I feel down right silly turning to the internet for Health advice, however, it's been 4+ years, 3 different family Drs, and one specialist and I still have no answers only medication. The last few days have been some of the worst over those 4 years. I'll try to provide as much information as I can without putting everyone to sleep.

About 4 years ago, over the course of about a week and for no reason that I can connect to it, the muscles in my shoulders and neck started tightening up. At that time I could barely turn my head either direction and or lift my left arm. The pain was intense. It was like my neck would "catch" and a similar feeling on the back of my shoulder. I had had this type of thing happen before and thought I had just "slept wrong"; so I just dealt with it. A month passed and it didn't get better. So I thought. . .well, age must be catching up to me. . . it just needs more time. Lots of rest and stretching, heat, ice and rubs.

Another month passed and I finally decided to go see my Dr. By this time the "catching" in my shoulder was gone and I had regained more range of motion in my neck, but the pain was still tiring. So began my journey. . . .

We tried a whole list of things to try to "make it better". I got 4 different new pillows, a new matterss, physical therapy, Chiroprator, massage, Anti-Inflamatory, muscle relaxers, tramadol, lortab and a bunch of other drugs that I can't remember. He took an x-ray and didn't see anything he thought would explain it. Sent me to a specialist (Neurologist), he did a short exam and basically told me that this type of thing had happened to him and it took a year to recover. Then told me to give it time and sent me on my way. At some point this Dr. seemed to give up on trying to figure out what was causing the pain and simply gave me medication to mask it. In the end, I found that Flexiril at night (makes me really drowsy) and Lortab during the day was the only way I could be a productive employee and a useful single father.

I will say this. . . that over the 4 years that I've been dealing with it, I've started to understand a little better what exactly is happening just not why.

About 2 years ago, I began having chest pains. Went to the ER thinking I might be having a heart attack. Near the end of my visit, the ER Dr. came in and said everything looked fine. So he started asking me about my back and I told him what I had been going through. He asked me to sit up, then made a fist and placed it between my spine and shoulder blade and asked me to lay back down. With his fist still in place, he pushed down on the top of my shoulder. I instantly felt a "popping" sensation in both my back and strangely enough. . . my chest. The pain wasn't gone. . . but it was less intense.

He explained to me that he believed the cause of the pain in my chest was a result of the muscles around my rib cage (which connect to the muscles under the shoulder blade) pulling back on my ribs.

Over time, my neck has improved to the point that I would say it was back to normal. And, I will admit, that some things seemed to improve the pain. The improvement however wasn't consistent nor permanent. Off and on over these 4 years, I've learned to adjust to a new "normal" in regards to discomfort. Normal for me is that the muscles on both sides of my spine up to my neck and the muscles under the shoulder blades constantly "burn". They are constantly in a state of spasm. My chest, most notably on the left side, which is the same side where I experience the most "burning" under and around the shoulder blade constantly hurts. I take Flexiril nightly and Tramadol when the pain starts to increase from normal levels.

Every so often things seem to get worse. And at this point I can attribute and even plan on when things are going to get worse. Long hours on my feet or certain activities requiring repeated use of the muscles in my shoulders cause the burning and pain in my chest start rising in level. My neck muscles will begin tightening up. If I don't take something stronger than Tramadol, my neck will get to the point again where it's "catching" and I have very limited range of motion. When things get this bad, I'm useless as a father or an employee unless I medicate myself with Lortab. Then generally after a week or two on Lortab, and a little extra rest. . . thing start returning to my "normal".

It's tiring. . . and I'm at a point where I just need some reasonable ideas of things that can be looked at to identify the issue. Long term use of narcotic pain killers is not an option. I am a single father. . . the reason I'm a single father it that my ex-wife became an addict while we were married. . . her drug of choice. . . Lortab. Thanks to that, I'm well versed on Opiates and how they work on the brain. I'm also more aware of the signs of physical addiction and limit how much and how long I take it for any period of time.

My old Dr. moved out of town so I've started to see a new one. I've only visited him once about 3 months ago and I had mentioned my issues to him at that time. Things were normal at that point, and had been for several months, but I wanted to give him a heads up. Then about two weeks ago, I started the process of moving. Sorting, packing things, and getting rid of all stuff that I really don't have a need for. After two days of that and unusually long work days, things started getting bad. I decided to break from that and get a little more rest in hopes that things would get better. After a week, the pain started reaching levels that it hadn't in years. Decided to go to my new Dr. He writes me a script for 12 lortab and informed that if these didn't work he would have to send me to a pain management specialist. That is where I failed. I should have let him know that I'm looking for a root cause and possible solution, not just management of the pain.

Anyway, again. . . that's why I'm here. I'm just looking for a direction to head in finding an answer. I'm an IT guy and figure if I can use the internet to help troubleshoot strange IT related issues, maybe I can find some help in troubleshooting what's going on with my muscles.

