Question
I am 23 years old. About 4 years ago, I noticed this 'burning' type of pain in my back/right shoulder. It was towards the middle of my back, but right on the outside of my right shoulder blade. I am a website designer, so obviously my hand is always using a computer mouse. I thought this was the cause of the pain. I have tried everything to stop the pain, from positioning my arm differently to trying different chairs. I went to the doctor last year for a regular checkup and told her about this pain. She sent me for an x-ray. When the results were in I was told I have arthritis in my neck and a bone spur. She sent me to physical therapy. The physical therapist had me doing exercises at home every night. He said I needed to strengthen my back muscles. I had to lie on a raised surface (my bed was about the only place I had to do it on) and I had to lift my arms in different directions holding a 3 lb weight. After about a month of doing it every night, the pain in my neck and back was a little overwhelming and I didn't see a significant change with my shoulder pain. I never really had neck or back pain before this. So, I stopped the physical therapy and have dealt with the pain in my shoulder. The back & neck pain only occured (at the time) when I was doing the exercises.

This spring, March or April, I noticed I was waking up a lot at night with neck pain. It wasn't really sharp pain at the time. But I knew it wasn't a stiff neck. It kept me up at night so much, that I started taking Tylenol PM every night. In May of this year, I was back at my regular doctor and I told her I was still experiencing the back/shoulder pain and that now my neck was really bothering me. She said that I needed to buy one of those 'curved' pillows for my neck. I did, but it didn't really help. It was perfect for when I laid on my back. But in the middle of the night, I roll from my back, to my stomach, to my side. And the pillow makes it that much more uncomfortable in those positions.

Most recently, about 3 weeks ago, I went back to the doctor specifically for this pain. She sent me for an MRI. When the nurse called with my results, she said I have arthritis in my neck and a bulged disc. She said the best thing would be physical therapy.

To describe the pain in my neck in more detail, it's almost like a 'headache' in my neck. Nothing I can do will help the pain, like rubbing or stretching my neck. Sometimes the pain shoots up both sides of my neck into the back of my head. Some days are worse than others. Sometimes by the end of the work day, it's like I don't want to hold my head up any longer. I just want to lay it down. It's like I am tired of holding my head up.

My nurse or doctor never really described to me what a bulged disc was or what causes it. I haven't been in an accident and don't remember ever doing anything that would cause the neck pain. I am a little nervous about the physical therapy because of my experience the last time. I haven't been to my first physical therapy session yet, it isn't scheduled for a few weeks.

I guess my questions are:

What is a bulged disc? Is it the same as a herniated disc? Is there a common cause? What can Physical therapy do for me? Is there any other treatment?

I would normally call my doctor, but I feel that she is really quick to diagnose a problem, but doesn't really look hard into it. Should I get a second opinion? I guess I am just more worried because I am only 23 years old and have never had an injury - accident or sports related.

Any advice would be greatly appreciated. Thank you for your time.

Answer
Rachel,

What you're describing sounds like one or more tight muscles in your neck.  Tight muscles cause discs to bulge, the way overloading a car causes its tires to bulge at the bottom, and that's a herniation.  Tight muscles are fatigued, and cause the sense of your head being heavy.

Pillows, strengthening, or stretching won't help -- as you've found out.  You need to retrain your control of those muscles.  Physical therapists commonly think in terms of strengthening and stretching, but not in terms of coordination and control, which is what you need to develop in order to relax your neck.

The easiest way to do so is to have some sessions with a somatic educator; lacking anyone near you, some of the self-training programs available have instructions for neck muscles.  See somatics.com/page7.htm.  For practitioners, click the link in the blue navigation bar, Practitioners, at somatics.com

with regard,
Lawrence Gold