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I need help and advice! This is a long story so I will try and make it as short as possible while trying to include as many details as possible. In September I got married and went on my honeymoon, the day after I returned from our honeymoon (in Miami) I came down with a wicked case of bronchitis that lasted 2 weeks and I had to go through 3 separate rounds of steroids. a few days after I finally was feeling better I woke up with what felt like a bubble in my back. After a few days the bubble turned into a sharp knife like pain in what I thought was the back of my left lung that felt like it went all the way through to the front of my chest. I went to a chiropractor who diagnosed me as having a rib head out. So he adjusted me a few times and the pain just kept escalating to the point I actually called the paramedics because I thought I was having a heart attack (I am 29). Was not having a heart attack so I went to an urgent care center who did chest x-rays and found my lungs looked clear and nothing was obviously broken, they gave me a steroid and sent me on my way…next day pain was so bad I got physically ill on my way home so I went back to urgent care who gave me another steroid shot and told me to see an orthopedic. First ortho I saw scratched his head and took some more x-rays and sent me out the door and told me to see a general practitioner. 2 weeks pass and I woke up one morning with a searing hot pain radiating from my right arm pit anytime I moved it. The skin above where the pain is was also completely numb. General practitioner puts me on neurotin and ordered a ct scan which showed everything was clear. Since the neurotin was helping with the pain from the right shoulder he suggested I see a neurologist. I see the neurologist and he tells me that my c-1 is out of place and that I need to see a chiropractor to get that adjusted. Go to a new chiropractor who has physical therapists and medical doctors in the same office, they diagnosed me as having “army neck” and also a rib head out…after 2 months and over 30 trigger point shots I decide to get a second opinion from another orthopedic. He orders a thoracic mri which shows everything normal so he orders a cervical mri which shows I have a SLIGHT bulge in my c5-c6 and early stages of degenerative disk disease. So I get 2 epidurals in my neck…no relief…and then I got another epidural this time in my left shoulder joint, also with no relief. No one thinks my nerve damage on my right side is associated with the pain on my left side (seems awfully coincidental to me but hey I’m not a medical expert) shortening my story I have been going to another physical therapist for 2 months now, have had another ct myelogram. The physical therapist says I have a rib head out (but that he’s never had a patient who’s rib didn’t go back in after a few manipulations and the exercises); the orthopedic said he doesn’t believe in that. So here I am 8 months later, with an invissible knife sticking through my left chest area and no sensation in my right shoulder area and I feel like I am no closer to a diagnosis. I have ANOTHER (this will be #3) Mri tomorrow morning this time FINALLY of my left shoulder. I don’t know where to go next. Do I look into a pain management clinic if the mri doesn’t show anything obvious? Do I try a heart doctor to narrow out that I haven’t got something wrong with my heart (since the pain is so close to that area) I just don’t know. Any advice on either what to do next or ideas of what you might think is going on for me to bring up to my doctor next visit would be greatly appreciated. PS I have actually had 2 nerve conduction studies both of which have validated that I’m not crazy and I do indeed have nerve problems (the study actually showed it was on my left as well as my right).
Pain in this region could emanate from the cervical spine, the thoracic spine, the shoulder itself or injury to a local nerve (long thoracic, axillary, etc..). Non-muscular/nervous structures (lungs, heart, etc..) could also cause these symptoms (except for the numbness which is typically associated with nerve dysfunction).
You mention findings on your EMG testing. What were those findings?
There can be mechanical problems present from a subscapular bursa (an oil-filled sac under the shoulder blade) or a shoulder joint problem. You might need to come to the office and visit with one of my shoulder expert partners for an appropriate workup.
Dr. Corenman
PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.I have had a t-spine mri and a cervical mri. The cervical Mri said “There is mild left convexity cervical scoliotic deformity. This is associated with slight reversal cervical lordosis. There is mild degenerative desiccation of the disk at the c5-6 level. This is associated with mild left posterior bulging.” The t-spine said everything was within normal range. I don’t have the full report from the Nerve test (last doc kept it) but I did have a blog for awhile and luckily I posted a potion of the results: “This is an abnormal NCV/needle EMG test. There is electrophysiological evidence of nerve root compromise at the C5/6/7 root level on the right, with representation in the corresponding myotomal distribution.” I have had 2 epidurals in my neck the first was c5 I think and the second was in the c6 (again I think) I’ve also had a 3rd epidural this one was done in my shoulder joint. I just had an mri done of my shoulder this morning at 9 so I should have those results tomorrow afternoon or Monday. Do you have a clinic in or near Atlanta Georgia because that’s where I live and I can’t find where you’re located.
I got the results of my shoulder MRI: “There is no significant joint effusion. The supraspinatus tendon appears intact without evidence of a tear or significant degeneration. The infraspinatus and subscapularis tendons are normal. The glenoid labrum is grossly intact on this noncontrast study. There is no acute appearing osseous abnormality. The distal clavicle is slightly elevated related to the acromion. Thee is no fluid or other inflammatory changes in this area, and this may be a developmental variant rather than traumatic injury, Mild subacromial impingement may be present. An old injury to the acromioclavicular joint cannot be excluded.”
You note that the EMG found “electrophysiological evidence of nerve root compromise at the C5/6/7 root level on the right, with representation in the corresponding myotomal distribution.” The MRI report was somewhat contradictory as it noted “mild degenerative desiccation of the disk at the c5-6 level. This is associated with mild left posterior bulging.” What side is your pain predominantly on?
You have had multiple injections but I assume you did not keep a pain diary for the first three hours which is necessary for a diagnostic injection (see pain diary on the website). Most injectionists so not ask for a record of the first three hour symptom presentation after the injection which is a shame. Do you remember if any injection gave you good relief only in the first three hours (any information after that window will be irrelevant).
My clinic is in Vail, Colorado and if you call the 888 number, I can set you up with one of my partners who specialize in shoulder dysfunction.
Dr. Corenman
PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.The pain is predominately on the left. If I take my right arm and reach over my left shoulder where my finger tips touch is where the pain begins and shoots through to the front side of my chest. The right side was excruciating for only about 5 days until I was put on Gabapentin and then the pain on the right side disappeared. But even when the right was causing me pain it was nothing like the left side. The right was a shooting hot pain and the left is a constant stabbing pain) I still have no sensations on my right shoulder (the skin is completely numb). But the pain started and has continued on my left side. None of the injections gave me any sort of relief and in fact actually made the pain worse from the moment I left the clinic until about 72 hours later.
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