Chronic Neck, Shoulder, and Back Pain: Causes and Treatments

Neck, shoulder, waist, and back issues?

Hello, doctor.
I have been experiencing long-term symptoms of pain and weakness in my shoulders, neck, lower back, and upper back.
I feel a heavy, sinking pressure in my body and head, and I am unable to maintain an upright posture.
I often sway and tilt, and sometimes I even lean forward or backward.
Changing positions frequently produces cracking sounds.
Additionally, I feel as though my body weight is leaning to one side, and I have a sensation of having one leg shorter than the other when standing.
(I often sit cross-legged, look down at my phone, and lie down to read...) Could this indicate a problem with my spine or another issue? What could be the possible diagnosis? Are there other symptoms that might arise? What is the severity of my condition? What treatment options are available, and what are their potential effects? Which specialty should I consult? I would greatly appreciate your assistance.
Thank you.

Mei, 20~29 year old female. Ask Date: 2020/12/08

Dr. Wang Zhaomin reply Rehabilitation

There are numerous causes for shoulder, neck, and lower back pain symptoms, including poor posture, muscle strains, external injuries, and natural degeneration.
A proper assessment can only be made through an in-person examination, as online consultations cannot replace actual medical visits.
Please consult an orthopedic or rehabilitation specialist for an accurate diagnosis and appropriate medication or rehabilitation treatment.

Reply Date: 2020/12/08

More Info

Chronic neck, shoulder, and back pain can be a complex issue, often resulting from a combination of factors including poor posture, muscle strain, and underlying spinal conditions. Based on your description of symptoms such as persistent pain, a feeling of heaviness in the body and head, difficulty maintaining an upright posture, and audible sounds when changing positions, it is essential to consider both muscular and skeletal components.

Possible Causes
1. Muscle Strain and Overuse: Prolonged poor posture, such as slouching while using a smartphone or reading, can lead to muscle fatigue and strain. This is particularly common among individuals who spend long hours in static positions.

2. Cervical and Lumbar Spine Issues: Conditions such as cervical spondylosis (age-related wear and tear affecting the spinal disks in your neck) or lumbar disc herniation can contribute to chronic pain. These conditions may also lead to nerve compression, resulting in symptoms like numbness or tingling in the arms or legs.

3. Postural Imbalances: Your description of feeling as if your body weight is unevenly distributed may indicate postural imbalances. This could be due to muscular imbalances where some muscles are overactive while others are underactive, leading to compensatory patterns that can exacerbate pain.

4. Joint Dysfunction: The "clicking" or "popping" sounds you hear when moving may be related to joint dysfunction or tightness in the muscles surrounding the joints. This can occur in the cervical spine, shoulders, or even the thoracic spine.

5. Psychosomatic Factors: Chronic pain can also be influenced by stress and anxiety, which may lead to muscle tension and exacerbate physical symptoms.

Potential Symptoms
In addition to the symptoms you are currently experiencing, other related symptoms may include:
- Headaches, particularly tension-type headaches.

- Numbness or tingling in the arms or legs, indicating possible nerve involvement.

- Fatigue or a general feeling of malaise.

- Difficulty sleeping due to discomfort.

Severity and Impact
The severity of your condition can vary widely. Chronic pain can significantly impact daily activities, work performance, and overall quality of life. If left untreated, it may lead to further complications, including chronic fatigue syndrome or depression.

Treatment Options
1. Physical Therapy: A physical therapist can assess your posture and movement patterns, providing tailored exercises to strengthen weak muscles and stretch tight ones. This is often the first line of treatment for musculoskeletal pain.

2. Chiropractic Care: Chiropractors can perform spinal manipulations to improve alignment and relieve pressure on nerves.

3. Medication: Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce pain and inflammation. In some cases, prescription medications may be necessary.

4. Lifestyle Modifications: Ergonomic adjustments to your workspace, regular breaks during prolonged activities, and incorporating stretching and strengthening exercises into your routine can be beneficial.

5. Alternative Therapies: Techniques such as acupuncture, massage therapy, and yoga may provide relief for some individuals.

6. Surgery: In severe cases where conservative treatments fail, surgical options may be considered, particularly if there is significant nerve compression or structural abnormalities.

When to Seek Medical Help
It is advisable to consult with a healthcare professional, such as a primary care physician, orthopedic specialist, or neurologist, to accurately diagnose your condition. They may recommend imaging studies like X-rays or MRIs to assess the spine and surrounding structures.

In summary, chronic neck, shoulder, and back pain can stem from various causes, and understanding these can guide effective treatment. Early intervention is key to preventing further complications and improving your quality of life. If you continue to experience these symptoms, seeking professional medical advice is crucial.

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