Chronic Neck and Shoulder Pain: Possible Causes and Solutions

Frequent neck pain?

Hello doctor, I have been experiencing shoulder and neck pain for almost two years, but recently the pain has become unbearable.
It hurts even when I'm not moving, and it almost always hurts when I'm at work.
When I stay at home during my days off, it feels better.
Every time I go to work, the pain flares up to the point where I can’t lift my arm, and putting on or taking off a jacket is very difficult.
Sometimes, the pain is so severe that even sneezing or riding a motorcycle causes intense discomfort.
Recently, it has gotten worse to the point where I have weakness in my arm.
When the pain flares up, gentle pressure on my clavicle causes significant pain, and sometimes a normal movement, not even lifting my arm high, can trigger severe pain.
However, the intense pain is located around my heart, clavicle, and shoulder, not in the joints.
I previously went to the emergency room and had an X-ray, which showed nothing significant.
I also received anti-inflammatory injections but did not feel any relief.
I have tried acupuncture and massage therapy, but nothing has worked...
Could this be calcific tendonitis? The symptoms are very similar to frozen shoulder, but there are times when the pain is excruciating.

yuqc, 20~29 year old female. Ask Date: 2017/07/23

Dr. Zhou Jianwen reply Rehabilitation

It is possible that it is chronic tendinitis with an acute flare-up.
It is recommended to visit a rehabilitation clinic for further diagnosis and treatment.

Reply Date: 2017/07/23

More Info

Chronic neck and shoulder pain can be a debilitating condition that significantly impacts daily life and activities. Based on your description, it seems that you have been experiencing persistent pain for nearly two years, with symptoms worsening recently. The pain you describe, particularly when performing everyday tasks like dressing or even sneezing, suggests that there may be underlying issues that need to be addressed.

Possible Causes
1. Rotator Cuff Injury: Given your symptoms of pain and weakness in the shoulder, a rotator cuff injury could be a potential cause. This injury often results from repetitive overhead activities or trauma, leading to inflammation or tears in the tendons that stabilize the shoulder joint.

2. Cervical Radiculopathy: The pain radiating from your neck to your shoulder and arm could indicate cervical radiculopathy, where a nerve in the neck is compressed or irritated. This can lead to pain, numbness, and weakness in the shoulder and arm.

3. Tendinitis or Bursitis: Inflammation of the tendons (tendinitis) or the bursa (bursitis) around the shoulder joint can cause pain, especially during movement. This is often exacerbated by repetitive motions or poor posture.

4. Cervical Spondylosis: Age-related wear and tear on the cervical spine can lead to degenerative changes, resulting in pain and stiffness in the neck and shoulders. This condition can also contribute to nerve compression.

5. Myofascial Pain Syndrome: This condition involves trigger points in the muscles that can cause referred pain in other areas, including the neck and shoulders. Stress, poor posture, and muscle overuse can contribute to this syndrome.

Recommended Solutions
1. Medical Evaluation: Since you have already undergone X-rays and received anti-inflammatory injections without relief, it may be beneficial to seek further evaluation. An MRI could provide more detailed images of soft tissues, including muscles, tendons, and nerves, which may help identify any underlying issues such as tears or inflammation.

2. Physical Therapy: Engaging in a structured physical therapy program can be highly beneficial. A physical therapist can design a personalized exercise regimen to strengthen the shoulder and neck muscles, improve flexibility, and correct posture. Manual therapy techniques may also help alleviate pain.

3. Pain Management: If over-the-counter medications and anti-inflammatory injections have not provided relief, discussing other pain management options with your healthcare provider may be necessary. This could include prescription medications, corticosteroid injections, or alternative therapies such as acupuncture.

4. Lifestyle Modifications: Ergonomic adjustments in your workspace can help reduce strain on your neck and shoulders. Taking regular breaks to stretch and move can also alleviate tension. Incorporating relaxation techniques such as yoga or mindfulness may help manage stress, which can exacerbate muscle tension.

5. Surgical Options: If conservative treatments fail and your quality of life is significantly affected, surgical intervention may be considered, especially if there is evidence of a structural issue such as a rotator cuff tear or significant nerve compression.

Conclusion
Chronic neck and shoulder pain can stem from various causes, and it is essential to approach the issue holistically. A thorough evaluation by a healthcare professional, possibly including imaging studies, is crucial for accurate diagnosis and effective treatment. Engaging in physical therapy, making lifestyle adjustments, and exploring pain management strategies can significantly improve your symptoms and overall quality of life. If your symptoms persist or worsen, do not hesitate to seek further medical advice.

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