Chicken versus egg versus back pain
August 31, 2012 8:26 AM   Subscribe

Back pain and swallowing difficulty - is the shoulder pain causing the swallowing situation or the other way around? Your experience wanted as I wait for my doctor visit.

Okay, so I have a slightly-worsening problem with food feeling "stuck"/discomfort at one particular point. YANMD.

In theory, this could be anything from esophageal stricture to GERD to anxiety to cancer. However:

I have always carried a lot of tension in my left shoulder blade - partner can apparently feel "knots" and it hurts to press them. (Partner is aces about backrubs.) There is one particular sore spot right beside my shoulder blade at approximately the point where food feels stuck/weird. Partner says there's an enormous knot there. I also have some general left-shoulder pain and arm pain.

So in my head I am all "is this a giant esophageal tumor which is pressing on my spine and I am going to die or does the muscle there cause the swallowing weirdness". I know that I'm up for an endoscopy or a barium swallow. I also have episodes of acid reflux and am currently taking prilosec. I also am really good at somatizing my anxiety.

Basically, have you ever had back issues affect your throat/swallowing?
posted by Frowner to Health & Fitness (10 answers total) 1 user marked this as a favorite
"is this a giant esophageal tumor which is pressing on my spine and I am going to die" The answer is No. This not based on any particular medical, clinical, scientific information but rather on living 70 years.
posted by rmhsinc at 8:43 AM on August 31, 2012 [2 favorites]

I have one friend who had three herniated discs in her cervical spine that caused all sorts of issues including shoulder/back/arm pain, weird feelings when swallowing, and even other random stuff like hip pain and shooting pains in her legs. I have another friend who has no muscle or spinal issues but whose throat closes up when she is stressed - she will literally gag on food because her throat gets that "stuck" feeling as you describe. My dad had acid reflux, as you do, and had some swallowing issues until he got on a regular regimen of meds to treat it.

So, yeah, all kinds of non-cancer things like back issues and acid reflux can cause a swallowing issue like that, and it can be exacerbated by stress and anxiety. Maybe try some relaxation exercises until you can see the doctor so you don't stress yourself out even more.
posted by bedhead at 8:54 AM on August 31, 2012

The chances of this being cancer are so very very slim. That being said, I was diagnosed 2 and a half weeks ago with Non-Hodgkin's Lymphoma, with a mediastinal mass (right between my lungs). Trouble swallowing, back and neck pain, low grade fever, and a cough were my only symptoms.

Again, you almost certainly do not have cancer. I only write this to stress to anyone reading that it is crucial that you take care of your health and really stay on top of odd symptoms that seem to persist. I'm lucky that we caught it pretty early, though I have a really annoying road ahead of me.

Being in this position just makes me really want to urge people to not tough it out in situations like these. My uncle did just that, and he ended up with stage 4 liver cancer and a poor prognosis. His cancer is now in his lungs. Good on you, Frowner, for being proactive, and I'm sure the hooves are those of horses, not zebras.
posted by afton at 9:22 AM on August 31, 2012 [1 favorite]

I have had chronic back pain since I was a child. When I have the exact pain you are describing, it's from the deeper muscles' spasms, causing pain elsewhere, and often confusing me as to where the pain is.

I get the same thing on my stomach. The very deep back muscle spasms against my stomach are so bad that it causes me to throw up sometimes.
posted by TinWhistle at 9:34 AM on August 31, 2012

Do you sleep on your left side? I get this and I notice it more when I have had hormonal issues (i.e. PMS causing inflammation). And when I eat the wrong foods. Do you take a lot of ibuprofen? That can tear your insides up, but my guess would be acid, poor posture, and possibly hormones (if you are female). Also, if I eat gassy foods, like broccoli, forget it. Something about prilosec didn't agree with me. Do you have a cough?

