3 replies to this topic

[Jason E]

Overview

I will apologize in advance for the length of my post. The detail I believe is necessary to improve the discussion. The purpose of this post is to reach out to find others with a similar condition. Hopefully, we can work together to find a solution. I don't see pain pills as a solution long-term.

At this point, I believe that the source of my pain is scapular winging and the resulting poor mechanics of movement. However, everything I read indicates that scapular pain results in neck and shoulder pain. My pain is in my hands and forearms.

I’m a C5-C6 complete quadriplegic 16 years post injury. I'm generally a very positive individual struggling a little more as the pain increases. I consider myself fortunate to have enjoyed 5+ years with almost no pain. The pain started minimally after that time and has grown to be quite severe and the focus of my attention now.

Symptom details

The pain starts fairly early in the morning with minimal discomfort. It almost always is much stronger on the right side than the left but exists in both hands. I'm a little more paralyzed on the right, since I am right-handed, this only contributes to the pain. It generally progresses throughout the day with some days being worse than others. I have not identified a common denominator between good days and bad.

Aggravating factors include anything where I reach across my body or reach forward often. This includes typing on a keyboard or any other minimal activity. Spasms seem to also contribute as they seem to aggravate cramping and trigger points around the scapula.

The only thing that seems to really help bring the pain down is trigger point massage therapy. The right person focusing in the right areas can almost eliminate the pain for some time. I've noticed that drinking lots of fluids seems to help but, this could be my imagination. Ibuprofen helped greatly for a while but, I'm quickly becoming immune.

What I've tried

1. Physical therapy on several occasions with different therapists. All seem to focus around strengthening of the muscles in the shoulder and those around the scapula.
2. Myofascial release
3. Moved the ulner nerve in my right arm. Nerve conduction studies indicated damage to the nerve in the elbow and carpal tunnel.
4. Disc replacement of C7. Since C4-C6 were fused, C7 develop significant bone spurs. Instead of fusing this it was replaced with a joint.
5. Lots of pain medication. Helps but becoming immune.
6. Trigger point massage therapy. This is shown the greatest degree of success. There seem to be cramps and knots between the spinal cord and scapula as well as below the scapula and to the right. Relaxing these significantly decrease the pain.

Current working theory and plans

I was fairly brief in describing what I've tried because nothing has worked to fix the pain. However, I've done significant research throughout the 10 years or so trying to stop this progression. My understanding is that the Stratus anterior (one of the muscle groups stabilizing the scapular) is paralyzed or significantly weakened. Because of this, I am stretching muscles abnormally with poor stability. This is causing trigger points to form around the scapular. These trigger points are causing "referral" pain in my hands and forearms.

If (and that is a huge if) all of this is correct, I believe I would have to stabilize the scapula before having any chance at fixing the problem. This is where I'm stuck.

Questions

1. Does anyone have the same type of symptoms?
2. Does anyone have experience with surgery to stabilize the scapula? I'm aware of one where they tether the scapula to three ribs.
3. Any other ideas/suggestions? I feel like I'm running out of options but certainly don't want to give up.

I would appreciate any positive feedback. I generally have a narrow window of time to type before the pain becomes an issue. Therefore, I choose to use that time focusing on discussions moving forward and am not likely to respond to negative comments. Thank you in advance to anyone taking the time to read my post. I hope that someone finds it beneficial.

[Zack]

Hello,

You've said a couple things that make me think they lead to the same thing that might be causing your pain.

Drinking lots of fluid seems to help, but might be your imagination. 1. Lack of fluid causes muscles to cramp, tighten up even if it's not enough for you to notice. Tight muscles squeeze, pinch Nerves. Correct me if I'm wrong! Pinched Nerve, Big OUCH!!!

Trigger Point Massage therapy helps. 2. That's Relaxes a Muscle, Stopping it from Pinching, Squeezing a Nerve. Big Relief until you Tense up again, Bring back the Pain.

Do you Stretch Enough, or have you Tried Extensive Stretching? As to relieve your Pain.

I'm the Furthest thing from a Doctor, Yet if I was Suffering in pain with all what you've said. I'd think I have a Nerve being pinched somewhere, and that Extensive Stretching might be my answer!

That's my Best Guess, even if I'm Way off Target!

I have a Right Scapular that sticks out so far its gross. Pain in Right Shoulder, Elbow, and Wrist. My Only relief is to have someone grab my wrist while my arm is extended out to the side and have pull Hard stretching my shoulder outwards and holding it stretched out for a few minutes. Then doing it again, usually until their tired of pulling. It's such a relief I dont want them to stop!

Good Luck

Edited by Zack, 26 December 2011 - 04:31 AM.

[Jason E]

Zack,

Thank you for taking the time to read my post and reply. I appreciate your thoughts and will try focusing on fluid intake and stretching to see if that helps. I'm hoping it's a relatively simple fix. I'm also hopeful that you will find a solution for your issue as well. Scapular winging it is a serious problem with our level of injury.

Jason

[Zack]

Your welcome,

30 years of mine sticking out a grossly distance and I'm now looking like laying on my back with it sticking out that far, is starting to develop a pressure sore if I don't watch it often!

Good Luck !!