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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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've left alone. After seven treatments his pain and stiffness is 50 percent better, and he's 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's 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 painfree. 

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's well pleased; sixty five percent better after three treatments.

5. Mr T is a wise man; he's 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 walk 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.

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. Xrays 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 year 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's a non complicated upper cervical facet syndrome, and she's doing well.

12. Mr D is a 38 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 couldn't 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 shouldn't be treating the elderly most medical sites state but that's so much bunkum.



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