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Dr. Andrew Rynne

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Can i try acupuncture or chiropractic solution for muscle pain in shoulder blade and arm?

Answered by
Dr.
Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 3702 Questions

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Posted on Tue, 10 May 2016 in Headache and Migraines
Question: Hello! I wonder if you could give me some advice on something. I have a herniated cervical disc - c4/c5 and I believe c5/c6 is now showing signs of trouble. In general, the main pain/discomfort from that has come from my trapezius muscles on either side being tense, I'm guessing from trying to support the area around the herniated discs. This often causes me to have headaches and feel like my neck is not supporting my head to the point where I have to take something and lie down to make it feel better.

However, for the last 6-8 weeks, I have had a *stabbing* pain in the muscle between my left shoulder blade and spine. Where it hurts, it is tender to the touch, yet I don't feel a "knot" in the muscle that would suggest tired muscle tension. The pain gets so bad, it radiates down my arm into my elbow and wrist. During the day is bad enough, but it also wakes me at night when I move around, so my sleep has not been restful for quite some time now. During the day, if I reach for something or look up, it is a horrible stabbing pain in that muscle and my neck and it shoots from my neck down my left arm to my fingers. In that muscle, it literally feels like someone is stabbing me. The pain down my arm is more of an electric jolt.

I take NSAIDs (advil), pain killers (oxycodone) and muscle relaxers (tizanidine), and they help, but nothing takes the pain completely away - especially when I move my shoulder, turn my head a certain way or look up. The fingers on my left hand often have pins and needles in the pointer, middle and ring fingers. I've had 2 rounds of trigger point injections, that have helped a little, but again, nothing takes it completely away. The TPI’s help the tension in my trapezius muscles tremendously, but have had almost no effect on this pain.

This pain is different than the normal muscle tension pain I usually have in this area. I've been using Aspercreme, my meds and my heating pad every night just to get to sleep. What is wrong with me? Is it all from the troubled discs in my neck? Or is it a pulled or torn muscle? I have no memory of an injury – it seems like it all just started one day. What can I do to make it go away? Will using a TENS unit help, or will that just aggravate it?

For a quick medical snapshot, I have RA, Fibromyalgia, Diabetes II and Celiac disease - the auto-immune jackpot. My main medications for these conditions are Enbrel, Methotrexate, Prednisone, Gabapentin and Bydurean. There is family history of Degenerative Disc disease, Sciatica and Diabetes.

Please offer some advice! I’m at my wits end and don’t know who else to turn to.
Should I try an acupuncture or chiropractic solution? I refuse to have spinal fusions done. My mother has had 8 and is 79 and in a wheel chair now, so I am terrified of any kind of surgical solution to this.
doctor
Answered by Dr. Erion Spaho 32 minutes later
Brief Answer:
Physical therapy, epidural injection, TENS.

Detailed Answer:
Hello and thanks for using HCM.

I have read your question and understand your concerns.

Symptoms you describe irradiating to upper back muscles and down the arm and fingers indicate C7 nerve root involvement.

So, besides C4/5 you are suffering from C6/7 level damage clinically.

It could be herniated disc, or bone spurs that are irritating that nerve root/ spinal cord, and MRI of the spine is the best imaging tool to confirm the diagnosis.

Since you refuse to undergo surgery (fusion is not the only one option, discectomy with autologous bone graft is another possible treatment), other treatment possibilities include physical therapy (neck traction exercises), epidural or periradicular injections of steroids at affected level(s), Transcutaneous electrical nerve stimulation (TENS), besides NSAID and painkillers use.

I'm not sure about acupuncture, but it also can offer some relief.

I suggest you to consider initially traction neck exercises and later on you can consider epidural injections, TENS.

Hope you found the answer helpful.

I remain at your disposal for further questions and clarifications.

Greetings.


Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Erion Spaho 11 minutes later
Thank you for your reply. I had not heard anything about c6/c7, so that's concerning. I have had 4 epidural injections, as well as the trigger point injections. I guess I'm really concerned because this pain is so different than the pain and discomfort I've had in the past. Would that concern you?

As for the surgical alternative - does a discectomy with autologous bone graft leave the vertebrae rigid? The problem my mother has had - and I've confirmed this with the first neurologist I consulted with a year ago - is that once she had a fusion done, it left that set of vertebrae rigid, so the adjacent vertebrae and discs started failing in a cascading manner, resulting in her multiple fusions. Does that happen with discectomies?
What is your opinion of Artificial Cervical Disc Replacement? Are the recovery and longevity for this procedure any better than fusions?
doctor
Answered by Dr. Erion Spaho 5 hours later
Brief Answer:
C7 level implication needs to be confirmed by imaging too.

Detailed Answer:
Welcome back and thanks for being on follow up.

C7 level implication is a possibility regarding to clinical findings and symptoms you refer, imaging confirmation is needed.

Discectomy with autologous bone graft also results in fusion of adjacent vertebrae, but, let's say is more "natural".

Artificial disc replacement doesn't cause fusion of the adjacent vertebrae and long term results are seen with this method, as is true the opposite failure also may occur.

This depends on several other factors such bone condition ( osteoporosis eg.) other health problems, overall general health condition. etc.

In my opinion, when it comes to herniated disc disease, conservative measures should be exhausted first, surgery is the last resort to try.

Hope I helped you.

Wishing you good health.



Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Erion Spaho 2 hours later
Thank you very much - you were very informative and have given me a basis for talking with my doctors in a more informed manner. Thanks again, XXXXXXX
doctor
Answered by Dr. Erion Spaho 2 hours later
Brief Answer:
Follow up.

Detailed Answer:
Hello again XXXXXXX

Glad I helped you.

Feel free to discuss with us about your health issues in the future.

In good health.
Above answer was peer-reviewed by : Dr. Naveen Kumar
doctor
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