Question
I am 19 years old and have been dealing with chronic right scapula pain for
over 2 years now.  It started shortly after I got T-boned in my car, but that
was at a very low speed in my subdivision so I don't really think that is the
cause.  The pain is an intense burning pain that goes from the bottom part of
the right side of my neck, following along the inside of my right scapula.  It
seems to get worse when I am doing repetitive motions with my right arm, or
if I am walking around all day, looking down for long periods of time, or
sleeping on my right side.  I started out my adventure by seeing an
orthopedic surgeon who diagnosed me with Multi-directional instability.  My
right shoulder would continually sub-lux out of place.  He started me in
physical therapy which did not seem to help too much.  Months later, after no
evident progress and being faithful to all my excersises, he opted to do
surgery.  He performed the surgery arthroscopically and used heat to shrink
the cavity and also used sutures to sew it tighter into place.  This was
followed by more physical therapy.  The surgery has wored so stabilize my
joint because it no longer pops out of place, but it has not corrected the
chronic pain along my scapula like it was supposed to.  I continued my
adventure by going to a chiropractor who ordered MRIs of my cervical and
thoracic spine to rule out lesions and such.  No lesions were found thankfully,
but still no answer.  He then referred me to a Chronic Pain Institute.  This new
doctor told me to get a personal trainer and focus on neck, upper back, and
shoulder exercises.  I faithfully went to my trainer and didn't notice any
significant changes.  The doctor at the pain institute then wanted to try facet
joint injections to see if they worked and if they do, he wants to do the
denervation.  On Monday, Sept. 24 I had the initial injections which I was very
hopeful about.  Unfortunately, it is 3 days later and I feel no relief.  

At this point, I am extremely frustrated.  I am only 19 years old, I shouldn't
have to go through all of this!  I want to be able to do things like go bowling
with my friends without pain, or file at my job, or even just have a normal
day.  I don't remember what it is like to go a day without pain.  Do you have
any advice or suggestions?  I'll take any help that I can get!!

Desperate,
Katie

Answer
Hi, Katie.

If you were my client, I would be taking you through a training process in which you recapture control of the muscles that go from the back of your neck down your back (between your scapula and spine), which are presently in spasm.  In other words, I agree with your chiropractor that no lesion is present.

Your doctor is close to the mark to advise conditioning of the musculature:  neck and upper back exercises of the right type will help.  That would not be strengthening or stretching, but training in muscular control -- something few personal trainers do because they concentrate on strengthening without equal emphasis on coordination and control (which, when successful, results in muscular relaxation).

DO NOT have denervation done; it's irreversible and will impair your movement and sensation for life.  It's a last resort; it's neither necessary nor will it work to alleviate the muscles in spasm, which are kept that way by brain-conditioning caused by your accident.

Please see the article on whiplash injuries at somatics.com/page4.htm

I'd advise finding a clinical somatic educator for a few sessions.  LIST:  www.hannasomatics.com/practitioners.

Keep me posted.

with regard,
Lawrence Gold