Long-Term Pain: Seeking Insights on Musculoskeletal Issues

Long-term suffering requires advice?

Hello, I have been suffering from a range of symptoms for about a year and a half.
These include dizziness, headaches, tinnitus, hearing loss, weakness in my limbs (I struggle to open a glue bottle, and from an outsider's perspective, it looks like I'm about to fall when I walk), severe body pain that wakes me up during sleep, mild pain and shortness of breath with slight joint movement, decreased concentration, difficulty swallowing, frequent nausea, and hand tremors.
During this time, I have consulted numerous major hospitals, medical practitioners, chiropractors, and traditional Chinese medicine doctors.
Recently, a friend introduced me to a physical therapist.
The physical therapist diagnosed me with cervical spine misalignment and disc displacement (inferred to be due to improper exertion), shoulder periarthritis, and both big toes curling upwards (the nails are also deformed, not congenital).
Additionally, there is soft tissue damage, and I experience overall muscle weakness, tightness, and stiffness, with thin muscles and strains.
After about two months of treatment, most of the symptoms I described have disappeared, with occasional relapses that can be managed with further physical therapy, although I still need to focus on my muscles.
Before seeing the physical therapist, I was so desperate that I consulted a psychiatrist and was hospitalized for about a week.
My symptoms were categorized as being influenced by pre-conscious factors, deemed to be imaginary, and I was diagnosed with depression.
However, when I took antidepressants, my symptoms became more pronounced, and I stopped after taking just two pills at home.
Could the aforementioned bone/muscle issues cause additional side effects from the antidepressants? Prior to seeing the psychiatrist, I had been visiting a traditional Chinese medicine practitioner for over six months.
The herbal medicine he prescribed did provide some relief, and he identified bone issues: sprains in both hands and feet, neck misalignment, and internal pressure in the sternum.
He would manipulate my neck, which made cracking sounds, and when he pressed on my back, he would prescribe medication after just a couple of adjustments.
When he believed I had recovered but I still felt unwell, he suspected it was merely depression.
I sought help from the psychiatrist in hopes of recovery and did not continue taking his herbal medicine during that time (I had been taking it twice daily for six months, which helped with dizziness; not taking it for about three days made me feel worse).
He claimed I was recovering but insisted I continue taking his medicine, which made me suspicious.
I would like to hear your personal opinion on this matter.

After enduring these symptoms for a year and a half, could the misalignment of my bones have caused trauma to my muscles as well? The physical therapist recently mentioned that my muscles are always tight and discussed deep muscle fatigue, muscle knots (which make sounds when pressed), and the presence of nodules when palpated.
Is it possible that my lack of physical activity over the past six months has led to these issues? (The traditional Chinese medicine practitioner stated that my bone and muscle problems were not this severe during treatment.) The physical therapy process has been extremely painful; I often cry and drool from the pain.
The physical therapist noted that I was experiencing hyperventilation and needed to rest when I felt slightly dizzy.
The first three treatment sessions lasted up to three hours each.
Although the results were good, is this level of pain normal?
Regarding my shoulder periarthritis, which I have had since I was 19, the physical therapist also mentioned that he wouldn't believe it if he hadn't seen it himself, stating that it is a condition that can recur.
Is it possible for shoulder periarthritis to fully recover? After all, being young should make recovery easier compared to older individuals, right? Thank you, doctor.

Xie Xie, 10~19 year old female. Ask Date: 2017/02/21

Dr. Shi Guozheng reply Orthopedics

Based on your description, it is possible that this could be a systemic condition, such as an issue related to rheumatology or autoimmune disorders.
You may consider consulting a rheumatologist or a rehabilitation physician.
Generally, with shoulder periarthritis, engaging in rehabilitation can lead to significant improvement.

Reply Date: 2017/02/21

More Info

It sounds like you have been experiencing a complex array of symptoms that have significantly impacted your quality of life. Your situation involves a combination of musculoskeletal issues, potential neurological symptoms, and psychological factors, which can complicate diagnosis and treatment.
From what you've described, it appears that you have undergone a variety of assessments and treatments, including visits to multiple specialists, physical therapy, and even psychiatric evaluation. The symptoms you mention—such as dizziness, headaches, tinnitus, weakness in limbs, widespread pain, and difficulty swallowing—can be indicative of several underlying conditions.
Musculoskeletal disorders, such as cervical disc displacement and shoulder impingement (often referred to as shoulder bursitis or rotator cuff syndrome), can lead to significant pain and discomfort. These conditions can also cause referred pain, where discomfort in one area (like the neck) can manifest as pain in another area (like the shoulders or arms). The tightness and knots in your muscles that your physical therapist mentioned could be a result of muscle guarding due to pain or injury, leading to a cycle of tension and discomfort.

Your experience with physical therapy, while painful, is not uncommon. Physical therapy often involves pushing the limits of what your body can handle to promote healing and regain function. The pain you felt during treatment could be a normal response to the manipulation of tight or injured muscles, but it should be monitored closely. If the pain is excessive or leads to increased symptoms, it’s important to communicate this with your therapist. They may need to adjust their approach or the intensity of the treatment.

Regarding your concerns about antidepressants, it’s important to note that these medications can have side effects, and not everyone responds to them in the same way. Some individuals may experience increased anxiety or other symptoms when starting or adjusting these medications. If you feel that your symptoms worsened after starting antidepressants, it would be beneficial to discuss this with your prescribing physician. They can help determine whether the medication is appropriate for you or if adjustments are needed.

As for your question about whether the displacement of bones could cause muscle trauma, the answer is yes. Misalignment or displacement can lead to abnormal stress on muscles and connective tissues, potentially resulting in pain, tightness, and dysfunction. This is especially true if the body has been compensating for these issues over time, leading to muscle imbalances and further discomfort.

In terms of your shoulder condition, shoulder impingement can indeed be recurrent, but many individuals can achieve significant improvement or even full recovery with appropriate treatment, including physical therapy, exercises, and sometimes injections or surgery if conservative measures fail. Your age can be an advantage in recovery, as younger individuals often heal more quickly than older adults.

In conclusion, it’s crucial to maintain open communication with your healthcare providers about your symptoms and treatment responses. A multidisciplinary approach, involving physical therapy, possibly medication management, and regular follow-ups with specialists, may be the best way to address your complex situation. Additionally, consider seeking a second opinion if you feel your concerns are not being adequately addressed. Your health and well-being are paramount, and finding the right path to recovery may take time and persistence.

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