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Old 12-12-2006, 04:14 PM   #1
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Differentiating shoulder pain from cervical causes or shoulder causes

Hello and thanks for taking the time to read my post. I have had neck pain and shoulder/arm pain for about 6 months. I went to GP in Oct. and he gave me steroids and muscle relaxers and said to call if it didn't improve. It initially improved then was back to being very painful within 6 weeks. I called and he ordered a cervical MRI. The results showed a herniated disc at C5-C6. My dr. suggested injections into the neck. My question is this. My pain is very primarily in the shoulder and upper arm. My neck rarely hurts. The pain feels like it is originating in my shoulder right where my upper arm starts. I understand the whole radiating pain thing, but how do I know that it is coming from my neck and not shoulder? Should I let someone give me shots in my neck when I am unsure of the origin of the pain?? How likely is it that it is actually my neck?
TIA
emalee

 
Old 12-12-2006, 07:57 PM   #2
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Re: Differentiating shoulder pain from cervical causes or shoulder causes

My neck pain went into my upper back for a while and thought that I had a upper back problem and shoulder problems as well, but it was indeed my neck. Your muscles and nerves have memory and it take a long time sometimes for healing. Have you been to see a Neurosurgeon or Othopedic Surgeon yet? They would be able to explain things better to you probably, as well as tell you how likely you will need surgery or not. Good Luck to you and God Bless.

 
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Old 12-12-2006, 08:26 PM   #3
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Re: Differentiating shoulder pain from cervical causes or shoulder causes

my pain was in my right arm/shoulder- at it's worst just above my right elbow. the doctor's attributed it to disc herniations at C5-6 and C6-7. they said the herniations were pressing on the nerves that go down into the arm.

I would recommend you see a neurosurgeon vs. soley relying on your gp....

I had torn my right rotator cuff in a sports injury and had surgery to repair it 5+ years ago, so I too wondered if my pain might be more related to that. but the doctors convinced me it was disc related. I chose a minimally invasive option over fusion, and so far 4 months post surgery my arm pain is virtually gone. the doctors have said that I will still have flare ups now and then, until the nerves affected are completely healed. but overall I feel monumentally better.

your situation may be resolved without surgery however, I would recommend that as your last resort...

good luck

bw

Last edited by bw67; 12-12-2006 at 08:31 PM.

 
Old 12-13-2006, 02:37 AM   #4
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Re: Differentiating shoulder pain from cervical causes or shoulder causes

hi emalee----I also have a really bad neck. stenosis, bulged sidks, bone spurs, and a possible pinched nerve at the C7. since i injured my shoulder at the same time it was impossilbe for anyone to know what was what. have had 2 injections and months of therapy on my shoulder (impinged rotator cuff) and have had some relief. the pain oringinally was in my neck, shoulder and the bicep pain was horrendous. I never knew at that time that the neck can cause this but it can. i also have a dead tricep on the same side as the bad shoulder. after getting a trigger point injection in each trapezious muscle i have had my greatest releif. neck still hurts and shoulder still locks if i try to lift it beyond half way up but i feel the pain in my neck now is from my neck. hope I helped.

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Old 12-13-2006, 07:22 AM   #5
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Re: Differentiating shoulder pain from cervical causes or shoulder causes

BW-

I was wondering who did your surgery in the middle TN area. I've had an ACDF already, and my right arm hurts like heck above my right elbow. thanks.

wb

 
Old 12-13-2006, 06:07 PM   #6
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Re: Differentiating shoulder pain from cervical causes or shoulder causes

Actually, it is very likely that the pain is from the cervical disc problem. The nerves have "dermatomes" - areas affected by nerve impingement. For example, in the C5-6 area shoudler pain is quite common. Different areas or levels of impingement can lead to different types and strengths of pain.

