Question
Hello,
I'm not sure my case is something you would be able to evaluate but I thought I would give it a try. I am a 23 year old otherwise healthy female. About 3 months ago I started experiencing severe left shoulder blade pain and left neck stiffness and pain with movement.There is no known cause I can think of for this, but my guess is bad posture and possibly carrying my purse on that side all the time. Since then have aggressively been trying to find an answer to this issue.

At this point I do see a chiropractor but I find that the treatments don't seem to affect the spots that cause me pain.  To date the pain has gotten worse and I am also experiencing left arm and hand tingling and pain, left chest tingling and chest ache and blurred vision with dizziness on the left side.
Aside from that the shoulder blade pain only hurts when I breathe in (with every breath, no relief) and with movement, but as I mentioned NOT to the touch.

I am having an MRI of the cervical spine and am seeking an echo stress test to be sure this isn't heart related. At this point I am discouraged and not sure if this will help with any conclusion. More so if this testing doesn't show anything concrete I don't know what my next steps will be.

If you have any advice on the matter it would be greatly appreciated.

Answer
Dear Mary Kate,

Symptoms such as you have described are often seen in chiropractic offices, but the bottom line is that you should have been given a diagnosis by now on what anatomical structures are responsible for your pain. I am not sure what your chiropractor is doing, I assume just adjusting the spine, but more is probably needed.

With radicular complaints (pain that goes down the arm), this implies that there is either compression or irritation to the nerve roots in the neck.  The specific nerve roots that are involved can be differentiated by the areas of the arm which are experiencing the numbness, tingling, pain etc...   

Moreover, if you have any specific muscle weakness, this will help to corroborate what nerve roots are affected.  Simple clinical history and orthopedic testing will be able to determine this, along with whether or not the facet joints in the neck or the disks are suspected as part of the problem.  The chiropractor should have performed this on the initial examination, and then considered this information along with a four/five view x-ray series of the neck to include oblique views.  Then an appropriate course of action could be implemented in relation to what anatomical structures had been identified as problematic.  Treatment can be vastly different depending on what is the original source and/or cause of pain and dysfunction.

The MRI is a great test to look at the disk material, the spinal cord and surrounding soft tissue, and should help determine the extent of the problem, but I only order MRI's to confirm what I already suspect to be the problematic tissue, or when a patient is not responding to the care plan I have outlined.  So ask your doctor why it was ordered, as it should have been explained to you.  

Additionally, if the doctor did not take a complete history, did not take any x-rays, and did not perform an examination to include orthopedic tests, and neurological tests, then maybe you need to find a better doctor.  Just make sure that this has all been performed.

Good Luck Mary Kate, and feel free to write back with any further comments or questions if needed.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net