Rib pain with associated shoulder tingling and burning

So Chicago was HOT, but wonderful to see old friends and colleagues.  Addison went to her first music festival, and I have to say she rocked it.

So, on  to our case of the week.  This week I had a patient come in with severe neck pain.  Restricted ranges of motion in all directions.  She couldn't look up, down, over her shoulders etc. without excruciating pain in her neck and burning into her left shoulder.  Upon initial examination, a complete neurological examination was performed to determine the source of the shoulder burning.  She did have positive findings indicating a disc herniation with nerve impingement.  So her initial treatment that day consisted of determining which directions decreased pain, some physical therapy to reduce inflammation and gentle spinal mobilizations.

On her followup visit, she was about 30% better and her range of motion had improved, however, she still was in significant pain and was having trouble sleeping. She mentioned getting an MRI or other diagnostics and I explained to her that we would complete several treatments and if things weren't going in the direction I assumed they would, then I would be more than happy to order the diagnostics.

I have spoken about this before, and I will repeat again.  MOST of us walk around with some type of disc bulge/herniation.  It is a part of getting older unfortunately.  Hence, MRI's have can have many false positive findings.  In other words, an MRI will most likely report with some type of pathology, now whether or not that is the source of pain is the question.

In our case, I wasn't convinced that her symptoms were neck related.  Her ranges of motion had improved except with extension.  Now, if a rib is subluxated, looking up will pull on the affected joint/musculature and give similar pain/burning.  On her initial visit, she was too acute to adjust the rib cage, but today she was not. So we did..... and......

I received an email later that evening that the burning was completely gone.  AWESOME!  I was so happy.  So couple thoughts here: 1. Probably don't need to order an unnecessary diagnostic test and rack up her insurance charges.  Be aware here.  If an MRI that had been ordered showed a positive finding for a disc herniation, and surgery was performed, and the pain didn't go away, how upset would you be?!!  Careful examination is REQUIRED.  2. Rib subluxations can be confused with disc problems in the neck as they present with similar symptoms. 3. Follow up is required and strengthening of the scapular stabilizers is mandatory so this doesn't keep happening.

If you have shoulder tingling and neck pain, it could very well be a neck issue, or it may be something else.  Proper diagnoses are ALWAYS needed, to get rid of pain the quickest as well as to avoid unnecessary diagnostic imaging/radiation.

Great case here, and the best of all, a pain free patient.  Gotta love it:)

Take Responsibility for Your Health TODAY.

Dr. Courtney Conley
Chiropractor Golden CO
Chiropractor Idaho Springs CO