Question
I received an injury to my neck and shoulder over a year ago. The pain is chronic and nothing I do offers relief. I hurt under my scapula and sharp shooting pains down my arm. My thumb and pinkie finger go numb and I wear a TENS to tolerate the pain when I drive. I have had an MRI, EMG, and X-rays with none explaining the problem. I have massive head aches and have had a diagnosis of right trap strain. However, it is my left shoulder that was injurd. What might be the problem and how can I relieve the pain?

Answer
Dear Shannon,

If you have had an MRI, EMG, and x-rays, and nothing has shown up, then I would suggest that your problems lies within the muscle and fascial systems.  Muscle spasms and trigger points can frequently cause significant pain when chronic.  

After injury, the muscular system with go though spasm due to their response to the trauma.  This in itself is enough to cause pain, but when continued for a period of time, adhesions can form which adhere the tissue to each other, and this further compounds the problem.  Trigger points can form (focal spasms that refer pain away from the source), and these trigger points have been mapped out with scientific testing.  They can refer pain all the way down the arms and into the fingers.

Moreover, scar formation due to injury is accumulating as the body tries to repair damage.  Unfortunately the bodies response to trauma is to try and stabilize the area fast which means that scar tissue is produced rapidly and in a haphazard manner.  The tissue is vastly different than normal tissue due to its composition, and it is always less elastic, prone to re-injury, and more painful than normal tissue.  This is because as the body grows new nerves for the scar tissue, only pain nerves are generated...they are (unmyelinated c-fiber nerve endings)

So what does all of this mean?  I think you should try a soft tissue approach...a functional examination of the muscular and fascial system which will likely result in myofacial deep tissue mobilization techniques to break up the adhesions and poor scar tissue while lessening the trigger points and muscle spasms.  These types of techniques are very effective and have been shown to increase function while reducing pain.

I want you to research a few options, and check out a few of these techniques on the internet.  You will be able to find clinicians who are certified in these techniques as well on their respective websites.  IF you cannot find a clinician locally, then try an aggressive massage therapist in your area...one who is not afraid to perform deep tissue work.

www.activerelease.com
www.grastontechnique.com
www.rolf.org
www.sastm.com

Good Luck Shannon.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net