Pain in the neck that extends to the shoulder

I have been having this pain now for the past six months after a fall on my stairway and I took the impart on my upper back right side. The pain is usually intermittent aches and burning sensation around my upper back, upper arm, under arm, and in my right breast and sometimes tingling down the arm.

I've been to my GP and blood test were done, came back clear, we did ultra sound scan for gallbladder came out fine. Been to the Physio a couple of times, which did help a bit.

Noticed with stretches the pains stops but will come back later.
I work sitting using a computer 5 days a week.

Kindly help.

Hello,
What's needed is a diagnosis, and it seems like there may be two distinct injuries. Here are a few questions; the more accurately you can answer each one, the more likely I may be able to help. A one liner will be a waste of your and my time.

1. Take in a very deep breath; anything unusual?

2. Press firmly on the joints between the ribs and your breast bone, first left and right. Any specific tenderness? Just medial to the breast tissue. Is there a lump?

3. Which part of the arm, precisely is affected by the tingling? Did your doctor take reflexes, test skin sensation and look for any weakness in the arm; most usually the triceps and the finger muscles may be affected.

4. Turn your head to the right, and then simultaneously look up. What happens.

5. Ask your husband to do the 'upper limb tension test'. Find it using the Site Search function at Chiropractic Help.

There's a lot to be done. Do it thoroughly and give me a complete answer if you want this to be of any use.

Meantime go on with the physio if it's helping; they may be able to help you answer some of the above.

Dr B

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Jun 05, 2018
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RE - Pain in the neck
by: Anonymous

1. Take in a very deep breath; anything unusual? - When I take a deep breath I do not feel anything unusual. Then it's not an acute rib sprain, good.


2. Press firmly on the joints between the ribs and your breast bone, first left and right. Any specific tenderness? Just medial to the breast tissue. Is there a lump? - There is no lump but it is very sore when I press on the joints between the ribs and my breast in the right side. And the pain extends to my neck on the right side. Left side fine. You have a costochondritis which, ignored, may lead on to Tietze's syndrome; a stubborn painful condition of the joint between the rib and breastbone.

3. Which part of the arm, precisely is affected by the tingling? Did your doctor take reflexes, test skin sensation and look for any weakness in the arm; most usually the triceps and the finger muscles may be affected. - The tingling mostly is in the upper arm close to the collar bone and sometimes in my fingers. My DR did not take reflexes but there is weakness in the arm if raised or stretched out. And when I try to stretch it to the back there is a tightness in the under arm and can't freely go backwards. As I thought there is more than one component to this injury; there is tied in with your answer to 4 which points to an irritated nerve root in the lower neck; it's affecting your shoulder; or, it could be a separate shoulder injury, but more usually it's tied in with the pain in the lower neck and positive ULTT.


4. Turn your head to the right, and then simultaneously look up. What happens? - There is a tightness in one of the muscles at the right side of my neck and it's painful. This is called a positive Kemp's test and, if it immediately goes down your arm, a positive Spurling's sign.


5. Ask your husband to do the 'upper limb tension test'- With this I had pain in my lower arm that seems like a stretched vein and this runs up to my upper arm to the neck. Definitely a positive test.

One last question: does raising your hand above your head relieve or increase the pain in your arm?

It's time to have an x-ray of your neck and then find someone who specialises in the treatment of the neck, midback and costo-sternal joints. Preferably not a surgeon at this stage, but you may end up there.

It's really quite a serious injury and pain pills and anti-inflammatory drugs just mask the pain and are likely to give you an ulcer if you continue with them for too long.

Get help. Let me know how you get on. Perhaps print all of this and take it with you.

Dr B



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