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Jennifer asked...

I have had aching in my shoulders and neck over the last year which is getting progressively worse. I often have tingling fingers (worse when cold). I pulled my shoulder last summer lifting something and whilst the movement came back after a few days the pain has never fully gone and made everything much worse - to the point I take painkillers daily to try and reduce the aching. I recently went to the doctors who gave an MRI on my neck - but the nurses said the results came back as normal. What should I do next to try to help improve the situation, my neck and shoulder muscles are very tense. I have tried various massages but not really effective.

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The Answer

You say that since you pulled your shoulder in the summer although you are able to move your arm it has always been painful we wonder whether you have possibly trapped a nerve or damaged the muscles or rotator cuff in your shoulder.

Your GP has rightly asked for you to have an MRI of your neck as pain from neck injury can often radiate to the shoulders as well. However if the MRI is only of the neck it may well have not excluded and muscle or nerve entrapment in the shoulder.

You say that as well as pain you often having tingling in your fingers – this could be a sign of a nerve being impinged in the shoulder area – particularly the ulnar nerve. This is particularly possible if the tingling is present in the 4th and 5th fingers.

Unfortunately with muscle injury it can often take longer for healing to occur as oxygen is not as easily absorbed by the muscles.

Other than the MRI you do not say what other investigations you have had.

We would suggest that it might be a good idea to ask for x-rays or ultrasound of your shoulder joint to look for injury, blood tests to rule out diabetes and rheumatoid arthritis and nerve conduction tests to look for entrapment of your ulnar nerve.

In relation to the management of pain we would suggest that you see your GP to review the medication you are using and to discuss the possibility of physiotherapy and possibly corticosteroid injections./ pain relief injections. Non chemical ways of trying to alleviate pain can involve the use of heat/ice packs and a TENS machine.

A chiropractor/ osteopath may also help as they can help realign your body posture and manipulate your muscles and joints and this can help relieve the tension and pain you are experiencing.

Massage although it can be helpful is quite different from the treatment you will receive from a physiotherapist or osteopath.

Making sure that you try to maintain a good posture and taking care when lifting and pulling things can also help.

Exercise is also a good idea as this helps with maintaining mobility of the joint – low impact exercise such as swimming and hydrotherapy may be particularly suitable.

If the above suggestions have been tried we would ask the GP to investigate further to ensure that you are receiving the best help and that other medical causes can be eliminated.

Answered by the Health at Hand nurses  

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