[gonzagnr]

#10959

Dear Dr,
I am a very healthy 25 old male, since 18 years old i train with weights, never had an injury, never felt a pain, never pulled a muscle, i was a 100% healthy person. I am experiencing a lot of different pains in my thoracic area, all in the back, not in the chest or abdominal.
This pain began 1.5 years ago as a painfull dull point in my right shoulder blade, the pain was increased with deep breathing, but only in that point, also the pain was increased with aerobic activity like running, also i was able to feel that the point was painfully beating with aerobic activity.
2 weeks after resting, the pain didnt improve so i say ok maybe it will go if i return lifting, that day i was doing traps and BAM a very strong pain started in my neck, and my neck become very stiff also my traps and shoulder blades (BOTH sides), also after that and till present day my upper back cracks a lot, even when breathing you can feel the spine cracking.
From that day for the following 3 or 4 month i had all that area (neck and both side thoracic) VERY sore and, and i woke up in terrible pain/stiffnes.
Also i started getting pain in some points over my ribs on my back and lateral (both sides, pain is SYMETRICAL, however at the begining the right side was a little more painfull, but after some time left side started hurting more and now both are equals).
After those month the neck stiffnes went away, but i still have very sore shoulder blades and wake up in severe pain in both sides.
The more i am seated, the stiffer/painfull i get on those areas.
i have never experienced wrapping pain along the ribs, or numbness or burning or tingling in any part of the body.
Also after the pain started i had the feeling like i have knots under both shoulder blades and there are things rubbing each other under shoulder blades, dr said is NOT scapulothoracic bursitis.
I have tried the following therapy with NO relief:
acupunture, chiropractic, ESI in the thoracic area, laser and ultrasound (these two increased the pain), cervical traction, massage and hydrotherapy.
Attached is a picture of the areas where i get the more pain and stiffnes and images of a cervical/thoracic mri, please delete the space after the second T and before de P of images url, i was recieving an error for posting links.
pain areas:
htt p://i.imgur.com/m1xO30B.jpg
notice that the lower pain over the ribs, is a pain felt over a portion of the lower border of the rib, also increased with pressure over the border, very very rare pain, can be related with the schmorl node??

mri:
htt p://i.imgur.com/Tkyjgef.jpg

thoracic:
htt p://i.imgur.com/aDmxcn9.jpg

Another thing, 3 or 4 month after my pains started, also started suffering from pain in right shoulder, but it was diagnosed as distal clavicle osteolysis and very minor slap type 2 tear, shoulder surgeon told me that this has nothing to do with my back pain, and spine surgeon says that this mri is pretty normal, and pain is myofacial pain and trigger points.
Took muscle relaxers like diazepam and cyclobenzaprine with no success, the only thing that helped (also helped the shoulder) was dexamethasone.
Also had cortizone injection in ac joint, and shoulder pain went away, but not the back pain.
I feel that my pain is muscular, because i have very very hard areas on my lats for example, also my pain improves with hot showers, but only for a few minutes, but there is no therapy working for me, i am very frustrated.
can for example a nerve injury make some muscles areas become hard as a rock on both sides almost symetrically??? or is this some fybromialgia??
Thank you in advance doctor, waiting for your very valuable opinion.

[gonzagnr]

#10960

pain areas:
htt p://i.imgur.com/m1xO30B.jpg

mri cervical:
htt p://i.imgur.com/Tkyjgef.jpg

mri thoracic:
htt p://i.imgur.com/aDmxcn9.jpg
notice that the lower pain over the ribs, is a pain felt over a portion of the lower border of the rib, also increased with pressure over the border, very very rare pain, can be related with the schmorl node??

[Donald Corenman, MD, DC]

#10967

Pain in the region you note could originate from the cervical spine, the thoracic spine or the right shoulder. The images you sent are not enough to come to some sort of diagnosis. The correct way to diagnose a condition is with a thorough history, a complete physical examination, a careful analysis of the images and potential use of diagnostic injections (SNRB/ESI-see website).

Most commonly, cervical herniated disc or foraminal stenosis is the first disorder to look for and rule in or out. Thoracic disc hernation would be the second, shoulder disorder the third and finally, insertional muscle disorders (like tennis elbow of the shoulder) the fourth.

There are unusual systemic disorders like polymyalgia rheumatica that can also cause this type of pain.

There are unusual times that a shoulder disorder can refer more pain than to be expected. Since you have a known osteolysis of the AC joint, an anesthetic injection into this area might give you more pain relief than you expect (see pain diary).

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.

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