I too had primarily shoulder and arm pain - radiating down the left arm into my fingers (some finger numbness). The first thing I noticed when waking from the ACDF was that the arm/shoulder pain was gone!
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Rt&Lt thumb arthroplasty 2012 ; RT TKR & Bilat CTS 2011
Fusions: L5-S1 (87), L4-S1 (93), C5-C7 ('06), L3-S1 ('10)
C5-C7 foraminotomy 08

 
Old 12-13-2006, 06:52 PM   #7
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Re: Differentiating shoulder pain from cervical causes or shoulder causes

whackedback-

I didn't have my surgery in mid-tn. I couldn't find anyone in the Nashville area that performed minimally invasive procedures. I did not want fusion.

I had my surgery done in Lake Worth, FLA, by Dr. Merrill Reuter at Advanced Orthopedics of South Florida. Again, 4 months post-op, so far so good. The staff there is tremendous on follow up as well...

As for the Nashville area- I liked every doctor I saw, I just didn't get the answer I wanted to hear. Most notably- Dr. GEORGE LIEN, at MIDSTATE NEUROSURGERY, out of the Stonecrest Medical Center in Smyrna. He was awesome, and he does perform minimally invasive procedures, but he didn't feel I was a candidate- he felt that fusion was my only option.

I also really liked Dr. Harold Smith at Baptist, but he too only recommended fusion.

Who performed your acdf? How long ago was it? Your nerves may still be recovering if it wasn't that long ago...

FYI- I'm going to be off the boards for a few days, my wife is scheduled to deliver our second son tomorrow morning...

good luck

BW

 
Old 12-13-2006, 07:58 PM   #8
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Re: Differentiating shoulder pain from cervical causes or shoulder causes

Hi Emalee,

I had the same symptoms that you describe, and thought, that it was from my shoulder. I had neck pain, mainly at the bottom of my neck, reliable daily pain (i thought) in my shoulder, and in the upper arm. So much so, that they thought I had a rotor cuff injury and were treating me for it.

I had been in an accident and thought I just had muscle strains, ect. Well, after 5 months of treatment consisting of trigger point injections, pt, manipulation, ect., nothing worked. An x-ray indicated ddd at C5-6, but after two more months of complaining, the Dr. ordered a Ct, and found out that I had a large C5-6 herniation with nerve impingment.

I had ACDF, and from the moment that I woke up from surgery, all that pain was gone!

You should ask your GP for a referral to a spine specialist, either Neuro or Ortho. I don't think it matters which one, except if you can, try to pick one that has a fellowship in the spine. It can't hurt to get another opinion and certainly one from a Dr. who specializes in that area.

Good luck to you and please let us know how your doing.
Bernie

 
Old 12-14-2006, 10:01 AM   #9
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Re: Differentiating shoulder pain from cervical causes or shoulder causes

I have pain that started in Jan. felt like I had slept wrong on the left side of my neck and stayed like that for a long time. Then it went down into my shoulder and shoulder blade. The muscles in my upper left arm are terrible...feels like I am being punched or getting shots with HUGE needles!!!
Hard to explain....I have been told that I could have a herniated disc in my neck......but I think now I have something in my shoulder too....I had an EMG this summer that was normal, but it was before all this other stuff started. I'm wondering if I may have a rotator cuff problem, or mybe a spur on my shoulder. I am left handed and have a hard time at work...holding a pen gets difficult after a long time, my handwriting is aweful by the end of the day...I have a hard time filing if I have a lot to do. Plus I have had a lumbar laminectomy a long time ago, and still have problems with my lower back. So I feel like crud most of the time!!
My next step is to get some MRI's and labs to rule out other things... I'm scared to death of what the diagnosis is going to be...(MS,Lupus) I have been kind of told to rule out my diganosis of Fibromyalgia, so that is kind of out of my head!
I know I have said a lot of this before on the boards, but I have had a hard time with the pain this week and need to vent...lol...
I know that I have to be patient until Jan. when I get my insurance.
I know depression doesn't help the pain, it's Christmas and my son just left for Korea a little over 2 weeks ago...so That doesn't help the pain.... I have thought of trying other meds. but I guess I have to wait and see!!
TC

