4-5 years chronic shoulder pain

[ButNowImGone]

My name is Tyler. i am currently 22 years old, 17 when my problem started. I currently weigh roughly 160lb, roughly 125 when the problem started and was in good shape. No known trauma or previous health conditions.

I have been dealing with a chronic shoulder problem for over 4 years now. The pain started when i was waiting tables working 60-80 hour weeks regularly. It started as a sharp pain that worsened with movement and especially worsened when trying to lift something heavy or light. Details of 4 years ago are blurry but i try to recount as much as i can. I ignored the pain for roughly 4 months thinking it would simply go away. When i finally saw my family physician we didnt think much of it and i believe i tried some hydrocodine and rest. I cant remember if the pain went away after resting or if it persisted at that time. Over the years the pain has been cyclical coming and going. the general pattern has been roughly 6-8 months of pain then a few months of relief or minor relief.

The pain originated as a sharp pain however shortly after evolved into more of a pain familiar with swelling. im not entirely sure if this has persisted the entire length of the problem or simply most of it, but i can more times then not find a large muscle knot somewhere around the rhomboid major. I say that muscle as the general location but i do not know if it is a deep or superficial muscle in that spot. I can say it is between the scapula and spine below the scapula and just on the outside of the medial border.

Over the last year to year and a half i have been experiencing what i believe to be an impinged radial nerve in the same arm. I have an on and off burning pain in my elbow along with arthritic type pains in my wrist and hand.

I know that my high levels of stress and anxiety will worsen the pain and very regularly trigger the pain if it is not currently bothering me.

I have seen numerous types of doctors or medical professionals major and alternative. My regular physician has seen me since before the pain started and is familiar with my problem as the first person i went to for help. I have seen an orthopedist who did and MRI on my cervical spine first followed by one on my shoulder later on at my request. Both MRI's and X-rays have been seen by multiple doctors of varying specialties and all have found nothing at all out of the ordinary.

the list of different specialists i have seen goes as follows.
regular physician, orthopedist, multiple chiropractors, massage therapist, pain management, acupuncture, Active Release Therapist/Chiropractor, Airrosty soft tissue, psychiatrist, and multiple physical therapists

i have tried multiple medications including:(most i tried different dosages)
hydrocodine, darvocet, flexoril, skelaxin, xanax XR(after other anxiety meds that i cant remember) and finally i have been taking AmbienCR for chronic insomnia for about 4 months and a few months before that at other times.

pain killers and muscle relaxers did absolutely nothing for the pain. anxiety meds offered some but very little help. the part i stress the most at the moment is what i discovered with the AmbienCR. At first the ambien was strong enough that it knocked me out and did what i wanted, let me sleep. I quickly built up a tolerance(as i do with EVERY medication i have taken) and realized that the AmbienCR would relax me to a point that ALL pain went away and i would flat out feel amazing. Call it a euphoric high if you want, my focus is on the fact that forcing myself to relax seemed to get rid of the pain. I used the Ambien for about 2 months as more of a pain killer then sleep aid and it worked wonders. I could function during the day, i wasnt constantly depressed or frustrated, and i was able to sleep at night. Im not trying to convince you or anyone that this is a solution i should or want to use but  i want to offer as much knowledge as i have that might point towards finding a problem or a solution.

It would be amazing if anyone has an idea as to what the actual problem is however i realize that without a real visit it is asking quite a lot.

I would love simply if someone could suggest to a specific type of doctor or specialist that i can set up an appointment with. my pain management dr dismissed me in less then 5 minutes and had me out the door with a referral to a sports medicine doctor. My physician seems to be out of ideas whether he will admit it or not, and my chiropractor wants me to see an endocrinologist for blood work to focus on the idea that i build up a tolerance to medications within weeks of starting.

The cycle seems to be pain causes stress, stress causes pain, both cause depression, and i have no idea how to fix any of it.

