Shoulder, Neck, and Back Pain: Seeking the Right Specialist - Orthopedics

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Based on your description, it sounds like you are experiencing a complex set of symptoms that may involve multiple systems, including musculoskeletal, neurological, and possibly even respiratory components. Given the long duration of your symptoms and their impact on your daily life, it is crucial to approach this situation methodically.


Understanding Your Symptoms
1. Shoulder Pain and Numbness: The pain and numbness in your right shoulder, along with the inability to fully extend your arm, could indicate a rotator cuff injury or other shoulder pathology. The rotator cuff is a group of muscles and tendons that stabilize the shoulder joint. Injuries here can lead to pain, weakness, and limited range of motion.

2. Neck Stiffness and Pain: The stiffness and pain in your neck, combined with the numbness radiating down your arm, suggest possible cervical spine issues. Conditions like cervical spondylosis or herniated discs can compress nerves, leading to pain and neurological symptoms in the upper extremities.

3. Facial Discomfort and Double Vision: The discomfort in your right side of the face and the episodes of double vision could be related to nerve involvement or even muscle weakness. Although your nerve conduction studies were normal, it’s essential to consider other neurological evaluations, including imaging studies of the brain, to rule out any central nervous system issues.

4. Breathing Difficulties: The sensation of difficulty breathing and the inability to turn your head to the right while sleeping could indicate muscular tension or possibly thoracic outlet syndrome, where nerves or blood vessels are compressed in the neck and shoulder area.


Recommended Specialists
Given the complexity of your symptoms, I recommend the following specialists:
1. Orthopedic Surgeon: An orthopedic surgeon specializing in shoulder and neck issues can evaluate your musculoskeletal symptoms. They may recommend imaging studies such as MRI to assess the rotator cuff and cervical spine in detail.

2. Neurologist: A neurologist can further investigate your neurological symptoms, including the facial discomfort and double vision. They may suggest additional tests, such as an MRI of the brain, to rule out any central nervous system conditions.

3. Physical Therapist: A physical therapist can help with rehabilitation exercises tailored to your specific needs. They can address posture, strengthen the shoulder and neck muscles, and improve your range of motion.

4. Pain Management Specialist: If your pain is severe and persistent, a pain management specialist can offer interventions such as injections or medications to help manage your symptoms.


Next Steps
1. Comprehensive Evaluation: Schedule appointments with both an orthopedic surgeon and a neurologist. Bring all previous imaging and test results to these appointments for a comprehensive evaluation.

2. Physical Therapy: Consider starting physical therapy as soon as possible. A therapist can help you with exercises that may alleviate some of your symptoms and improve your posture.

3. Monitor Symptoms: Keep a detailed log of your symptoms, noting when they occur, their severity, and any triggers. This information can be invaluable for your healthcare providers.

4. Lifestyle Modifications: While awaiting appointments, consider making ergonomic adjustments to your workspace, practicing good posture, and incorporating regular breaks to reduce strain on your neck and shoulders.


Conclusion
Your symptoms are multifaceted and warrant a thorough evaluation by the appropriate specialists. By addressing each component of your condition, you can work towards a comprehensive treatment plan that alleviates your discomfort and improves your quality of life. Don’t hesitate to seek immediate care if your symptoms worsen or if you experience new symptoms, such as severe headaches or changes in vision.