1.5 years of deep upper back pain goes undiagnosed

by Jeremy

I beg you for your help.

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.

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)

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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Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I have left alone. After seven treatments his pain and stiffness is 50 percent better, and he is happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti-inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He is doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost pain-free. 

Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he is well pleased; sixty-five percent better after three treatments.

5. Mr T is a wise man; he has taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily stroll has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift; he has a short leg.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. X-rays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65-year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88-year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done. 

10. Mr X is a 71-year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a few months ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It is a non-complicated upper cervical facet syndrome, and she is doing well.

12. Mr D is a 38-year old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he could not sleep on that shoulder.

13. Mr D, a 71-year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors should not be treating the elderly most medical sites state but that is so much bunkum.

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