Back & neck pain (Rhomboid & Scalene)

by Rob
(London)

Hi there,

I recently saw a neurologist with regard to a 9-month long pain in my neck and upper back - After a lengthy consultation a possible cause for these hellish symptoms has been highlighted. He studied my cervical MRI but as the images weren’t clear enough for him to give me a firm diagnosis he suggested I have a higher quality MRI scan of my cervical spine.

He said he is 99% sure that the pain is being caused by 'foraminal stenosis' between the C5 & C6 vertebrae causing the entrapment of a nerve in my neck.

The issue is; he cannot diagnose whether the entrapment is being caused by the cervical vertebrae itself or if the compression is taking place in the scalene muscles within the neck and apparently the only way to diagnose this correctly would be to have an EMG nerve test and to then have a high-quality MRI scan of the cervical spine.

As my pain is constantly present in between the spine and right scapula and also in the front-right side of my neck with occasional tinging and coldness in my right hand there could be potential damage / entrapment of the Dorsal Scapula Nerve as my rhomboid is very problematic.

Can you recommend anything to ease the pain until I'm able to get these tests done / find a solution? Currently just started taking Naproxen, I was prescribed Diazepam, trying light stretches and light weights to keep the back muscles active (the pain isn't causing a loss of strength to what I can tell).

Many thanks,
Rob
London, UK

Hello Rob,
Yes, hellish is the word; this hurts.

A few important things:

1. Exactly where in the tingling in your hand; which fingers. This is vital.

2. If you turn to the right and then look up, do you get pain in the neck, midback or arm? Be specific.

3. Type Upper Limb Tension Test into the search function in the navigation bar. Do the test and tell me exactly what you feel.

4. Has anyone done Adson's test on you? Search for it too; testing the pulse in your wrist with certain specific movements of the neck. It's the definitive test for a pinched nerve between the scalenes. But a difficult test only be done by someone experienced with doing it regularly. You get many false positives; in normal people.

The dorsal scapular nerve is a C5 nerve, thus exiting between C4-C5, not C5-C6.

Added to those woes, is that the pain is sometimes caused by a joint in the midback; also one of the ribs.

Give me some answers; keep to this thread.

Dr B

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