As I started to put together our next SpineCare Newsletter, I noticed that one of the main topics in the news these days is the prescribing of narcotics by physicians for pain management and the subsequent drug addiction and overdoses this creates. Take for example the singer Prince.
Pain in the middle of your back? Between your shoulder blades? Felt pain wrapping around your ribs? Pain in the mid-back is an area of the body that that is often misunderstood and not well treated by most medical practitioners. The cervical and lumbar spine get a lot of attention and most of the treatment. The thoracic spine, which is the part of the spine which is located in the middle of the back, is the longest part of the spine with the most discs and vertebrae. If you look at the figure below you can see how each one of the twelve thoracic nerves cover their own part of the middle of the back. They are labeled in this diagram from T1 to T12.
Arthritic joint pain from your knee? Hip? Shoulder?
If your joints ache, they have lots of company. Over 46 million Americans suffer from arthritis. Osteoarthritis of the knee is the most common type, and the way it affects the knee is painfully simple. Osteoarthritis causes the lubricating properties of the synovial fluid in the knee joint to diminish, resulting in less protection and cushioning. In addition, osteoarthritis wears down the cartilage, resulting in your bones grinding against each other. That grinding hurts! You can feel it climbing stairs, working in the garden, walking or bending your knees to sit. It may even keep you up at night. Similar issues can affect many other joints, including the shoulder, hip and even the fingers.
1) How do you diagnose whether the pain I have is coming from the shoulder or the neck?
We use a continuous x-ray machine and place an anesthetic inside the shoulder joint. We then assess the patient to see if the pain is gone. If the pain is not significantly better, we know there is another reason for the shoulder pain. We will then place an anesthetic and steroid on the nerve that goes from the neck to the shoulder. If the pain is gone within ten to fifteen minutes after this procedure, we have a diagnosis of a cervical nerve that is creating “referred” pain to the shoulder.