Neuromuscular In memory of Rose Marie.


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Old 06-29-2017, 08:08 PM #1
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Default 13+ months burning medial scapula pain after accident

Without drilling you with tons of detail (the clipped word document can do that for me), last May (2016) I was rear-ended at a stop light. I was looking down and to my right when it happened (which is apparently an important detail). The woman wasn't driving fast at all (as evidenced from basically zero damage to my bumper).

That was on a Monday. Just as a pre-caution, I went and got cervical x-rays, etc. at an urgent care facility. All was okay. About five days later, I was working out doing high-knees and I felt a sharp, albeit short pain in my butt and calf. Skipping a lot of the story ...I was told it was a grade 1 hamstring tear and did some PT. From that day on (working out), I've had this 'pulling' sensation in my calf at all times and random tingling in my feet. It turns out it wasn't a hamstring pull but a realization that I have a spondylolisthesis (grade 1, 4mm slip at L5-S1/ bi lateral pars defect right above it) and that it is some sort of nerve sensation (all the EMGs check out and show no nerve damage). Before discovering it was this, they were worried it was DVT.

More importantly - two weeks after the accident I had a tiny amount of pain in my left rhomboid. Nothing crazy ... until it was. About a month later I developed this parascapular pain (along my left medial shoulder blade) that is awful and comes and goes - I have done EVERYTHING and every test (I've consulted orthos, neurologists, spine surgeons, pain specialists (although I have zero interest in ever getting pain killers - I refuse to get on those)

I was an athlete who was working out all the time and now am significantly cut back as I experience this pain every day

My symptoms:
- Burning pain around the left medial scapular border with palpable tenderness (I do not get it while laying down or sleeping)
- Some left (same side as pain) facial numbness. Comes and goes
- Ever so slight temperature change in hands

Potential theories:
- Brachial plexopathy - neurogenic thoracic outlet syndrome
- Cervical radiculopathy at c7 (I'm avoiding cervical epidurals... especially if we aren't sure it is this)
- Dorsal scapular nerve entrapment
- Long thoracic nerve injury (Dr. Nath thinks decompression of the long thoracic will help me)

Imaging (which I can make available for anyone)
- Cervical/ brachial plexus/ thoracic MRIs

Medicines Attempted
- Medrol Dose Pack
- Neurontin (300mg 2x/ a day). Stopped after 4 months due to mood side effects

Procedures attempted:
- Medial Branch Block of C5,C6,C7
- Trigger point injections
- PT (tens unit, etc)
- Accupuncture
- I just began neuromuscular massage (I'm in LOS ANGELES if anyone has a recommendation)

Other Factors
- Ever since the accident my testosterone has been incredibly low (went to ~200 levels from about 650)

I have a digital health record of all this since the last year and am more than happy to share with someone.

Thank you so much for taking the time to hear this out
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Old 06-29-2017, 11:24 PM #2
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If you want to explore more about TOS, here is the link to our forum for it -
https://www.neurotalk.org/forum24/

Look though the useful sticky threads there too..
We do have some CA TOS drs, PTs, DCs mentioned .
Manual trigger point is useful and as a self care option.. (see the TrP sticky thread)
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Old 06-30-2017, 04:23 PM #3
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Thank you!

I know this is a crazy question to ask ... does this sound more like TOS or CRPS?
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Old 06-30-2017, 05:26 PM #4
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Does the working out include weightlifting or quite a bit of arms forward or overhead?
If so TOS, is very likely.
In the past some have had C spine issues, plus TOS , plus CRPS
and it is really hard to separate the symptoms then..

I'd suggest keep searching and asking , nurses, PTs , staff.. for the best well rounded drs etc you can find.. It may take a team PTs /DC MDs..to get best recovery.
It takes time to find the best fit, so don't stay with any that are getting 0 results..or worse going backwards...with more pain..

Nutrition awareness & health supplements can be helpful.
https://www.neurotalk.org/forum49/
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Old 07-03-2017, 02:32 PM #5
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Thank you! A little more context to help me (at least guess) figure out if CPRS is an issue here. If so, I know treating early makes a difference:

Upper body:
- Laying down, sleeping I have no pain
- Pain typically comes on 2-3 hours after working out (and yes that can include weight lifting)
- Some facial numbness on the left side

Relief:
I have an AlignMed S3 - while wearing it, by symptoms are dramatically reduced
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