Help me escape the cycle of pain!

March 30, 2007 5:53 PM

Help me find some relief. Injured my back years ago in a bicycle accident and the chronic pain is getting old. Long explanation inside.

It was back in the fall of 2002, I was a freshman and Northern Michigan University in Marquette, Michigan. I had just finished up physical therapy for a torn ACL I suffered my senior year in football, and the physical therapist said that exercise was the best way for my knee to feel better. So, I got myself a nice Trek from a cycle shop...

Anyway, one day I was cruising down one of the many steep hills in Marquette when the chain failed, and I flew head first over the handle bars. I absorbed most of the impact with my right arm and shoulder. For days afterwards I had excruciatingly painful spasms in the muscles over my right shoulder blade. The on campus doctor gave me some Flexeril and sent me on my way. That helped me sleep, but really, didn't do much else to ease my pain during the day.

When I came home for Thanksgiving I saw my orthopedic surgeon and he said that it felt like some muscles or tendons had partially tore, and healed themselves up, but there was a lot of scare tissue in there. He likened it to a hard piece of gristle in a piece of meat. He suggested I do some stretching exercises and some light weight training. I did the exercises for a few months and I felt much better. The pain came back about a year later and the exercises help, but the pain hasn't ever gone away since.

I saw a chiropractor (yeah, I know) after I hurt my back in nasty fall on some ice, and he said that my right shoulder was much lower than my left, and showed me by drawing a line on the wall where my left shoulder was and where my right shoulder was. It didn't make any difference as to what the chrio did, the shoulder never got better, but that's not really why I went there in the first place, as my lower back was extremely out of whack.

Now I'm sitting here and my shoulder blade muscles are still very tender. Stretching helps a bit, but my shoulder has developed a nasty popping sound and clicking feeling when I make circles (can't think of a better explanation) with my arms stretched horizontally. I've had a few professional massages, and the masseuse says it feels like there are a lot of knots in those muscles, but she couldn't ever get them worked out and they were very painful when she pressed on them. What can I do to relieve the pain and make it more tolerable in the long run... I'm 23 and I feel like I'm 63.

posted by ganzhimself to health & fitness (10 comments total)

For working on the knots yourself, get a theracane.
posted by Manjusri at 6:00 PM on March 30, 2007

Do you have decent insurance? Can you get a referral to a good doctor, maybe one specializing in sports medicine?

Basically, I think you need to consult a real doctor, not us random internet people. But if you have no insurance, then things get more complicated.

Anecdotally, friends and family with chronic pain have done well with acupuncture, but only after exhausting the "regular" medical options first. Similar stories are told about yoga's effects on injured bodies. Particularly if you are uninsured and short of cash, a yoga teacher with sliding scale fees might help you heal, at least for the time being.
posted by Forktine at 6:20 PM on March 30, 2007

Acupuncture is a symptomatic treatment (ie it relieves symptoms temporarily -- or it may -- but doesn't do anything for the underlying cause).

You need to suck it up and go to a doctor, and get a referral to a specialist. A good sports clinic is also a possibility. There's no reason to suffer like this. You need x-rays and probably an MRI.

There are many possibilities here including a trapped nerve or cervical herniated disc, which would cause spasming muscles which no massage will cure.

At this point stay away from chiropractors and anyone who only has an 'alternative' as opposed to 'medical' qualification.
posted by unSane at 6:31 PM on March 30, 2007

Yeah, I second forktine - you need major PT, massage, etc etc, and your health care plan (if you have one) should help you.
posted by tristeza at 6:32 PM on March 30, 2007

I'm going through a similar situation (right shoulder lower than left, poor posture, various old injuries from sports related strains and accidents + working at a desk) - have been trying various therapies for 12 months (osteopaths, trigger point, deep tissue, exercise) - nothing worked until about 6 weeks ago when I went to a physiotherapist/pilates combo - with some acupuncture thrown in (I don't believe the acupuncture is really achieving much).

