Could my shoulder/neck pain be caused by a nerve problem?

July 4, 2011 8:21 PM

Could my shoulder/neck pain be caused by a nerve problem?

Background: 26 year old female in good physical health.

Three years ago I began having severe shoulder and neck pain on the left side. I've seen half a dozen massage therapists, a couple chiropractors, a physiotherapist, three personal trainers and even a counsellor to try to fix this problem. In the beginning it prevented me from undressing and unclasping bras but now it's gotten to the point where I can't hold a light purse, carry my own groceries, or do regular daily tasks without constant pain. The pain is always present, however it gets more severe if I attempt to do anything physical (ie. exercise, carry groceries etc.). Two years ago while getting my neck adjusted at the chiropractor my right pupil became enlarged while the left remained regular sized. I insisted that my family doctor send me to get a CT scan which didn't show anything. The problem remained for a few months and eventually went away and the CT scan showed nothing. I've also insisted on having an MRI done when the pain did not subside after 2.5 years and it showed a tear in my right rotator cuff, inflamation and something to do with my C-disks in my neck...I asked for clarification on what this might mean and the doctor said he didn't know bones and recommended a topical over-the-counter pain relief cream, which obviously did not work. Recently, I had been seeing a physiotherapist who dramatically stretched my neck off of a treatment table causing my pupil to become enlarged again. I ceased seeing her due to this problem and the fact that the exercises she was having me do made me feel significantly worse than I was already feeling.

My current massage therapist and chiropractor both have said that they believe it may be a problem with my cervical nerve since I have tingling, numbness, inability to lift my arms above my head without discomfort, almost complete loss of grip (ie. can't hold a light purse, can't hold hands with someone on my left etc.). Also, regardless of how much adjusting and massaging I do, my scapula and traps (along with other back/shoulder muscles) will not release and my ribs/neck disks keep subluxating.

Could this be a nerve problem and what solutions might there be? At this point I will try anything because I can't sleep, I'm always tired, and I'm in constant severe pain and can't move my neck and shoulder most of the time.

Thank you for your advice.

posted by DorothySmith to health & fitness (18 answers total)

Does your job involve working with a compute? If so, is your screen set up directly in front of you with the top of the screen at your eye height, or is it offset to one side?
posted by flabdablet at 8:39 PM on July 4, 2011

I am a social sciences doctoral student, however I am past my course work and haven't been steadily sitting in front of a computer for 2 years. I have an ergonomic chair, an ergonomic foot step and I stretch regularly. Stretching helps momentarily but does not solve anything.
posted by DorothySmith at 8:50 PM on July 4, 2011

Yes, it could. I had awful shoulder pain (unresponsive to any pain meds) that turned overnight into numb/uncontrollable arms (and BTW it is very hard to sign ER admission papers in that kind of condition.) They did nerve conduction tests to figure out what was happening after the MRI proved useless. I regained full function after about six and a half months, though my hand strength never really came all the way back. Unfortunately, in my case it was time and rest that fixed it - nothing the doctors did helped at all.
posted by SMPA at 8:53 PM on July 4, 2011

I'm glad you're mostly better now! Time and rest hasn't really helped me unfortunately. My family doctor is useless... but I'm going on Friday to try to get a referral to a neurologist because I've tried everything else and I'm desperate to not feel broken. I've given up so many years of youthful fun (ie. no dancing, no rock climbing, bowling, running, biking etc.). I want my life back!
posted by DorothySmith at 8:59 PM on July 4, 2011

I'm super-confused. You said the MRI showed you had "a tear in my right rotator cuff, inflamation and something to do with my C-disks in my neck", but it seems like your GP did nothing? Holy moly, get a new GP immediately, then get referred to a specialist who knows how to interpret MRIs. It sounds like you have problems with your cervical vertebrae, but what kind of problems, who knows? It could be arthritis, could be a blown disc in your neck - seek qualified help immediately - it's insane for you to put up with this for another minute. It sounds like the medical professionals you are currently seeing are useless.

