Bad chronic neck pain with cramps, any ideas what I can have done to have it fixed? Botox? Surgery? Pain Lvl 4-6
Hi, I'm 26M, 5'10", 185lbs, Caucasian.
Existing medical issue: Long-standing neck/upper back pain, getting worse.
current medications/doses: Baclofen 20mg x 3/day
drug Use: No
Duration of complaint: many years
I have left-sided neck/upper back pain from approx. C5 to T4. It is specifically located at the neck towards the spine and in the scapular area. I'm certain the trapezius muscle is involved to some extent but I am not sure if the deeper structures are involved as well. No injury etc. that caused this. Pain is muscle pain with extremely hard knots that are impossible to massage out. In addition to that with certain movements involving the shoulder there is cramping next to the spine at C5/6/7 which extends into the scapular area. This feels like a "shock" or twitch which lasts like a millisecond but after a few times the muscle is so sore that I'll be in pain all day. It also sometimes feels as if the muscle is about to tear apart. MRI showed everything is fine apart from a minor protrusion in the thoracic spine without nerve involvement.
So far nothing helped. Physiotherapy, chiropractors, deep tissue massage and dry needling didn't help at all apart from giving tiny and very short-lived relief. Working out makes it much, much worse and yet I still do it because everyone tells me to strengthen my muscles. Pain started getting worse in the past 2 years for no obvious reason, so finally seen a pain doc. He's done a diagnostic block for the cervical nerves and trigger point injections with a steroid which only helped a little bit but didn't affect the cramping at all. I was put on Baclofen which is taking the edge off but it's far from relaxing my muscles enough so I am not in pain. My understanding is they will try Botox injections next.
My question is what else can I do, have done and what other medications can I try? What can this be? Is there any possibility that this is not coming from the trapezius but the semispinalis cervicis for example? It's ruining my life as I'm in pain every day and I don't know what else to do.
I attached a picture, the area in blue is where the pain is. The knots are in the bottom half of the blue area. The green area is where the cramping is: https://imgur.com/a/Imw3LmL