Muscle and Bone Pain: Common Orthopedic Concerns Explained

I am unsure whether the pain is in the muscles or the bones?

Hello, doctor.

1.
Is it normal to hear popping or cracking sounds when rotating the head during stretching exercises?
2.
There is a muscle located two finger widths behind the upper right shoulder that becomes sore and numb in cold weather, affecting the fingers.
What could be the issue? Heat therapy has not been effective; how should it be treated?
3.
When standing straight and performing knee bends while lifting the legs, there is a cracking sound in the lumbar spine, and after resting, the spine hurts.
What could be the problem (it was fine before)?
4.
A recent X-ray of the lumbar spine during a health check revealed that the vertebrae are not square-shaped but rather slightly rounded and concave.
Could this be due to prolonged bending at work? Should it be treated aggressively? Please provide a detailed explanation.
Thank you.

Taibei Ren, 40~49 year old female. Ask Date: 2021/11/15

Dr. Wang Shouji reply Orthopedics

Hello, 1.
Joint sounds during movement are usually not a concern if there are no accompanying symptoms such as pain.
2.
Shoulder issues may be caused by muscle stiffness or poor circulation, and it is advisable to visit a hospital to check for potential cervical spine issues.
3.
It is important to warm up before engaging in such activities to prevent sports injuries.
4.
Long-term heavy lifting can lead to changes in the shape of the vertebrae, so it is important to reduce this activity and protect the lower back with regular follow-ups.
Changhua Hospital cares about your health.
Wang Shou-ji.

Reply Date: 2021/11/15

More Info

Dear Patient,
Thank you for your detailed questions regarding your orthopedic concerns. Let's address each of your queries systematically, as they relate to common issues associated with muscle and bone pain.

1. Audible Sounds During Neck Movement: Hearing popping or cracking sounds (crepitus) when rotating your head or performing soft tissue exercises is relatively common and often considered normal. These sounds can result from various factors, including the movement of tendons over bones, gas bubbles in the synovial fluid of joints, or even the ligaments stretching. However, if these sounds are accompanied by pain or discomfort, it may indicate an underlying issue that warrants further investigation.

2. Shoulder Muscle Pain in Cold Weather: The discomfort you experience in the upper right shoulder, particularly when exposed to cold, could be attributed to muscle tightness or a condition known as myofascial pain syndrome. Cold weather can cause muscles to contract, leading to stiffness and pain. If heat therapy (like hot packs) is not providing relief, consider incorporating gentle stretching and strengthening exercises into your routine. Additionally, physical therapy may be beneficial to address muscle imbalances and improve flexibility. If symptoms persist, a consultation with a healthcare provider for a tailored treatment plan is advisable.

3. Sounds and Pain in the Spine During Leg Exercises: The popping or cracking sounds in your spine during knee bends or leg lifts, followed by pain, may suggest a few possibilities. It could be related to the natural movement of the vertebrae or the intervertebral discs. However, if you are experiencing pain, it may indicate that your spine is under stress, possibly due to poor posture or muscle weakness. It’s essential to ensure that you are performing exercises with proper form and alignment. If the pain continues, consider seeking a physical therapist who can assess your movement patterns and provide corrective strategies.

4. X-ray Findings of the Spine: The observation that your spine is not perfectly rectangular but has a rounded or concave appearance could be indicative of postural changes or degenerative changes due to prolonged periods of bending or poor ergonomics. This condition, often referred to as "hyperkyphosis" or "lordosis," can develop from repetitive strain or improper lifting techniques. While not all changes in spinal curvature require aggressive treatment, it is essential to address any associated pain or functional limitations. Engaging in a physical therapy program focused on strengthening the core and back muscles, along with ergonomic adjustments to your workspace, can be beneficial.

In summary, your symptoms suggest a combination of muscular and postural issues that are common in individuals with sedentary lifestyles or those who perform repetitive tasks. It is crucial to maintain an active lifestyle, incorporate regular stretching and strengthening exercises, and pay attention to your posture during daily activities. If your symptoms persist or worsen, I recommend consulting with a healthcare professional, such as a physical therapist or an orthopedic specialist, who can provide a comprehensive evaluation and tailored treatment plan.

Wishing you the best in your recovery and health journey!
Best regards.

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