1.5 years of deep upper back pain goes undiagnosed

by Jeremy
(MA)

I beg you for your help.

Introduction:
I am in great pain every day. I am a 25 year-old male, healthy, but I live off of Motrin. I understand that this is terrible for my stomach. I average roughly 7 Motrin a day, every day. When the stomach burning becomes too great, I take Tylenol (not nearly as effective in pain reduction or duration), and supplement with L-Glutamine, in hopes of repairing some stomach. Literally every single thing I do every day I have to consider moving incorrectly, and sometimes, it doesn't matter - I can make motion A, be fine, repeat motion A, severe pain.
I'm very desperate, and hoping you'll be able to help me in any way possible. About 1.5 years ago, I sat up one day and was in a new pain. Nothing too severe, but something didn't feel right. Hurt somewhat on and off, but these last 7 months for me have been unbelievably uncomfortable / painful.

Guilty:
I had poor posture at the computer for a while, and I also "cracked" my own neck a little, just by rotating side to side, hands-free. The neck cracking didn't last long at all though, maybe once every 2 days, for a 2 week period.
When I say that I sat up, it was from being cross-legged hunched over on my phone, leaning on my elbows. I understand this is bad. In no way did it feel strenuous to me at the time, though.
I work at a desk job.

Description: (pain level)
1. constant throbbing pain above left shoulderblade, radiates down my left arm. no motrin (5.5/10). motrin (0.5/10). i feel this pain no matter what i am doing, even if perfectly postured and still
2. when moved incorrectly (arm, neck, back, and certain relative motions between them), sharp pain from shoulderblade up through the side of my neck (8-9/10), with or without motrin. sometimes extremely unbearable
3. after sharp pain, throbbing pain is greatly intensified for the next few minutes
4. massage / pressure seems to make inflammation worse. ice / heat dont seem to help. stretching doesnt seem to help. muscle relaxers dont help. stretching / exercise don't help
5. chiro called it "thoracic outlet syndrome" and adjusted my back / neck, no help. physical therapy called it herniated disc C4~C6 (from mri), then called it an out of alignment facet joint issue (xray)
6. the ONLY thing which has helped my pain so far is pills, namely NSAIDS. ibuprofin works much better than acetaminophen. 2 extra strength tylenol < 1 regular motrin for me
7. on occasion, only my left hand has gone numb. when i get a very sharp pain, i feel some numbness in left hand, more pain = more numbness in hand
8. coughing sneezing or even a chill can cause sharp pains for me
9. sometimes when pain creeps up side of my neck, it hurts in my ear, somewhat like an earache
10. 200mg motrin used to provide 6 hours of relief. now, about 3 hours.

Treatments thus far:
So far, I have talked to my primary care doctor, nurse practitioner, tried Motrin (helpful), muscle relaxers (not helpful), gone to chiropractor (about 1 month, not helpful), tried massage (causes more inflammation), gone to physical therapy (about 3 months, not helpful), had an x-ray, had an mri, and recently talked to an orthopaedic specialist. He will be poking me with a needle to reset muscle tightness, and I will be going to physical therapy in conjunction with the shots.

Diagnoses thus far:
Thoracic Outlet (chiropractor)
Herniated Disc (C4~C6) - physical therapy
Facet joint not properly aligned (physical therapy)

Conclusion:
I suffer a lot every day. I have a decently high tolerance to pain but I almost cry on a daily basis from some of the sharp pains this causes me. Everyone seems to just tell me to maintain better posture and keep taking Motrin. If I continue to take Motrin, my stomach will disappear. I have paid much attention to posture the past few months.
If there is anything you can recommend to me, exercises, alternative to Motrin, next course of action, just something that will help me, it would be very much appreciated and I will buy 10 copies of your book. My life would be amazing without this. With it, I am miserable.

Hello Jeremy,
You are in a pickle, so I understand your frustration. This is complex and you must understand that without being able to examine you it would be presumptuous to come up with a diagnosis.

Am I correct in understanding that your xrays and scan are largely normal?

And the reflexes, muscle strength and light touch and pinprick are normal.

I'd like you to do two tests for me please.

1. Turn your head to the left and look up. What happens?

2. Go to Chiropractic Help and, using the search function, type in "upper limb tension test". Ask a friend to help you do the test. What's the result?

Keep to this thread.

Dr B

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