Neck pain when using 2 arms not 1 (Ask me anything!)

[ouchpainoof]

Ask me anything (AMA) or tell me what you think it is? Beyond frustrated trying to deal with the chronic pain. Thanks!

Summary: 36yo male, desk job, decent posture and exercise technique

Symptoms:
- Chronic neck pain/ shoulder pain when performing any overhead or lateral arm exercise with both arms (but not just when using one arm) or any "push" (eccentric) exercise with both hands.
- Pain even comes in when I do very light overhead movements (2lbs dumbbell overhead press, putting arms outstretched at chest height or above in opposite directions).

Description of pain:
- Pain is delayed - will appear a day later and last for 2 days and i cannot "switch" the pain off completely once it comes in. Sometimes the pain does not come in at all - cannot detect a pattern.
- Pain feels like a deep ache. At it worst, the pain becomes sharper and deeper and i cannot move the neck beyond 30 degrees.
- Pain ranges from 5 to 8/10 (sometimes need to medicate instantly. Pain can get to the point where even looking at the phone intensifies it.
- Not a shooting pain

Hypothesis: Upper cross syndrome. Smudged neural mapping where the neck/ shoulder is being recruited to perform movement, instead of the bigger muscles. Thoracic outside syndrome (TOS)

Imaging: MRIs and CT scans- Small bulge left C5-6, some narrowing L4-5 left; no obvious evidence of nerve impingement. No rotator cuff injuries.

Other possibly relevant info: Extremely tight hamstrings, extremely tight muscles in general (stretching/ yoga feels like torture)

Treatments:
Surgery administer paravertebral block, peripheral nerve block, intra-articular shoulder injections, platelet rich plasma
Dry needling
Osteopathy manipulations
Physical therapy
Stretching

Current symptoms:
Current triggers:
Working out at the gym (doing v light exercises)
Using handphone while seated in toilet or first thing in the morning
Forced stretching (e.g. by a physiotherapist)
Bad pillows
Tight t-shirts
Two handed overhead movements
Lack of sleep

Any two-handed exercises that “push” away from the body (eccentric exercises)
using exercise bands overhead or laterally with both hands at the same time

Current ways to soothe pain (nothing ever works completely)
Avoid all shoulder, trap and overhead exercises
Neck support brace
medication: Arcoxia, Anarex, Lyrica 75mg, Clonotril 0.5mg, Venlafaxine 75mg and Celebrex 200mg

Sleeping/ lying down
Stretches; (Prayer Stretch, Standing chin tuck against wall)
Foam rolling
+ Pain relief gel (Volatren)
Doing heavy bicep curls
Heat (hot showers, sauna)

[specialmom]

I would have gone with shoulder impingement for the pain and wouldn't rule it out just because you can't isolate to one shoulder or don't feel it but you get this pain when both are in action. And there are muscles that go from the top of your shoulder blade up the side of  your neck and attach behind your ear. It's all interrelated and if one area is tight, all of that tightens up.  I'm a chronic head sufferer for just this reason . I understand your concern is that this happens when both arms are involved verses one and that is an explanation maybe your doctor will give you. See your doctor, get referred to an orthopod if need be or a psychical therapist.  How are you with the stretching? It sounds like you work out a lot but this is really an important thing, almost as much as the exercise, after you are done.

[ouchpainoof]

Thanks so much for chiming in. One thing that's a bit strange is that even when not load bearing e.g. putting two arms out and overhead to make a 'Y' shape for a sustained period of time, the pain kicks in, and the pain typically only comes in 1 day later. As a head sufferer, have you experienced something like this?

[ouchpainoof]

As for stretching I do 5-10 minutes before a workout, focusing on chin tucks, pec stretches and supply dog stretches. I've tried low resistance exercise bands for stabilising the back and neck but any eccentric repeated movements cause the neck to flare up in pain.