has been experiencing severe upper back and neck pain for about the last two months. Our GP is finally going to refer her to a rheumatologist. How can we work best with the rheumatologist to diagnose and resolve this pain as quickly as possible? Way more details inside.
This is a follow-up to
this question that I asked at the beginning of Sept. Since then, the hand/arm pain has been replaced with much more severe neck pain and her shoulder/upper back pain has also increased in severity. The back and left side of her neck, in addition to her left shoulder, are tremendously painful. It's not the shoulder joint though, it's around/under the shoulder blade itself.
The pain isn't constant, but it does occur every day and usually increases in severity later in the day. She is unable to sit, stand, work at the computer, walk or almost anything else for more than an hour or two without the pain becoming severe to the point that she can no longer continue whatever she was doing.
My fiancée is 23, in reasonably good health and has no family history of disorders anything like this. Aside from the pain, she doesn't have any other neurological symptoms, leading our GP to say MS was unlikely. She had an x-ray to check for
Thoracic Outlet Syndrome, which the GP also ruled out. The GP did comment on a large amount of tension and spasm in my fiancée's neck and trapezius.
At the original appointment, the GP suggested going to physiotherapy. My fiancée did so in the middle of September. The physiotherapist thought T4 Syndrome might be the cause and cracked her back to correct it. He also applied electric muscle stimulation to her back and neck to help relieve the tension.
Afterward, my fiancée's neck was quite sore and then soreness soon turned into pain. She had three more sessions with the physiotherapist, this time insisting upon the gentlest treatments possible, and each time she still ended up with more pain than she began with. After the fourth session, she opted not to go back and just see if things improved on their own.
For a little while, they did. In early October, she was starting to feel better. There was still pain, but it was more isolated and manageable. On the weekend of Oct 13-14, we took a short 3 hour road trip to visit from friends in Seattle and while we were there, her left shoulder and neck started to hurt again. Since then, things are almost as bad as they've ever been.
She met with our GP again yesterday and the GP ordered c-spine and t-spine x-rays. My fiancée will go back to the GP at the beginning of November and if there isn't something very obvious on the x-rays, she'll be referred to a rheumatologist.
It seems to be that if this was just muscle tension/soreness, it would have at least improved somewhat my now. But the pain is so severe that it's significantly impairing her ability to live normally. Anyone experience something similar? Any ideas on what this might be or how to present it, so we can make our time with the rheumatologist as effective as possible.
Sorry for the long post, but I just wanted to give as much information as possible. It's tremendously frustrating for us, as we don't even know what the cause of the problem is or why it doesn't seem to be getting any better over two months. My fiancée and I just want her to be pain free again. Thanks!
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Hey there. I don't claim to be a professional of any sort, but I did suffer from severe back and knee pain for many years. I went to several doctors, but it wasn't until I saw a knee specialist that I discovered the root of all my pain issues -- Lack of flexibility in my hips and hamstrings --
As a child I played a lot of soccer and rode my bike everywhere, and in my adolescence I sat in front of a computer for most of my day, and I never stretched. I couldn't even sit at a 90 degree angle with my legs out in front of me without slouching my back. I had all types of back and neck pain, and my solution was to stretch and work out my back to make it stronger and more resilient. But the pain persisted, regardless.
Then, like I said, I went to a knee guy that knows my father. He did a full diagnostic, and basically told me my life story as described above, all without ever hearing a word from me. He told me that he saw it all the time.
Turns out, the neck, back, and hamstrings are all connected to each other like three bungee cords working in unison. Now imaging that the hamstring-cord is made of inelastic rope. The neck and back have to do all the extra bending and straining. By stretching my back to deal with the pain, I was actually enabling my hamstrings to remain inflexible, and keeping the day-to-day wear-and-tear of living on my neck and back. Being over flexible meant that my back lost a lot of power and control over its movements, and lead to multiple, frequent, minor injuries.
The doctor told me that I didn't need any surgery (yet) until I gave four months of flexibility training a try. My solution (and this may not be for you) was to start doing yoga. I did yoga two to four times a week, and I really focused on the hamstring stretches, but not all of them. Some of the seated forward bends are hard on the lower back, so I skipped those and just did supine hamstring stretch and pyramid stretch and pigeon pose. I also skipped ALL of the back bends (except for standing back bends), twists, and hard ab workouts (intense ab workouts are VERY hard on the back).
Within two months, my back, neck and knee pain was gone. Completely.
Give it a try. If you think that yoga is too spiritually charged and hokey, who cares? An hour a day with a couple of hippies (I personally like the meditation) is better than a life of pain, and it really helps to have an instructor to make sure you're doing the movements correctly to avoid hurting yourself. And who knows? Maybe you'll make a friend or two.
Good luck.
posted by lukeklein at 11:37 AM on October 23, 2008 [1 favorite has favorites]