Can nerve irritation......

[fun meter]

I have on going problems, and I've been searching through google with little luck.

I wondered whether anyone knew if nerve irritation in the area of the neck could cause inflammation or the feeling of inflammation in the shoulder (subacromial)? Similar to shoulder tendonitis / bursitis.


Thanks in advance

[Monk]

Excluding viseral referral which I don't think you are talking about nerve irritation is most likely to present as highly localised or linear pain. It is usually quite sharp and would likely be associated with a loss of strength and sensation.

Nothing can be definite in this game but from the very little info you have given I would suggest nerve irritation is unlikley. Look up levator scapula syndrome... see if that fits the bill, if not give us some more info.

[fun meter]

Thank you for the reply.

The orthopedic consultant I saw said he didnt know what was going on, as the feelings I had are intermitent across different area's. Lateral X-ray of neck and two of shoulder showed no problems (checking for extra rib on one). All tests that where done (neer's etc...) didnt not cause any pain.
He believed it may be mild cervical radiculopathy or brachial plexus injury, but they are only possibilities, as nothing seemed to make it worse.

Sometimes I find I can wake up with no problems at all, but within 2-3minutes, I start getting problems. I had an orthopedic pillow which I think helps with that.

I always have this tightness over my right side - whole of shoulder, upper traps and rhomboid area. Sometimes I get this into my neck, which can become tight and tender. I often have some sort of pain in the following areas - down front and side of shoulder, inner bicep (very sharp, in a line), just to the edge of the scapula (rhomboid area) and across my upper trap (either front of back, again feeling like it goes in a line). I also have mild tingling in my middle two fingers, but sometimes it changes to others. Also have had tightness, heaviness, circulation problems to my hand, burning, flashes of redness, hot / cold sensation. But they are some random across of the the right side.
I do get some similar pain in my left side, but no where near as bad.
About 3-4 times ow, it flares up, and I get a lot of these symptoms quite badly. And it makes it feel like I cant move my arm due to pain (like a muscle has gone or serious inflammation). But when I do, it doesnt actually hurt any more, and I can move it.

I have seen chiropractor which didnt help that much, and have had about a massage every week since the injury. My mid and upper back just keeps tightening up. My posture is fairly good, its not perfect but only a bit of kyphosis and lordosis - nothing that major though.

Edit - the levator scapula muscle is always tight. So are the other mid back muscle. I can feel them pull / really tight with even the gentlest of stretches.

[Monk]

Dude,

If you've been to an orthopod and he/she's not found anything then I've got buckley's chance of adding to what they've already told you!!

If you want a second opinion and suspect something neurological then it might be worth finding a neurological physiotherapist. Most physio's are Mckenzie trained but you want a Bobath (they specialize in neurological stuff especially spinal cord injury if that's what you suspect) Make sure you ask the right questions before booking any appointments.

Having said that I still don't think your symptoms sound neurological as they are not really following any dermatomal pattern other than possibly as secondary symptoms. From what you say (I take it they did Adson's and it was positive) I would be thinking about some sort of gross impingement. What was the onset of your problems? ie did they come on gradually or as a result of an accident?

[fun meter]

Thanks again for the reply.

I do think that the nerve and referred pain is secondary. As you have said (and my chiropractor pointed out), it isnt following any specific patterns.

I done something to my right shoulder early September, and had bicep tedonitis, and bursitis that wouldnt go away (had injection for that, and the stiffness in the shoulder went). About two weeks later (from inital injury), my back started tightening up more, and I started getting these nerve and referred pains.

I do seem to have a few trigger points on my back (rhomboid, teres min/maj, trapezius etc...). When rolling about on a tennis ball today, it seemed to ease it for a bit. But they are very stubborn points, as many very firm normal sports massages havent got rid of them (seems to make it worse the day after slightly). Can espcially feel the ones on my rhomboids, along with the taut bands of muscle. Had this TP (but not as bad) before injury too.
I had a physio try and release the TP, but she didnt have any where near enough force for it to have any benefit.

I am looking into trying acupuncture. I cant seem to find anyone in the area who advertises trigger point therapy, and acupuncture seems to look into that.

[Monk]

No problem... good luck with it.

Let us know how you get on.

[fun meter]

Is it possible for a muscle to tightened up, if its opposing muscle is weak?

My shoulder blades stick out a bit on the medial edge, and the rhomboids are so tight (but always seem to tighten up, even after massage / soft tissue work). Would that suggest a serratus anterior weakness? Wouldnt say my pecs or lats where tight, and dont have much of a slouched posture.
I had a read through one of many good articles on T-nation, and I think Bill Hartman described the scapula is a bit like tug-of-war - with levator and rhomboids vs serratus anterior.

Have to admit even though I did some RC work when I use to workout, I never really done serratus anterior or lower trap work - Im thinking this might be the problem.

[Monk]

Yeah, definitely.

Have you heard of reciprocal inhibition... it's where the opposing muscle relaxes to allow the agonist to contract.

The classic example is tight psoas versus dormant glutes but the same is definetly true in the upper back allthough it's usually a bit more complicated... look up upper cross syndrome.... this also involves tight scalenes which would explain erratic neurological symptoms as the brachial plexus passes between them.

Most people who have tight pecs don't realise it. This is because the pecs are stronger than the back muscles and are therfore winning the agonist/antagonist battle... thus pecs are dominant and not stressed therfore no pain. Where as the back muscles are generally losing the battle, therfore they are stressed and feel sore/achey.

Often people come and see me with a sore upper back and i end up working chest which confuses the hell out of them but you would be amazed how often it works!!

If you suspect this stretch the chest loads and lay off chest stregthening exercises.... focus on rows and pull ups to strenthen the back.

[fun meter]

Thanks for the reply, its a shame you arent in Kent, otherwise I would book an appointment with yourself.

I just looked up upper cross syndrome, and I believe it may be whats going on. As the test where you draw a line from the middle of your ear, it does not go through the middle of my shoulder.

Im going to start doing some scapular push-ups (just for the S.A.), seated cable rows, Dip Shrugs, Face Pulls and external rotations. And get the massage therapist I use to work my chest.

Thanks again, appricate the help.

[Monk]

No problem...Good luck