My symptoms are basically extreme shoulder and upper arm pain, coupled with sternum pain (chostocondritus - maybe spelt incorrectly).

The shoulder pain has practically gone - and I've been able to get back into surfing again after almost a year - the pilates is incredible and is helping me correct the weakness in my core body strength which basically eliminates a lot of the compensatory/referred pain.

I totally recommend the physio/pilates combination and it will do wonders for your ACL injury also (I have a personal trainer friend who has an ACL injury and has also achieved relief through pilates).

Of course, you should probably get it xrayed or get an MRI - but having been through all of this, I am certain there is hope for you.
posted by strawberryviagra at 8:18 PM on March 30, 2007

I was hoping that there was someone who had experienced something similar and had found something that worked for them. I do have insurance, but it's the first time I've ever had my own insurance, and I don't know the coverages/limits/whatever. I'll be calling to find out what is and isn't covered ASAP.

I got over my chiropractor phase, the initial adjustments did help, but I think that a lot of it was just smoke and mirrors. Since I stopped going my back has been just fine. The shoulder, well, that's a different story, and I don't think a spinal adjustment would ever help that, nor did my chrio ever claim that it would.

I think that a lot of the pain is compensating for the "dip" in the right shoulder as opposed to the left, the muscles tightening to compensate, perhaps? Once I figure out what will be covered, it's just a matter of finding a doctor and then finding the time to go with 40+ hours of work each week and 6 college credits.

On a side note, I did get my ACL rebuilt after I blew it out, and my right knee feels better than it ever did before the injury. I have a pretty high threshold for pain, I practiced in full pads for a week (in a brace) before I gave in and went to the orthopedic surgeon. Luckily I didn't destroy my knee... The fact that it was swollen to a freakishly large size, to the point I couldn't even put any weight on it, the Friday morning before the next game probably saved me much, much more surgery.
posted by ganzhimself at 10:32 PM on March 30, 2007

I have had family members get amazing results from osteopaths. There is no smoke and mirrors from them, either; they really know what they're doing.

For example, my brother had some weird muscle knot in his chest develop after a summer playing tuba in a marching band. After a doctor couldn't treat it and recommended surgery, he went to an osteopath, who correctly diagnosed the cause as strain travelling up from the leg when he stomped it down as the parade halted. Some stretching exercises and two weeks later he was fine.
posted by PercussivePaul at 12:40 PM on March 31, 2007

Chiropracters vary a LOT. Some are little better than quacks, others seem to have almost miraculous healing power. I'd tried chiro for a longstanding problem and gave up when it didn't help.

A year later I took a friend with very bad back trouble to a (different) chiropracter who'd been recommended to him. He went in semi-crippled and came out dancing. I went to the same guy, and he fixed my problem too; really fixed it permanently, which previous MDs, physiotherapists and the prior chiro had failed to do.

So you might want to check out other chiropracters in your region, by personal recommendation if possible.
posted by anadem at 2:07 PM on March 31, 2007

Find yourself a physical therapist who specializes in manual therapy. Let them give you a complete workup.

The reason I recommend a physical therapist over a chiropractor is this: a good PT will not only address your current pain, but will try to work out the cause of that pain and what you can do to make it not happen again. A lot of chiropractors (not all, but quite a few) are happy to have you come back over and over again, never actually addressing the root cause of your pain, but just treating the symptoms.

There are good and bad PTs, and there are good and bad chiros. But I trust the level of education that is mandatory for PT licensure, and most of chiropractic's effective therapies are also available to PTs.
posted by jennyjenny at 7:17 AM on April 1, 2007

The chiropractor I went to was able to help out immensely, I wasn't able to walk upright, I had hurt my back pretty badly. They were grads of Palmer, and from what I've heard they're the go to guys in town. Of course, there's just no way adjusting my spine is going to miraculously fix busted up muscles. Only PT or something else entirely, like surgery(maybe?), would help.
posted by ganzhimself at 9:38 PM on April 1, 2007