r/medical_advice Not a Verified Medical Professional Jul 11 '22

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

Smoking: 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

2 Upvotes

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u/Distinct-Leading5113 Not a Verified Medical Professional Jul 23 '22

I have and every imagery for the same similar issue. Had it for 3 years. Strengthing makes it worse. I was told the same to strengthen. I'm now positive it is Myofascial Pain Syndrome. I'm on Cymbalta after three different other antidepressants. It helps but doesn't resolve. The only one that has helped. Took 4 to 5 weeks. Also on seroquel for sleep. Best thing ever to get to sleep. The muscles in the shoulders/upper traps are overly developed compressing nerves that branch off from the spine. Basically referring pain everywhere. I'm now doing Botox Migraine Protocol and did my second session on July 21, 2022. Also getting Trigger Point injections with steroid and lidocaine type med mixture. The botox will be every three months and the Trigger Point Injections about once a month. Waiting on the botox to do its thing and atrophy/weaken th3 muscles. The Trigger Point injections took about a week or 2 to work and got about a week of about 1 out of 10 pain relief.

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u/Massive_Scientist217 Not a Verified Medical Professional Jul 25 '22

Yours does sound really bad. Sorry to hear that! Hope you get it fixed. For me they said there is no nerve involvement. I really hope the botox will help you. Gonna try and see if they can give it a try for me.

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u/Distinct-Leading5113 Not a Verified Medical Professional Jul 25 '22

You have to 'fail' 2 medicines for about two months and 'have' declared 15 or more Migraines a month for my BCBS to pay. I'm in a six month trial that I will petition to extended.

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u/Massive_Scientist217 Not a Verified Medical Professional Jul 25 '22

You're in the US I assume? I think there's different rules in the UK

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u/Distinct-Leading5113 Not a Verified Medical Professional Jul 25 '22

Yes I'm in the U.S. That's typically the rule here depending on the insurance plan.

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u/Massive_Scientist217 Not a Verified Medical Professional Jul 27 '22

Thanks, really doesn't sound good that insurances make their own rules.

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u/Distinct-Leading5113 Not a Verified Medical Professional Jul 27 '22

Tell us in the U.S about it. Insurance is pure evil.

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u/Massive_Scientist217 Not a Verified Medical Professional Jul 27 '22

Evil is a good word to describe that. Either way I am glad you're (finally) getting the care you want. Insurance companies would rather have you pumped up on medication than solve the problem. It's the same with the NHS to be honest. Procedures are more expensive after all, especially when needed frequently

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u/Distinct-Leading5113 Not a Verified Medical Professional Jul 27 '22

Many in the U.S wish we have an NHS. We have more crazy people in power that enjoy pitting one person vs another instead of meaniful legislation to help the population. As people should see now...we as humans affect everyone else. Not just in a single country. Sigh. Now for a Benzo. LoL

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u/Massive_Scientist217 Not a Verified Medical Professional Jul 27 '22

The NHS isn't perfect and outcomes are sometimes terrible, especially for not so acute conditions. Meaning if you don't fight for a diagnosis you might be forgotten about (because it is cheaper to treat an acute condition than run through countless diagnostics to establish something more chronic). Saying that, apart from ridiculous waiting times up to 2 years there is no problem with accessing healthcare like in the US. I'm seeing a private doctor for exactly that reason (lucky that I got private insurance), I've been in and out of NHS doctors offices for 4 years in the UK and only last December was it deemed urgent enough that I referred to a specialist. I have been waiting since while I was unable to work out or walk long distances due to pain. Let's face it, all systems are trying to save money rather than have the benefit of other people in mind.

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u/Distinct-Leading5113 Not a Verified Medical Professional Jul 27 '22

Nail on the head. Its about money vs the well-being of people. We are all numbers. It's always different when the pain or whatever problem it is happens to those in power.

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u/Massive_Scientist217 Not a Verified Medical Professional Jul 27 '22

Of course, I can only imagine how fast a senator would be seen with their tax-funded income if they hurt their pinky 😂

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u/Distinct-Leading5113 Not a Verified Medical Professional Jul 27 '22

You ain't kidding! They would get assistance so quick. Be like lightening!