Question
Hello and thank you for your help and thank you for this wonderful web site!  I have had ongoing right arm and shoulder pain for the past year.  I believe it originated when I lifted something heavy out of the bed of my truck.  I heard a pop and later felt like a rib may have fractured...as months went by, I have daily pain that, from all the research I've done, seems to be a rotator cuff and or bursitis problem.  I've never been to a Dr in my life (I'm 58) except for childhood shots required for school.  I'm am about convinced that this is one thing that is not going to go away on it's own.  My question is how should I proceed.  I don't have medical insurance and I don't want unecessary advice or treatment from the medical drs.  I have taken 4-6 ibuprofen 200mgs ea, everyday for the past year and I'm thinkin' that I may now have cause another problem with using it longterm.  I have to watch everything that I eat or I burp for hrs afterwards.  It's only the burping of air, but, it's very uncomfortable, especially when I feel the need to burp and can't!  I have always loved to eat but, now I'm afraid to.  I've lost a lot of weight in the last 6 mts from the change in my eating habits.  Any thing that you can tell me will be very helpful and very much appreciated.  Thank you,  Judith

Answer
Dear Judith, thank you for your question.
If it hadn't been for the rib pain, I would agree that you may have a shoulder problem. It sounds more like a neck problem, because the shoulder does not refer (send) pain to the rib area. Most commonly you have to strain your neck and upper back muscles to use your arms for heavy lifting. This puts a strain on the neck, especially, if one side of your body works harder than the other (when you twist slightly to one side). Commonly the pain is felt in the neck or upper back (close to the shoulder) or in the shoulderblade area, then it slowly begins to travel down the arm. If your hand, arm falls asleep or tingles, it definitely is a pinched nerve. This is a common problem that responds well to exercises.
The pain usually gets worse when using your arms a lot, especially at or above shoulder level, and with frequent/prolonged bending of the head. After a few weeks you may also notice that you are losing strength, noticing difficulties with opening jars, etc.
Posture plays an important role, because bending your head down will cause more pinching of the nerves. So, work on your posture first, trying to sit, stand and walk as erect as possible. You want to line up your ears over your shoulders. There is a great book out, called "Treat your own Neck", by Robin McKenzie. It has great information in it. Check http://www.optp.com/ it is $10. The book makes it a little clearer, what I am talking about.
Also work on your sleeping posture. Avoid sleeping curled up on your side (fetal position). Roll up a small towel and put it in the base of your pillow case, with your regular pillow). This will give your neck the added support during the night. Avoid heavey lifting for a week and keep house cleaning to a minimum. You can continue with your anti-infammatories (they only bring temporary relief) until your symptoms calm down. A doctor would most likely try the same thing for several weeks, then send you to Physical Therapy, where often treatments are given that bring only temporary relief (hotpacks, ultrasound, massage, electric stimulation).
Try the posture correction first and see what happens. Another good site is McKenzie Institute, where you can get a list of McKenzie certified therapist, who utilize exercises and teach you, how to get rid of your pain.
Hope this helps, let me know.
Heidi