The ows are not what they seem?
August 22, 2012 3:12 PM   Subscribe

¡Left Handed Typing Alert! After a week of basic tenderness/muscle pull feeling centered between my shoulderblades, I've awoken today with an incredibly acute pain that's basically taken away the use of my right (dominant) arm. Help me pre-game the upcoming doctor's appointment to try and narrow down/assuage the cause as soon as possible.

I've got: a doctor's appt for tomorrow afternoon, prohibitive pain, tingling/numbness and coldness and an inability to raise my arm behind my head or turn my neck towards the right more than ~20 degrees. This, seriously, cramps my style. I have no trauma in the past week or anything to immediately explain it away, so I'm left contemplating things like a disc herniating or something more grand and, ugh, involved. What, apart from a herniated disc, or related problem, have you encountered that have manifested symptoms like this? What possible tests/ recourses should I expect or avoid?
(I'm very much a medical NoOb. I haven't seen a doctor regularly, ever, and this is the first appt in approximately the last decade, so please be gentle).
I need to use my right arm and hand incessantly, so "resting" it is not an option.
posted by Cold Lurkey to Health & Fitness (12 answers total) 1 user marked this as a favorite
This is not the sort of thing to see a doctor for. You need a really good therapeutic massage therapist - e.g. one specializing in sports massage.

A doctor can cut you open, prescribe pain killers, or prescribe physical therapy. Neither are what you need. You need someone talented who can work the muscles out of spasm.

It may be a herniated disk, but only in the sense that a sharp headache might be a brain tumor. Stuff goes wrong with shoulder muscles all the time. It can be fixed. Easily and cheaply.

Invest some time networking to good massage therapists, and some money on appoitnments. Once you find a good one - who can get right to the problem and break it up - you'll have a potent life tool. It's worth the effort to find that.

You don't need shiatsu, swedish, and all those. That's about making rich ladies feel relaxed and anxious. Again, look for therapeutic massage/sports massage. And a good person will fix it in one visit or two at very most.
posted by Quisp Lover at 3:35 PM on August 22, 2012 [2 favorites]

Did you sleep wrong? Could you be supressing any big stressors in your life that might be held in your shoulders? Do you lean on your elbows while typing or any other "bracing" behavior at the keyboard?
posted by rhizome at 4:04 PM on August 22, 2012

First: I've had tendonitis in my right shoulder that gave me more-or-less the symptoms you're experiencing, and would flare up somewhat unexpectedly. I'm not saying that you have tendonitis, but a herniated disk seems pretty unlikely. Muscular and tendon-related stuff can hurt much more than you might expect, so wait until you see the doctor to start panicking.

Second, a brief story about why I wouldn't take Quisp Lover's advice quite yet:

I had on-and-off shoulder problems when I was younger. When I started a new job that involved lots of standing and lifting, I was not overly surprised to develop some nasty back and shoulder pain on my right side. The pain, I assumed, was radiating from my shoulder. My neck was in knots, my back was screaming, and I was still showing up to work, so my shoulder hadn't gotten better. I booked an appointment with my local chiropractor.

Several weeks later, when my fever spiked, I finally dragged myself to the hospital and was diagnosed with the worst case of pneumonia they had ever seen in someone my age. As it turns out, people generally can't distinguish between muscle pain, broken bones, and internal problems. I spent almost six months unable to work because of something that my general practitioner could have diagnosed in five minutes with a stethoscope.

And the chiropractor? She really is amazing at what she does, and when I finally got my internal organs back in the right places, I went to see her again. She did wonders for my shoulder.

Go to the doctor, let someone feel where the inflammation is, and then think seriously about seeing a massage therapist.
posted by catalytics at 4:38 PM on August 22, 2012

If you're going to your primary care doc, brace yourself for a referral, possibly to a neurologist. If you are referred to a neurologist, their in-house tests will likely be reflex testing, simple strength tests and assessing your range of motion.

Since you seem to have an acute injury, the primary care doc might prescribe meds to help you become more functional/provide immediate relief, like painkillers or NSAIDs. This is NOT a long term solution.

I had similar symptoms this past year, but chronic not sudden. This required a lot of further testing , and yeah, those tests were costly and a pain in the ass, but since this was chronic plus I had other weird symptoms that could have been indicated something bigger was going on, it was necessary to rule it out. The "good" news was that nothing big showed up, so my doc prescribed physical therapy (and my PT did involve massage), and I'm doing pretty well with exercise and working on my desk ergonomics to make it stay away. Massage is awesome and can work wonders -- I do that now more regularly too. But I don't know why you wouldn't see a doctor if you're in acute pain that is preventing you from functioning (are you insured? I realize cost is an issue).
posted by NikitaNikita at 7:38 PM on August 22, 2012 [1 favorite]

Catalyst, I'm sorry, but that's really bad advice. Here's why:

Yes, a simple muscle ache MAY be pneumonia or a tumor or anthrax or god knows what. There's always a tiny chance, it's true. But if you enter medical circles each time you have a sore shoulder, you will be tested to death (and radiated out the wazoo), and that brings you into a whole universe of potential problems, because one test might show something scary (perhaps totally unrelated to the issue at hand), requiring yet more invasive tests to rule that out (the doctor can't simply dismiss longshots; that's a liability risk; they've got to steer you down every single avenue). You can get sucked in to a cyclone of escalating procedures and drugs, always with the possibility of misdiagnosis. And your shoulder won't feel any better.