On preview, whew. Thank God you're getting away from this family doctor. Hope you find a qualified neurologist or orthopedic surgeon/spinal specialist - go for it.
posted by facetious at 9:04 PM on July 4, 2011 [2 favorites]

Yes, it can. I've had neck and back pain for the past several months - numbness, tingling, etc. pretty much just as you described. After consultations with both an orthopedist and a neurologist (along with a battery of tests including CT, MRI and myelogram) it was determined that my spinal cord is actually becoming compressed due to other issues (bone spurs and a ruptured disc). To that end, I'm scheduled for surgery at the end of the month to *hopefully* correct the problem.
posted by Telpethoron at 9:05 PM on July 4, 2011

The part about the pupil makes me think that your issue is not the same as the one I had, but I figured I should put this out there just in case: Have you had your potassium checked? It's routinely done with the basic metabolic panel doctors typically do during an annual exam.

The reason I ask is that I had a really similar sounding neck/shoulder issue, resulting in loss of strength and numbness and tingling in my left hand, for years. Had every test imaginable done and nothing showed any nerve damage. Almost ended up having an entirely unnecessary surgery for a herniated cervical disk which seemed to be the only possible culprit, even though the herniated disc was not the one that would have affected the nerve in question.

Long story short, it turned out that due to an entirely different health issue my potassium was too low. A drop in potassium below a certain level can cause muscles to go into spasm (and can even cause temporary paralysis). In my case, my trapezius muscle pressed on a nerve when it went into spasm, making my entire left arm practically useless.
posted by chez shoes at 9:44 PM on July 4, 2011

I've got similar symptoms and also a C4/5 disk herniation. Keep moving towards getting a new doctor (I always advise one at a big university/teaching hospital...only thing that helped me get anywhere with my complicated health issues) and push for the following:
1. Pain relief - don't be afraid of narcotics. They make my life bearable
2. A nerve conduction test (sucks! But could help)
3. Injections into the disk space if you indeed have a herniation
4. Change your pillow/matress to get something supportive (ask your new dr for recommendations)
5. Adjust your expectations. You may not ever have the "youthful fun" you've missed. Chronic pain robs you of so much and letting yourself dwell on what you are missing is a mindfuck - stay positive and be thankful for what you can do. Pain robs joy...try to keep whatever joy you can.

Also: if your doctor doesn't listen or believe you or isn't doing what you need, find someone else. You deserve someone to care about you and your treatment.

Memail me if you want to talk. Good luck.
posted by guster4lovers at 10:20 PM on July 4, 2011

Numbness and tingling do point towards nerve problems. I would get the EMG (not fun or anything, but a breeze compared to what you're already going through.) If you have neuropathy to the point where you're losing strength and grip in the hand, you really want to get this fixed now -- eventually the muscle starts to atrophy and there's no getting that back.
posted by escabeche at 10:57 PM on July 4, 2011

Chez Shoes -Hmm that's very interesting. I don't think my potassium is low, but that's something I will ask them to check on my yearly physical coming up. Thank you.

Guster4lovers -Thank you, you're definitely right. I sometimes get in the lows about how this pain is preventing me from doing certain things, however I'm still lucky in the grand scheme of things to have overall health. I actually think my doctor is very good... the problem is I've only met her once. She has these young doctors in training working below her and they typically don't know any of what I ask since they've never encountered any of it before due to their lack of medical experience. Regardless, I've got this number to help me search for a new doctor where I can have the continuity and experience all wrapped up into one solid doctor rather than a team of newbies.

