term changes in muscle function, joint stability, and even nerve pathways, which may explain the persistent pain and weakness you are experiencing.

The symptoms you describe, such as the tingling in your fingers and the difficulty lifting objects, may suggest nerve involvement, possibly due to compression or irritation of the nerves in the cervical spine or shoulder region. Conditions such as cervical radiculopathy, thoracic outlet syndrome, or even myofascial pain syndrome could be contributing to your symptoms. It is essential to consider that chronic inflammation can also lead to changes in the way your body perceives pain, potentially resulting in heightened sensitivity and discomfort.

You mentioned that you have been undergoing rehabilitation and have seen various specialists without significant improvement. This can be frustrating, but it is important to continue seeking appropriate care. Here are some recommendations based on your situation:
1. Comprehensive Evaluation: It may be beneficial to undergo a thorough evaluation by a specialist in physical medicine and rehabilitation or a neurologist. They can assess your symptoms in detail and may recommend imaging studies such as an MRI of the cervical spine to evaluate for any structural issues, such as herniated discs or nerve compression.

2. Physical Therapy: Continuing with physical therapy is crucial. A physical therapist can tailor a program specifically for your needs, focusing on strengthening the muscles around your neck and shoulders, improving posture, and enhancing flexibility. Techniques such as manual therapy, dry needling, or specific exercises may help alleviate pain and improve function.

3. Pain Management: If muscle relaxants and anti-inflammatory medications have not provided relief, discussing alternative pain management strategies with your healthcare provider may be worthwhile. Options such as corticosteroid injections, nerve blocks, or even acupuncture could be considered.

4. Lifestyle Modifications: Since you have reduced your computer time, consider incorporating regular breaks and ergonomic adjustments to your workspace to minimize strain. Gentle exercises, such as yoga or swimming, can also help improve flexibility and reduce tension.

5. Psychological Support: Chronic pain can take a toll on mental health. Engaging in counseling or cognitive-behavioral therapy may help you develop coping strategies for managing pain and stress, particularly as you prepare for exams.

6. Follow-Up on Previous Injuries: Given your history of fractures and dislocations, it may be worth revisiting those injuries with a specialist who can assess whether they are contributing to your current symptoms.

In conclusion, while chronic pain and inflammation in the neck and shoulders can be complex, a multidisciplinary approach involving thorough evaluation, targeted rehabilitation, and pain management strategies can lead to improvement. It is essential to remain proactive in your care and communicate openly with your healthcare providers about your symptoms and concerns.

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