Question
Dear Doctor:

I am a 50 year old female in generally good health.   For the past ten days I have been experiencing neck pain which radiates through my left shoulder and down the arm.  If I sit on a stool without back support, the pain becomes very annoying and I find that I have to stand in order to relieve the pain.  The pain is not as bad when lying down and I usually wake up feeling pretty good the first hours of the day.

I have not been evaluated and I am hoping that I will not have to be. Do you have any suggestions re: how to relieve the pain or what conservative measures I could take before seeking consultation?

Thank you.

L. Carden

Answer
Dear Linda:
The only advice that may help you is to check your posture, especially the shoulders. It sounds like your left shoulder is forward rounded, which may cause the radiating pain from the tightened neck musculature, causing all the symptoms you have described. If I am right, then a simple doorway stretch may help your symptoms: stand in a doorway with your arms at 90 degrees from your body, and elbows at 90 degrees so you are standing like you are sticking your arms straight out from your side with your elbows bent. Now go to a doorway and place each hand on the sides of the door frame, and lean into it. This should make a stretch on the front of your shoulders and chest, and make your shoulders push backward. When you are done after 30 seconds or so, you should feel like you are standing up straighter. Now, there are a hundred other reasons why this could be happening to you, and as you have stated you want to avoid the evaluation. Without jumping into your reasons why you are against this, let me say that if you do get an evaluation, make it count. The best of the best are special physical therapists called Certified Manual Therapists who have the intials MTC after their name. They are the guarantee that they can find your problem the first time. A regular physical therapist may be able to do the same thing, but only if you have a common problem that does not involve the spine. If the above mentioned stretch works, then a regular PT will do just fine. If that stretch makes your symptoms worse or no change, then seek the PT, MTC.
Good luck to you on this matter, I sincerely hope you take this advice in the concerned manner it was given.
Dr. Jeff Carr, DPT, MTC, ATC,CSCS