Escabeche -What does an EMG do? Yeah, the atrophy is not fun. Some of my muscles have gone stringy, which my massage therapist says is the muscles atrophying. It's very painful when she works on those.
posted by DorothySmith at 7:36 AM on July 5, 2011

EMG is the nerve conduction test. It can pinpoint exactly which nerve is damaged, and where along its length the problem is, and to some extent how severe the problem is.
posted by escabeche at 8:04 AM on July 5, 2011

Yes, get to a neurologist. I'm sorry to hear it sounds like you had an incompetent doctor and the least that should've been done is referred you to someone else. You may have some Radiculopathy or Neuropathy. If you work your way through some of these images you may be able to gather what nerves are affected.
posted by P.o.B. at 1:58 PM on July 5, 2011 [1 favorite]

Yes. I have a herniated cervical disc and it causes shoulder/neck pain and numbness in my fingers when it flares up. I would not take a GP saying "I don't know" and leaving it at that as in any way acceptable. Get a second opinion! I needed prescription muscle relaxants and physiotherapy when my disc first got diagnosed.
posted by biscotti at 7:23 PM on July 5, 2011

Given that you know you may have some sort of problem with the vertebrae in your neck, and that you've had a couple of incidents when people working on your neck caused a change in pupil size (!), it doesn't seem like a remotely good idea to let anyone be manipulating your neck in any way until you get a proper medical diagnosis. Under the circumstances, it seems rather reckless for anyone to be yanking on your neck.
posted by Corvid at 7:48 PM on July 5, 2011

I just came back from my chiropractic appointment and asked his opinion on whether or not I may need to see a neurologist. He doesn't seem to think that I do because he says I haven't completely lost mobility in any of my limbs. He did some checks for carpal tunnel and there was some slight numbness so he told me to do some stretches. He seems to think that all I need is continued chiropractic/massage/maybe physio work to fix all of this. I don't think I agree since I've been doing all of this for the past 3 years and it's not something that's getting better. He's said that he won't adjust my neck because of the pupil problem... but in a way I'd rather a wonky pupil and no neck pain, but I realize why he won't adjust it. I just can't see the quality of life being very good if my neck's in constant pain.

Anyway, I'm seeing my doctor on Friday and hoping I can plead with them enough to get the referral to the neurologist. *crosses fingers*
posted by DorothySmith at 9:15 AM on July 6, 2011

He doesn't seem to think that I [need to see a neurologist] because he says I haven't completely lost mobility in any of my limbs

This layperson says yikes! Does he not believe in preventive care at all, or just in your case?

IANAD, IANAChiropractor, IANAPhysicalTherapist, IAJustSomebodyWho'sDealtWithPainForManyYears. That said, I've gotten a lot of help from trigger point therapy. The Trigger Point Therapy Workbook has been very helpful for me. According to the authors, trigger points can cause symptoms that are mistaken for all kinds of other things. I've been surprised and very pleased by how much relief I've been able to get from self-treatment of trigger points using things like a foam roller and a lacrosse ball. (Got back from a long bike ride having done something to my lower back, to the point I could barely lift my leg up over the bike to dismount. I checked the book, determined it was probably a trigger point in the gluteus minimus, and spent 15 minutes leaning against the wall with a lacrosse ball pressing on the sore spots. Hurt like the dickens while I was doing it, but half an hour later the pain was significantly decreased, and the next morning it was gone entirely.)
posted by Lexica at 2:40 PM on July 6, 2011

Just as one point of advice, I would like to suggest that you drop every single person who's been working with you on this that hasn't helped. The thing is you shouldn't have to plead with a good doctor to get a referral. Likewise, good PTs, massage therapists, or chiropractors will not sit around shrugging their shoulders about what it could be.
I guess what I'm saying is please go find someone who can help you, I don't know if you're in a bind with insurance or have the freedom to see someone else but they are out there and will help you or at least help you find someone who can. I hope you feel better soon.
posted by P.o.B. at 6:48 PM on July 6, 2011

Thanks everyone for all of your advice. I did end up getting the referral and now I'm just waiting for them to call me. Other than that, I've just started acupuncture today from an actual doctor of Chinese medicine. I've heard wonderful things about him so hopefully he can help me ... but if not I've still go the neuro-referral.

Thanks again :)
posted by DorothySmith at 2:35 PM on July 12, 2011