It's just not worth it for a tremendous long shot. Usually, a sore shoulder is just a sore shoulder. Take it to a sore shoulder expert (a good massage therapist). If he's any good, he'll recognize if it's a garden variety sore shoulder (he's seen a zillion), and if it doesn't respond to treatment, he'll suggest going to a doctor to check for underlying problems. Or at very least, he'll work on you, you'll notice your shoulder hasn't gotten any better, and you'll go see a doctor.

Chiropractors can be good. But very very very many of them get you into back cracking and neck cracking which start getting addictive (you feel like crap if they're not cracked regularly), and can (though it's a longshot) lead to problems. They also often are into lots of alternative profit centers, like homeopathic cures they'll ply you with.

Massage therapist is the way to go. Find a good one. I have one, and he saves my life regularly.
posted by Quisp Lover at 8:24 PM on August 22, 2012

PS - be it a chiropractor or a massage therapist, beware of anyone who wants an ongoing scheduled relationship. That is not necessary for a sore shoulder. Such people are just trying to make you a profit center, and to keep you dependent.

Look for a solutions-oriented massage person who wants to fix you and get you out the door. They're rare, but they're out there. Ask dancers or athletes....e.g. college athletics coaches.
posted by Quisp Lover at 8:27 PM on August 22, 2012

Ask you MD if polymyalgia rheumatica is a possibility. Probably not, but you are clearly having problems with more than just your shoulder.
posted by SLC Mom at 9:25 PM on August 22, 2012

This might be a long shot, but when this happened to me I noticed that it was worst when I was using my computer - a standard desktop model with a mouse. I bought a trackpad, and the pain went away very quickly and has not returned. That was about ten years ago. Now I use a laptop, but instead of attaching a mouse I use the built-in trackpad only. I have become very adept at it and I get around the screen faster than my coworkers who use mice. It's a very handy skill for when you don't want to drag an extra peripheral around, and bonus! no more back and shoulder pain.
posted by caryatid at 10:35 PM on August 22, 2012

Switch your mouse to your other hand and give your aching parts that much of a rest.
posted by Carol Anne at 5:39 AM on August 23, 2012 [1 favorite]

You've got a doctor's appointment for tomorrow. That's great! You should go!
Pain like this could be all sorts of different things - anything from sleeping on it wrong, to repetetive stress, to tendonitis, to a pinched nerve way up at your neck that goes all the way down to leave your fingers numb. My guess is actually the pinched neck nerve (meaning you'll need to focus on posture and overall body alignment before your hand can recover) but I am so NotADoctor you'd be appallingly naive to take advice from me.

To have an effective doctor's appointment, try to keep a record of specific symptoms, when you have them (vary during the day?), what you were doing at the time (sitting, working, on the sofa, walking, chores); and of all the home remedies you're tried (ice, wraps, rest, working left-handed, ibuprofen vs asprin vs aleve) and how effective they were.
posted by aimedwander at 6:35 AM on August 23, 2012

Best answer: Hi, this has pretty much been my life for the last six months. My neck and shoulder muscles are extremely tight and they impinge on the nerve(s) that run down my arm. I think Quisp Lover is coming on a bit strong, but massage + stretching has helped me the most.

I would try, in roughly this order: NSAIDs like ibuprofen, heat, as much rest as possible, as little stress as possible, massage, referral from doctor to physical therapy, stronger painkillers. Really try to relax; being in pain makes you tense up more, which increases the pain. My fear was OMG this is never going to go away, and that becomes a self-fulfilling prophecy. Distract yourself with something like an engrossing movie and try not to focus on the pain.

On re-reading the question, I see you already have a doctor's appointment. In that case, I'd ask if physical therapy is indicated and don't be shy about telling the doctor exactly how much pain you are in. I mean, don't be all "can I have some narcotics" but don't try to be all tough guy about it either. I would not freak out about herniated disks quite yet. They'll probably get some X-rays to rule that out.

Be specific about how this is affecting your life. If you've had to take time off of work, say so. If you can't enjoy hobbies or take care of your kids or do the dishes, say so.

If your doctor wants to refer you to an orthopedist, make sure it's someone who specializes in the neck and/or shoulder area. I had a useless appointment with a generic ortho who just sent me to someone else anyway.
posted by desjardins at 9:48 AM on August 23, 2012 [1 favorite]

Response by poster: Thanks for all your responses. After a neat bit of mapping the problem out to veterbrae and nerve groupings it seems to be a severely spasming muscle, which twitched nicely during examination. There's already improvement from this morning, which was suck, so I'm hoping that a boat ton of ibuprofen and babying will allow for me to brush my hair again soon.
posted by Cold Lurkey at 5:50 PM on August 23, 2012 [1 favorite]

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