Myofascial Pain Syndrome - Pinched Nerve

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psychling
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Joined: November 20th, 2014, 4:53 pm

Myofascial Pain Syndrome - Pinched Nerve

Post by psychling » February 3rd, 2015, 11:12 am

http://www.ehealthstar.com/shoulder-blade-pain.php

I think I'm correct in the identification of an overuse injury to the nerve associated with my (R) scapula. A pain that begins in the muscle near the scapula and extends and descends down the anterior of the arm to the little finger. As it approaches the little finger the pain sensation changes to a pronounced tingling. Things that can cause the MPS include ... uh huh ... rowing a boat.

It should have been enough that I sensed this pain two days and 30K meters before I stopped rowing. So much for `rowing through.' Too much is never enough. (So say the walking wounded).

The pain was very intense for a few days, resulting in loss of sleep and a fair amount of restricted upper body mobility. The third day into this I started the NSAID ibuprofen. 200 mg every 6 or 8 hours at first. Little improvement. The fourth day I increased it to 400 mg every 6 to 8 hours.

By the fifth day the intensity and sensitivity reduced significantly. Thinking that the acute stage of the injury had passed I began working out on the elliptical, using my arms about half the time (30 minutes) with very little intensity. On the sixth day the pain was almost entirely gone. I felt fine lugging some groceries during the day. In the evening, while sitting at my desk and leaning back in the chair I felt the return of the pain. That night I was unable to sleep due to the pain and ache.

At this point (day seven) I will be cutting back on the NSAID and will be seeing the doc. I expect that I will get a cortisone shot and instructions to hold back on the elliptical and a return to household chores, etc. Or, he may just slap me upside the head and tell me that my penance for `rowing through' is another week of agony.

Pinched nerves are reported to take about 6 to 8 weeks to fully remediate. Mortality does, in fact, suck.

http://psychling1.blogspot.com/2015/02/ ... nerve.html

psychling
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Re: Myofascial Pain Syndrome - Pinched Nerve

Post by psychling » February 4th, 2015, 6:36 pm

I was right. No shot of cortisone. Stay off the erg for a good long time. Admit mortality.

Word to the wise: if it hurts ... there is a reason.

- Clark Kent

rondolce
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Re: Myofascial Pain Syndrome - Pinched Nerve

Post by rondolce » February 4th, 2015, 11:04 pm

I'm a physical therapist professionally and I'd be very reluctant to make a claim without evaluating you thoroughly so I have a few questions. Is the pain/numbness constant, intermittent, provoked by certain positions? Is it worse in the morning or evening? What's your posture like and do you do stretches after rowing? If your shoulders are rounded forward I'd suspect a tight pectoralis minor. The pec minor runs from some upper ribs about an inch lateral to the sternum and runs up to the coracoid process of the scapula, which is located in the indentation between the pec major, deltoid and clavicle. the nerves that service the arm run under the pec minor and, if the muscle is tight, can be compressed. Your description sounds like a nerve distribution (ulnar nerve) and, if rowing started the problem that would be my best guess. Here's a test if you're so inclined: Have a friend hold your right arm our to your side, at about 60 degrees, with his/'her left hand on your scapula and right hand on your pulse. He/she pulls your scapula down your back pretty hard and holds for about 30 seconds. If this provokes the symptoms AND dampens or stops your pulse (artery runs under the muscle as well) then the pec minor is it. I couldn't find a good version on Youtube so this is the best I can offer. Good luck.

psychling
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Joined: November 20th, 2014, 4:53 pm

Re: Myofascial Pain Syndrome - Pinched Nerve

Post by psychling » February 5th, 2015, 12:17 am

Thanks for your helpful reply. I'm not round shouldered (sloping forward). Though I didn't do the procedure you described I have further consulted with my physician and it has resulted in my description here: http://psychling1.blogspot.com/2015/02/ ... nerve.html

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