If it helps, I'm a 35 year old male. There's nothing over the last 4 years that I could call a consistent factor in this. I've been at the same job for 7 years, no changes to environmental considerations such as desk setup or actions that I perform. Diet has been consistent. While I don't exercise that much now. . . I did a reasonable amount for years before and when this started. Actually increased frequency as part of my "treatment" but finally reduced it. As it seemed to be making things worse.

I apologize for the book, but again, I'm an IT guy and hate nothing more than for someone to ask me for help then providing very little information. If you've made it all the way through, THANK YOU! If you have any ideas, thoughts, questions. . . please let me know.

--is more investigatory imaging; has anyone suggested an MRI of the area to look for possible brachial plexus problems, throacic outlet syndrome, or spinal problems?

Thanks for the quick response. I did forget to include MRI as one of the many things done early in trying to diagnose. The results of that imaging were reported back to me as being "negative".

You don't have any hand or arm symptoms with this?
Any previous whiplash type injuries, desk job, any previous RSI's?
How is your upper body posture?
head/shoulders forward of the body? rounded or hunched?

These factors may point to TOS - thoracic outlet syndrome.

I suppose the xrays/MRI would have shown if a extra cervical rib was present..but sometimes they are missed..
For more TOS info here is our forum for it-
http://neurotalk.psychcentral.com/forum24.html

Some of the therapies we post about may be helpful even if you don't have TOS.

Check out the trigger point sticky thread, if no one has mentioned trigger points to you during your appts/therapies.

I appreciate the feedback.

I will feel a sensation, like an "ache", down the back of my arm and into my hand. This only happens though when things are "BAD". Today. .. it's there.

There's no previous injuries that I can attribute to a reasonable amount of time before these issues started.

I've had a desk job for 15 years. (IT) But I've spent less time at my desk than I used to 7 years ago. My posture is not great, never has been. . and I'm aware of that. During my first physical therapy sessions, we worked on exercises to improve it and it's better today, but doesn't seem to have had a positive effect.

I reached a point for a while where I had "given up" on the cause and just decided to "do what I need to do" to be productive and take care of my girls. I spent a crazy amount of time going to appts for tests, therapy, imaging and was constantly being told. . "Not sure what's going on".

With this new Dr. and his philosophy on this being a pain management issue, my desire for answers has been renewed.

I'm thinking that I need to have a new conversation with my new Dr. Maybe go and get a copy of the MRI from 2 years ago and ask him to start from scratch.

I'll look through the TOS info. . . I really appreciate it!

Many MDs don't fully understand TOS, and your symptoms may be mild enough that you don't have a full blown case of it.. be happy about that..


If you can get into an advanced PT/body worker, or multi skilled multi disciplinary chiropractor it may be better than wasting time at MD office visits..

15 yrs IT & poor posture is a bad combo to set you up for TOS , I'd really try to seek out very good multifaceted PT/DC or even a very good DO.

Don't settle for just any poor or mediocre therapy - keep looking and learning to get the best care you need.


Self help you can try for now is just lie on the floor , knees up, arms along side of the body , palms up and if you can slide them out at 90 degrees away from body , or all the way above head with NO pain do that many times a day.
If pain or any symptoms increase - stop and go back to where there is No pain increase.
Drink lots of clear fluids also as tissues/fascia can get sticky and cause many problems.

Lots more info in the TOS forum all sticky threads..
posture videos on youtube are great too.

Welcome, Mac,

I was thinking sort of along the same lines as Jo*mar -- posture, job-related (DW & I both have similar issues; she was IT, I was primarily desk/computer related), TOS... I'm also thinking cervical degenerative disc disease and/or myofascial pain/trigger point syndrome because of the similarities (jobs/symptoms) between yourself and DW & I -- we both get/have something eerily similar to what you describe. I often hear/read, "But I've done the same job for X years and I was fine, then this just 'happened for no reason'", but it can take many years for this kind of stress to catch up and manifest, and then... it does just happen. Once the damage is done, it's very difficult (nigh impossible?) -- even with years of correction, PT, etc. -- to "fix".

A word about myofascial trigger point therapy... Many PTs claim to know about and do it, but IME, they don't know enough. We went to a certified MTP therapist (much more training & expertise) and there was a huge difference between her and all the PTs who claimed they knew the stuff and didn't. (NAYY)

IMO, there are a couple of ways (at least) of looking at pain management. One is the doctor throwing up hands out of frustration, treating the symptoms, dead-end way. The other (that I'm thinking of) is just using it as a way to keep you going and functional until better/more permanent amswers/solutions can be found. IME, attitude & outlook make a difference.

Doc

Agree, and/or possibly a physiatrist.

Doc