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Have elevated cervical ribs. Painful, tight scapula, tight pecks, scaliness. Had six shoulder dislocations. MRI done. Any suggestion?

Feb 2014
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Answered by

Orthopaedic Surgeon, Joint Replacement
Practicing since : 2004
Answered : 5931 Questions
Having neck and shoulder issues. Painful, tight levator scalpula, extremely tight pecs and scalenes. I am able to loosen up a bit when i massage by pecs, shoulders and scalenes, but not for long. PT says that I have elevated cervical ribs and there is swelling above the collar bone and at the top and back of the shoulder. There is definite crunching noises when I raise my shoulders and I can't raise them all the way without pain. Horrible tight and stiff in the morning in the upper back and neck. Under a lot of stress at work and have a history of six shoulder dislocations. Two on the left and four on the right. Type for hours for years in the computer and feel that my scalenes and pecs are so tight that they are pulling my shoulders forward. Have had MRI done of neck three years ago. I am told it was absolutely straight, however they thought that this was because of tight muscles. Have not had an MRI of shoulders
Posted Wed, 24 Apr 2013 in Bones, Muscles and Joints
Answered by Dr. Saurabh Gupta 2 hours later
Thanks for writing to us.

From description it seems you might having thoracic outlet syndrome.It is a group of disorders that occur when the blood vessels or nerves in the thoracic outlet — the space between your collarbone and your first rib — become compressed.Cervical rib is one of the cause. This can cause pain in your shoulders and neck .In this overhead activities are perticullary difficult because they worsen the compression of brachial plexus and blood vessels.

In most cases, a conservative approach to treatment is effective.
You have to learn how to do exercises that strengthen your shoulder muscles to open the thoracic outlet, improve your range of motion and improve your posture. These exercises, done over time, will take the pressure off your blood vessels and nerves in the thoracic outlet.
In general, to avoid unnecessary stress on your shoulders and muscles surrounding the thoracic outlet:

Maintain good posture
Take frequent breaks at work
Practice relaxation techniques

I suggest you to consult a doctor nearby for thorough examination.Your doctor may prescribe pain medications, muscle relaxants and anti-inflammatory drugs — aspirin or ibuprofen (Advil, Motrin, others) — to decrease inflammation and encourage muscle relaxation.

For your recurrent dislocation of shoulder(Shoulder instability),get a MRI done.

I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Please accept my answer in case you do not have further queries.

Wishing you good health...
Dr Saurabh Gupta.
Orthopaedic Surgeon.
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