TmackMemberApril 17, 2014 at 3:17 amPost count: 4
I’m 6 months out from C5-C7 fusion surgery. Overall, everything has gone well. I’ve been back in the gym for 4 months and recently have been able to amp up my workouts. While I’m gaining strength, I still have some lingering issues with tightness and some irritation in the upper back, trap, shoulder and pec area. I’ve been working with a massage therapist to loosen up my neck, which I thought all along was the main culprit. While she has made some definite progress with my neck, there is a major issue with the Obliquus Capitis Inferior and/or superior. They are wreaking havoc on everything around them. She has tried hitting every muscle that passes over/under or connects with these guys and can’t get a release. Is it possible that one of these guys or a muscle that overlaps them is caught on one of the screws? Or, could one of the screws have come loose and is protruding to a point that it’s stretching the muscles to an uncomfortable point? These are the only things she can think of that is preventing these muscles from relaxing. I can tell by feeling this area that something is not right.Donald Corenman, MD, DCModeratorApril 17, 2014 at 1:29 pmPost count: 8468
First I will assume that this was an ACDF (anterior fusion) of C5-7.
“Tightness and some irritation in the upper back, trap, shoulder and pec area” generally is an indication of pain generated by the lower cervical spine (C4-T1).
Obliquus Capitis Inferior and/or superior muscles are occiput to C2 muscles and would not cause the lower neck and shoulder pain you complain of. These muscles are more involved in headache and base of skull pain generation.
I would suspect continued pain as you describe as generated by a level not involved in surgery (C4-5 or C7-T1) or from a pseudoarthrosis (lack of fusion) of the levels involved with surgery.
Dr. CorenmanTmackMemberApril 17, 2014 at 8:06 pmPost count: 4
Thanks so much for the response. Yes, it was ACDF surgery for C5-C7. I don’t think I did a very good job of describing my issues. What I was referring to as pain in the trap,shoulder and pec area is really tightness. Some of my tightness was due to really tight lats. Some extensive work on them produced some limited relief. The next focus was the neck, in which we found everything, particularly the scalenes to be very tight. The work on loosening up my neck muscles has been very effective in reducing the tightness in the areas I mentioned. The last issue is one in which she can’t get the Obliquus Capitis muscles relaxed. They are aggressively pulling and just won’t let go. This is obviously irritating other muscles around them. The fact that they are acting in such a stubborn way is leading her to believe that possibly one of these muscles is stuck to one of the screws, being pushed by a screw that may have come loose, or is being affected by scar tissue that has built up around the plate. Have you ever come across an instance of this nature? Your comment on a lack of fusion is one that I have feared. However, could this be the case if I am not feeling pain in the area and have been getting considerably stronger over the past couple months and able to do heavy deadlifts, squats and presses?Donald Corenman, MD, DCModeratorApril 18, 2014 at 12:26 amPost count: 8468
Generally, “tight” muscles are a result of an underlying disorder and not by themselves, the cause for symptoms.
There are no screws that protrude into the back of the neck. The anterior plate has screws that enter the vertebral bodies but nothing in the rear of the spine.
You might have facet generated pain if there is base of the skull symptoms.
A pseudoarthrosis can easily be determined by a set of X-rays including flexion/extension.
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