Chiropractor question and advice

Posted by jadillow @jadillow, Oct 23, 2019

Hell all. Long story short. I have posted in many groups due to symptoms I believe were GERD/heart related. Had workup a done and they say all is good but still unsure. Recently I started getting a pain between shoulder blades (maybe closer to neck). Stays for a bit and goes. Two years ago I was out in a desk job as I used to be a floor manager prior. I am curious as if it something spine/back related as it feels like someone is pushing a fist and keeping it there In this area. I’m wondering if I should see a chiro and if this even sounds like one of these issues. I also have left arm muscle pain at times and wondering if it’s all related. Thanks in advance

@jadillow Welcome to Connect and thanks for asking the questions. I hope my experience can help.

If you have a possible spine issue, it could get worse if a chiropractor manipulates it. A spine problem can cause instability where one vertebrae slips past another because the disc isn't holding it together, and an abrupt push could move it and weaken it. As discs age, they dry out a bit and get weaker. If there was a prior injury from something like a car accident or a whiplash, there can be damage like small cracks in the outer fibrous bands of the spinal disc, and these cracks can open up more with aging as discs dry out, making a rupture or herniation more likely. I speak from experience. This happened to me, but not from a chiropractor.

All I had to do to rupture the C5/C6 disc in my neck was turn my head when I was stretching, and my disc ruptured with a pop sound, and my head suddenly turned past it's range of motion. I had a whiplash 20 years earlier, and this disc was bulging on the MRIs for years before this happened. When the jelly like nucleus inside the disc is expelled, it causes inflammation, and the body reacts to that and the uneven pressure on the end plates of the vertebrae by remodeling the bone and growing bone spurs. In my case, the disc ruptured into the central spinal canal, and the bone spurs grew there with it and all of it grew into and compressed my spinal cord which over time caused neural and muscular deficits. My disc lost 50% of its height. I had spine surgery at Mayo 3 years ago.

I did have scapular pain to the shoulder blades, and spine surgeons told me that it was related to the spine problem. The scapula are connected to the spine by muscles and function to allow arm movement by rotating. Every muscle has an opposite muscle that acts to control movement like a tug of war against each other. Spine injuries cause muscle spasms, and that tight muscle beats up on it's opponent and it all gets tight. It's the body's way of protecting itself when there is an an injury.

Other problems with similar symptoms can be posture related, and I have that too with thoracic outlet syndrome. If you are working a desk job with poor posture and have a forward head and arm position, you could be creating that type of issue that puts pressure on the nerve bundle that pass through some small spaces in the shoulder between the collar bone and rib cage. TOS causes arm pain and weakness as well as decreased circulation by compressing nerves and blood vessels and pressure in the chest. Doctors familiar with this are hard to find because it isn't covered well in medical school, but a teaching medical center like Mayo is a good place for an evaluation. Look for a place that treats TOS if you are looking for a specialist for diagnosis. My treatment is long term physical therapy. TOS causes the front of my neck and chest muscles to be too tight, and my physical therapist strengthens the muscles of the shoulder blades in back while stretching the opposing muscles in front.

Before you start any treatment, you need to define the problem. You might start with a neurologist who can determine where your pain is coming from and if it is being caused by nerve compression. They can order imaging of the spine, neck and shoulder that can find a structural problem or injury. If there is a spine issue, an evaluation with a spine surgeon would be a next step, but choose carefully as spine surgery is a big step and you want the best surgeon available. It's normal to get multiple opinions before surgery, and I had 6 opinions from different spine surgeons beore I found the right surgeon who would help me. 5 refused because they didn't fully understand the problem and didn't look further. I wasn't able to find a surgeon willing to help me near my home, and came to Mayo. It may not be a bad problem if you are catching it early, and physical therapy may help. My physical therapist also does myofascial release which stretches the tight fascia that is holding the body out out alignment, and it allows the body to return to more normal movement. That is a long process for me because of the issues that developed over years, and I have to work through the layers of tight tissue. Even if you do not get a diagnosis of a spine issue or TOS, you can still benefit from MFR therapy. The therapist can feel the tight network within the body and stretch accordingly. It's like kneading bread dough except that they push and hold it against the barrier until it releases.

Here are some links to more information and our Connect discussion about MFR therapy. Let me know if I can answer more questions, and if you do see specialists for evaluation, I hope you will share your journey.

My patient story https://sharing.mayoclinic.org/2019/01/09/using-the-art-of-medicine-to-overcome-fear-of-surgery/

Myofascial Release https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/

Thoracic Outlet Syndrome
https://www.mayoclinic.org/diseases-conditions/thoracic-outlet-syndrome/symptoms-causes/syc-20353988
https://trainingandrehabilitation.com/how-truly-treat-thoracic-outlet-syndrome/

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