 
Old 12-19-2006, 06:48 AM   #10
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Re: Differentiating shoulder pain from cervical causes or shoulder causes

Just wanted to check back to see if anybody knows anything about shoulder injuries or what else this could be....any input would be great!!!!!!! TC

 
Old 12-19-2006, 07:19 PM   #11
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Re: Differentiating shoulder pain from cervical causes or shoulder causes

Sorry, I have more questions on this subject than answers. Mine is a horrible ache behind the right shoulder blade. Not much in the arm. My right arm has became somwhat weaker than the the left and I'm right -handed.

MRI results show disc buldge and degeneration at C5-6. No reportable thorasic problems other than some inflamation. There is very little pain in the neck area and when there is, it doesn't last long.

I have had a cervical epidual and CT quided nerve root injections for the C5-6 area which have done nothing for that horrible shoulder blade pain. The neurosurgeon thinks he can help my pain with fusion surgery, but if none of the treatments being done for my neck work, why have surgery there when the pain is in the shoulder blade? Why have there been no tests checking for a shoulder problem?

This has been going on for 10 months. Celbrex and muscle relaxants do nothing.

Emalee, your post was so familar to what I'm going through, I just had to jump in with the hope of finding a reponse that made sense to me.

 
Old 12-20-2006, 06:06 AM   #12
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Re: Differentiating shoulder pain from cervical causes or shoulder causes

Do you have problems with the muscle in you upper arm? Feeling like you are getting an injection????? Then it feels like contraction pain!!!! ....you sound like me too...goo luck!!!
TC

 
Old 12-20-2006, 08:48 PM   #13
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Re: Differentiating shoulder pain from cervical causes or shoulder causes

No real pain in the upper arm. Just the shoulder blade, some neck and pain radiating from these areas. Finally they took an x-ray of the right shoulder blade today and said there was some degeneration in the joint. I'm to see a physical medicine doctor who specializes and can maybe inject the area of pain. FINALLY.

They weren't specific about the degeneration. A radioloist still needs to look at the x-ray. They did tell me a lot of it is typical for my age. I'm 48, active and my left side is fine so I don't quite get that.

Thanks and I hope everyone can get some answers and solutions.

 
Old 12-21-2006, 08:56 AM   #14
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Re: Differentiating shoulder pain from cervical causes or shoulder causes

I am getting pretty anxious about my appt....
I just want to know what is going on and what the next step is or steps are!
I almost have myself ready for another surgery in my mind although not sure that I need anymore...
I guess I just need to wait it out and try not to think about it.
It does help to be able to get on this board and get input!!!
thanks to everybody!!!
TC

 
Old 12-21-2006, 06:26 PM   #15
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Re: Differentiating shoulder pain from cervical causes or shoulder causes

lulu-

for what it's worth, I didn't have significant neck pain as a result of my disc herniations at C5-6 and C6-7. But those herniations/leakages were pressing on the nerves that go down into my right shoulder/arm and were causing the incredible pain.

I had my ACD w/out fusion surgery because the ARM PAIN was intolerable, not the neck...

But fixing the herniations was the only way to take the pressure off of those nerves...

anyone who's read my posts by now knows that in my own NON DR opinion, I recommend exhausting any and all options before resorting to any type of surgery, be it the fusion, minimally invasive without fusion, or otherwise. once you've gone under the knife, there's no going back. I found relief for over a year with traction and massage therapy. during that time I became more and more educated on the other options that are out there.

I obviously don't recommend putting off surgery if by doing so you're putting yourself in any risk of worsening the injury, but most of my doctors told me that the need for surgery was based on my pain tolerance. I tried everything until nothing else seemed to work and I just couldn't stand the pain any longer, then I finally caved in...

good luck

BW

 
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