I had a previous chronic back pain that started during a chiropractic adjustment while recieving help for my shoulder roughly 3 1/2 - 4 years ago that lasted for over a year before finding a solution. Novocain injections in the facets of L3-5 bilateral were done as a diagnostic procedure. For whatever reason, the injections relieved the back pain. I have no reason to believe this is relevant to my shoulder pain as the shoulder problem started over a year before the back problem. However i want to mention anything i can think of.

i have been upfront and honest with my regular physician about any irregular usage of my medications and alcohol. I drink in excess on and off as the pain worsens. Most medications i have taken were ineffective and i took larger dosages in hope of relief but generally got none. I tried using marijuana for pain management but the effects were more negative then positive.

i would appreciate any help or suggestions i can get. My entire adult life has revolved around pain and coping. I have been unable to hold down jobs for any respectable amount of time and school has suffered far to much. I need to break the cycle.


This discussion is related to weird ankle pain.

[madgames316]

Hey Tyler I read your post and I actually have a very similar situation to what you have described.  My pain started when I was 17 and in excellent shape, and now I’m 22 and stay in fairly good shape mostly though dealing with a good amount of pain while exercising. I have chronic shoulder pain and tingling in my arms and sometimes face or legs.  I also have an arthritic feeling in my joints, as they tend to grind or make other noises.  Having found nothing on my Mir’s for both shoulders, one orthopedic doctor said my shoulders were loose and that he could tighten them up with arthroscopic surgery.  I am no stranger to surgery since I had previously torn my acl, so I went for it hoping to see great results.  To make a long story short, although initially my shoulder felt stable, I still have the same pains around my shoulder as I did before the surgery, even after extensive physical therapy.  I did EMG's to test my nerves for any entrapment that could cause the tingling, nothing was found.  I ended up being sent to a rheumatologist and was then diagnosed with Fibromyalgia.  Many of the symptoms you describe seem to possibly fit that, or at least be worth checking out.  Fibro can cause sleep problems, and patients are often prescribed anti depressants as I was prescribed Cymbalta.  I cannot comment on the effectiveness because I did not want to be on anti depressants at the time.  I don't know if my shoulder problems are tied in with Fibromyalgia, but it seems that numerous people have chronic shoulder problems, just usually not at our age.  I would see a rheumatologist or at least Google Fibromyalgia and see the symptoms.

Good luck,
Mike

[Tuckamore]

Hello Tyler and Welcome to the Pain Mangement forum. I am sorry to hear about your long struggle with undiagnosed pain. You are too young to have had pain for such a long period of time without successful treatment or a definitive diagnosis.

I am concerned about your pain but also concerned about your usage of AmbienCR.  It is to be prescribed for short-term treatment of insomnia. The maximum dose is 12.5 mg in a 24 hour period. The more you use and the higher the dose the more apt you are to develop the dangerous side effects that this drug can bring. If I am reading your post correctly you are still taking AmbienCR. Visual and auditory hallucinations have been reported as well as behavioral changes such as bizarre behavior, agitation and depersonalization with the use of this medication.

I know you didn't some here for a lecture and please do not take this in that way. I, like you am trying to be totally honest. Complex behaviors such as “sleep-driving” (with amnesia for the event) have been reported with sedative-hypnotics, including Ambien. These behaviors may occur with Ambien alone at therapeutic doses however the use of alcohol and other CNS depressants increases the risk of such behaviors, as does the use of Ambien at doses exceeding the maximum recommended dose. I encourage you to discuss this with your physician and cease using the drug as a pain reliever.

Have you seen a neurologist or had an EMG? An electromyogram (EMG) measures the electrical activity of muscles at rest and during contraction. Nerve conduction studies measure how well and how fast the nerves can send electrical signals. They can reveal nerve damage or nerve entrapment.

You are correct that an MRI or any test or scan does not always show an injury or structure disease or condition. I have witnessed this over the years and often when surgery is concluded the physician has said the the MRI or CT either gave no indication of the severity of the condition or he "found" something that was totally missed by the test. You may want to consider seeing a surgeon for  Arthroscopic surgery. It is used to diagnose or detect shoulder problems that are often missed during routine testings.

Just don't give up. Only you know your body and what it is telling you. There are other PMP besides the one that abruptly dismissed you. If a neurologist cannot provide you with solutions that you are comfortable with that I suggest you see another PMP.  

Please keep in touch and let us know how you are doing. I will look forward to your updates. We are here to support you. Best of luck to you.

Take Care,
Tuck