Also: Google GERD & back pain. It's pretty common. My doctor always laughs and says, "sorry, nothing fatal! Eat right and exercise." Maybe there's some other med you can take for it. My Mom had this and the barium procedure actually made the pain go away for a while. There's some cocktail they give you at the ER that works too, it's a mix of some antacids and a numbing agent (because they tell you not to let it hit your tongue if possible).
posted by Marie Mon Dieu at 10:39 AM on August 31, 2012

While you are waiting for your doc's appointment, might I recommend a serious massage session with a licensed therapist, one including your entire neck and chest and shoulder region. If nothing else, it would really help with some aspect of the tension that (I would bet money on) has taken up residence in your body.
posted by computech_apolloniajames at 9:14 PM on August 31, 2012

How does it feel when you have your partner press firmly on the most sensitive part of the knot? Do you feel pain or sensation elsewhere in your body? I am guessing that you have a trigger point--very common on and around shoulder blades. I am also guessing it has nothing to do with your swallowing issue.

My father went to the doctor with the same worsening swallowing difficulty and it turned out to be esophageal cancer. As you likely already know, that fits in with GERD. If this were anxiety, why would it be getting worse? Is your anxiety getting worse?

When is your doctor visit? If it's not *incredibly* soon, I would push for moving the date if at all possible.
posted by parrot_person at 3:39 AM on September 1, 2012

Just think about it this way:

Your shoulderblade issue has gone on "forever". Not a few months, not a year, not 5 years, but forever....

Your swallowing issue, presumably, is much more recent.

Yes, there are rare issues that could relate back pain to swallowing problems, but the time courses of the 2 problems point to them being completely unrelated.
posted by treehorn+bunny at 4:56 AM on September 1, 2012

Well, vis-a-vis the swallowing/back pain combination - it's the fact that the tight point is exactly where the sore spot is, and that the sore spot has gone from "an occasional sore point that resolves" to "a big ouch" recently - I've always carried a lot of tension in my left shoulder but the specifics of it change. Googling has also suggested that weird swallowing feelings can come from injury to the trapezius muscle and from pinched nerves - apparently the vagus nerve innervates the whole shebang there.

And with the "worsening" - I didn't convey strongly enough in my question above that I am really good at somatizing my symptoms. I've had "worsening" symptoms of various kinds in the past that were purely stress/anxiety- generated. That is, I really had the symptoms, and they really did get worse (because I thought about them a lot, among other reasons) and yet they were not the result of a grave underlying condition. That's why it's so hard for me to parse this swallowing thing - I've had an anxiety-related lump-in-the-throat before, and it's hard for me to tell when I am worsening my symptom by anxiety versus when my symptom is getting worse on its own.

Today the swallowing is much better, actually. I still have a weird feeling on swallowing but it's a different weird in a different location - historically, "moving" symptoms often mean that I am causing them myself via anxiety. But I expect to see the doctor next week and I imagine he'll send me for either a barium swallow or an endoscopy or both - probably the barium swallow first as it will be easier to schedule. I just need to stay as calm as possible in the interval, and I find that remembering that symptoms can have many causes is really helpful.
posted by Frowner at 4:57 PM on September 1, 2012

Okay, a confusing update:

I saw the doctor. He said that because I had a totally normal endoscopy 2.5 years ago he did not recommend another one - he felt that it was unlikely that the swallowing difficulties were the result of, like, a thing in my throat. This seems fairly reasonable, as it is in keeping with endoscopy follow-up recommendations and risk. He suggested more prevacid and if it doesn't abate in a month a possible follow-up with a GI specialist.

I'm still kind of inclining toward the trigger-point/back pain explanation, as the back pain (which is obviously a trigger point - partner can feel it, it generates trigger-point type pain in my shoulder and arm) is still exactly where I feel the swallowing discomfort. It seems to be a little better now.

I can always ask for another endoscopy....I'm not absolutely sure I need to, though, since it seems so unlikely that I could go from no Barrett's/esophagitis at all to a sizeable tumor in two years. I am a bit uncertain how best to proceed!
posted by Frowner at 10:29 AM on September 17, 2012

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