Question
QUESTION: I'm hoping you can help me. A couple of months ago, my upper right back started to hurt. There are days that the pain it present all day long. Other days, I'm almost pain free. However, it always hurts when I lie down. It's something of a dull, aching pain. If I reach back with my left arm and push down with my fingers, it hurts. The pain isn't severe, but it's there.

I've been taking Naproxen, but that doesn't seem to be helping. Also, if I lift my right arm up over my head, I get a tingling sensation under my arm and across the top of my chest and back on the right side. The tingling does not go all the way down my arm. The same thing happens when I tilt my head back or if I lean it forward over my chest.  

I finally went to the doctor, who had some xrays taken. He said there is nothing shown in the xray that isn't expected for a person in her 60s (I'm 66). I have some arthritis, he said, and I'd have to come to an "easy peace" with the pain. He gave me a prescription for tramadl/apap (That's what's on the label). I thought at first it was helping, but it's not. Some days, the pain is there and some days it's not. It hurts when I lie down. It has been a week since I saw the doctor.

I find it hard to believe that this is normal "old age" pain. I asked the doctor if I might have a pinched nerve and he said "no."  I do have some stiffness also in my back on the right side, but I figure that's from being old and sitting at a desk all day. I have been trying to do some twists to loosen up, but the back of the shoulder pain really bothers me.

One last thing - if I roll me head by looking down and then up to the left, there is a loud crack in my neck. When I roll it back down and to the center, my neck cracks loudly again. It doesn't hurt, but I've never experienced such loud cracking in my neck before.

Sorry this is so long, but I'm trying to provide as much information as possible. If you can provide me with some tips and/or insight on this problem, I would appreciate it.

Thank you.

ANSWER: Hi Kait,

Sorry to hear about your problem.

Sounds like a nagging pain and there is something going on. There is a connection between the muscles of the neck and the scapula, which is below the shoulder on the back. Many times these muscles get overworked from years of use and poor posture. It is not uncommon for a muscle to stiffen and have areas of scar tissue. The scar tissue can form adhesions which can stick to nerves and cause pain. With signs of a type of instability in your neck, I would suggest an approach that might provide a solution.

Active Release is a method to deal with scar tissue that has not properly formed in line with the muscle fibers. This is when it can cause adhesions which can be painful and affect proper function. This becomes a chronic condition and is resistant to typical treatments and medications. Active Release is a specialty that I used in practice for many years with very good results and it is also used with professional athletes. It is usually practiced by a chiropractor or physical therapist who has been certified. If you would, try to find a practitioner in your area and, if you can find a chiropractor who is certified, he or she can evaluate your upper back and neck and have the methods to remedy it.

I feel this would be the most productive endeavor at this time. These things do not show up as something a standard doctor would find as an observation on an x-ray like a fracture. So, if your doctor has ruled out any gallbladder problem and you have not had an injury, you may want to look into this if it sounds reasonable.

All the best!

Dr. Steve

---------- FOLLOW-UP ----------

QUESTION: I want to thank you for your thorough answer. I did not see it right away because it ended up in my email junk folder. Thank you again so much!

ANSWER: Hi Kait,

My pleasure.

How are you feeling? Any better?

Dr. Steve

---------- FOLLOW-UP ----------

QUESTION: It actually comes and goes - periods where it's almost non-existant, except when I go to bed, and other times, when it hurts all day long and keeps me from sleeping at night. I was going to take your advice and find a chiropractor with expertise in active release, but my hours got cut to part-time at work, thanks to Obamacare, and I now have no insurance-- and can't afford to pay cash. But I will keep the advice in mind.  Thanks again.

Answer
Hi Kait,

Well I'm glad to hear it is not getting worse. Very sorry to hear about your job - "unintentional consequences"? I hope you are able to find some fulltime work.

Anyway, perhaps you can find a local chiropractor that can work with you. It may be beneficial to have at least one or two adjustments to the neck and upper back. This would break up any adhesions and free up any joints which may be contributing to your problem. This may be a more affordable option for now and I would hope a chiropractor would be understanding and work with you financially. It would be worth a try.

Kind Regards,

Dr. Steve