Question
My husband had neck surgery about 8 years ago and back surgery approximately 6 years ago.  For the past several years, he has been experiencing pain in his left side - near the ribs.  He has been to several doctors and he has not gotten any answers or any relief.  Several months ago - he started having severe left shoulder pain.  He had an MRI on his neck - several months ago - and they suggested surgery again.  He opted for a second opinion and that doctor wanted an additional MRI.  While I do not have the MRI results for his neck - I do have the results from his back MRI that was performed in May of this year.  These are some of the notes from the report on his back:  There has been a left side laminotomy and partial discetomy at L-5-S1.  There is not significant disc protrusion identified on the current study but there is epidural fibrosis surrounding the exiting left L5 nerve root and causing partial traction on the left L5 nerve root.  Except as noted above, vertebral body height, alignment and disc spaces are maintained and the posterior elements are normal.  No masses identified in the spinal canal.  The conus medullaris is at the superior endplate of L1.  IMPRESSION - Interval left L5 laminotomy and partial L5-S1 left discetomy with epidural  fibrosis adjacent to the exiting left nerve root causing partial traction on the left L5 nerve root.  No residual or recurrent disc is identified.
Any advise you can offer would be great.  My husband has been in severe pain for sometime and continues to work a job which requires him to operate heavy equipment.  I have been so worried about him because the pain seems to be causing a level of depression.   He has went through Edidural injections - he has not gotten any relief.  The pain management doctor stated that he felt that my husband would not benefit from any future injections.  Do you have any idea what might be causing the shoulder pain and pain on his left side.  He has had his liver and other organs examined - no problem was found.  

Answer
Dear M,

The condition at L5-S1 would have nothing to do with shoulder and rib pain.

Muscular contractions in the shoulder region and between the ribs -- something few doctors look for -- would account for the pain.  If here were my client, I would be examining to locate them or dis-confirm their existence.

If they do exist, the plan would be to train him in control of those muscles, so he can relax them and use them normally.  One would expect the pain to disappear.

I wonder why the surgeries were necessary, to begin with.

with regard,
Lawrence Gold