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Pain in upper trapezius radiating down arm
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Pain in upper trapezius radiating down arm

For the last 3 weeks I have had pain in my upper right trapezius, right arm and right hand.  It appears to originate in the right trapezius and travels down my right arm ending in a band of pain that travels across the metacarpals. I have been able to function ok but was a little uncomfortable.  I had one visit to the physio which helped a little.  It seemed to be getting better so I didn't take any further action.  Last monday I moved house and spent approx 6 hours unloading boxes of heavy kitchen stuff (cast iron pots and pans) and heavy electrical appliances (Kitchen Aid mixer for example).  Within 48 hours I was in so much pain I couldn't sleep and normal day to day activities have become very difficult.  It feels like nerve pain.  It is constant and nagging and hurts whether sitting, standing or lying down.  It is very painful when I first get up in the morning for the first 1/2 hour.  Most painful is neck flexion and extension (except lateral flexion not so bad) and shoulder girdle abduction.  I have full range of motion it's just very painful in some directions.  I have discovered a few positions that give it relief:

1. I internally rotate my right humerus and bring my arm behind my back,

2. I adduct the shoulder girdle (abducting the shoulder girdle produces pain).

3. Lying down on my back but only after having taken painkillers (probably producing a similar position to the shoulder girdle adduction.

I have worked many years in the fitness industry and am used to being very active.  I have had problems with my right rotator cuff which I believe was caused by pressing heavy weights over my head.  Thirteen years ago I was in a car accident in Australia when a vehicle coming from a side street tried to turn across the front of me as I was travelling straight.  The impact came mostly from the left side of the car causing my head to be jerked back and to the right.  I have recently moved from Australia to live in Malaysia (one month ago).  I put the early aches and pains down to a change of climate, different beds and pillows etc thinking it would go away.  I have been to the doctors here and they have tried the following medications which have brought only slight or no relief:

Voltaren (I think 50mg) 3x per day
Celebrex 400mg per day
Tramadol 50mg 2x per day

I am not familiar with Tramadol and would usually use Panadeine Forte for this much pain.  I realise I need to address the problem and not just treat with painkillers but I just need some relief from it right now.  Is anyone able to give me some advice?  I am getting very depressed with all this pain.
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