Persistent upper back/neck cracking & discomfort

[Jeff Evans]

Over the past year I've had this tenseness/discomfort in my upper back/neck that has gotten progressively worse. It's just where my neck joins the upper back, a bit to my left of center, near the right edge of my left lat muscle. At first it was a minor annoyance if anything. By now it's enough of a distraction that I have to crack my neck very often (every few minutes). I feel like it's also affecting my performance when doing lifts. The reason I haven't gotten it check out before is it wasn't what I would call painful, just annoying. Now in addition to constant cracking I am noticing a correlation between the discomfort, and a "hot" sensation on my lower left neck, and a slight tingling/numbness on my left forearm.

Last summer I saw a chiropractor who said my spine was slightly mis-aligned (my right shoulder was about an inch higher naturally when standing than the left). This was apparent from a mirror and the x-ray. She did several adjustments over a few months but it didn't seem to fix this problem. If anything now it's worse.

Now it's enough of a problem that I want to see someone again. But given my lack of success with my last chiropractor I'm wondering who I should even see. Physical therapist, trainer, or just general physician? My insurance allows me to go directly to a specialist so I'd rather not waste time with a GP visit if it would be worthless.

Also I'm wondering if anyone can take a stab at what may be causing it.

1. Food intolerance/inflammation (ex: nightshades) - I find this unlikely since I have eaten nightshades my entire life up until now with no issues, and if anything I have been eating fewer as the problem has worsened.
2. Spine/disc problem - not sure how likely this is given that it feels so asymmetric.
3. Chronic unconscious muscle contraction - this may be plausible since lately as I have been paying more attention, I've "caught" myself shrugging my shoulders or contracting my upper back without realizing I was doing it.

Have I missed any potential likely causes? Thank you for any input on my questions!

[Steven Low]

Could be structural in which case you would need to cut back. Or it could be caused by environment.

How's your posture? Using the computer a lot can generally mean the right arm is elevated more and lead to tightness in the traps causing the misalignment. Eventually it will get worse if not correct and bam there you go.

Pictures if you can get them would be great. Front, back, both sides.

Corey and perhaps I may be able to evaluate you.


FYI for all you people who rely on me a lot Corey probably knows more than me so take what I say with a grain of salt compared to him.

[Jeff Evans]

Of course I forgot to mention that I'm a full time code monkey so sitting in front of the computer occupies the bulk of my waking hours. Of course I have read just about every "correct posture" site and tried to correct it but that's no guarantee of anything. As they say, the camera never lies so I'll try to get some coworkers to photograph me at a candid moment this week. Thanks!

[Steven Low]

This is shirt off by the way.. so we can see the extent of the posture on your skin. It will be harder to tell if you have higher bodyfat though (I'm hoping not).

Hope you're not camara shy..

[Jeff Evans]

Sorry to resurrect such an old thread but this is still a problem for me. Since my last post I have been to a chiropractor, which may have been beneficial in some ways, but unfortunately this chief discomfort remains. Some more info which may or may not be relevant (sorry I'm going to be super verbose just so I don't leave anything out).

• Three years ago I had an acute injury during lifting. I had picked up an empty bar (45lb) in preparation to do curls. Suddenly I felt a sharp pain in my mid-back slightly to the right of my spine. I put the bar down and went home. The pain got worse throughout the evening until it was so unbearable I had a friend take me to the ER. They didn't try to diagnose it, just gave me pain meds. After about 5 days of laying around I was fine to walk around and gradually felt better. I still don't know what had happened, whether it was a disc issue, small muscle tear, or what.
• I first started finding this back thing a real problem about a year ago. I went to my first chiropractor who was very nice, but her full course of treatment (adjustments and a bit of electroshock) didn't seem to help. Recently, when I went to my next/last chiropractor, she found a weight imbalance of +25lbs on my right foot, and noted my right shoulder seemed to be higher by about an inch than the left (they had both noted this). She also took x-rays and sent them off for analysis (see below* for full review text). She also noted a hip rotation. Several months of exercises, adjustments, and massages later, the weight imbalance is all but corrected but the back discomfort remains.
• Recently on the train I started noticing that when my back was flush against the hard seat back, I felt more discomfort/sensation along my left scapula. It felt like more of my left scapula was "hitting" the seat back than my right. I noticed that resting my entire left arm on the seat in front of me brought some relief, as did consciously bringing/holding my left shoulder up and forward (toward my nose). This is the first time I suspected a connection between my asymmetric natural shoulder height and back discomfort.

I did some research and found out about winged scapula. Some of those symptoms sound familiar (I get the distinct impression that my left scapula sticks "out" from my back), but it's nothing to the degree that I saw on various websites/Youtube vids.

So what could this be? Is a mild case of winged scapula plausible? Could the shoulder height and/or back issue be connected to my prior injury? Are there any good tests/measurements/exercises to do so I can narrow down on what's going on? Will Captain Planet reach the city in time?

Finally, here are some pics. Between the poor camera quality and higher body fat it's difficult to really see anything, particularly on the back but I posted them just for completeness. All are w/fs but not very pretty.

• front
• left
• right
• back, relaxed, arms at sides
• back, relaxed, arms at sides (#2)
• back, arms straight forward
• back, arms up at an angle (about 45 degrees above parallel)

*full radiologist report from 4/22/08, which I can't fully understand myself:

Lumbar Spine and Pelvis
There is a pelvic unleveling, low on the right. A slight right list of the lumbar region is also identified. The sagittal curve is satisfactory.

There are five non-rib-bearing presacral segments. The lowest of these is transitional in nature with enlargment of the left transverse process and accessory joint formation at the adjacent sacral base. The disc at this level is hypolastic. The remaining lumbar intervertebral discs are normal in stature and exhibit no evidence of degeneration. The sacroiliac and hip joints are unremarkable. The soft tissues of the abdomen and pelvis are unremarkable.

Cervical Spine
There is a left list of the cervicothoracic region. The sagittal curve is flattened with no apparent alteration of the gravity line. There is an adequate overall motion at the end range of flexion and extension.

The intervertebral disc, apophyseal and uncovertebral joints are preserved. The vertebral body heights are maintained. The pervertebral soft tissues are satisfactory. The upper lung fields and bony thorax are unremarkable, to the extent visualized.

Impression

• Lumbosacral transitional segment, Type IIA.
• Postural/biomechanical alterations, as noted above.
• There is no evidence of recent fracture, dislocation or neoplastic change.

Comments
Clinical evaluation for functional or structural short left on the right is suggested. The postural faults of the cervical spine may be secondary to muscular antalgia and/or vertebral subluxation complex. The unilateral lumbrosacral transitional segment may delay this patient's response to manipulation, requiring an extended course of chiropractic management. There are no contraindications to high velocity-low amplitude manipulation of the cervical and/or lumbar region(s). Clinical correction is recommended.

[Frank E Morel]

in a nutshell.... he is telling you, your out of alignment.

cervical spine may be secondary to muscular antalgia and/or vertebral subluxation complex
-this means you have muscular antalgia ---- a muscle pain that kept you from being straight.
vertebral subluxation complex --- slipped disc.


regardless... the person that read and reported on this film, is weak at reading them. as he cannot make his final answer an answer. Either you have a slipped vertebrae or not. ( suspect it was read by the chiro himself.)

go see your md, not the chiro .. ask for a ct or mri if you can afford it, then ask for a neurosurgeon consult.

[Jeff Evans]

Originally Posted by Frank E Morel

in a nutshell.... he is telling you, your out of alignment.

cervical spine may be secondary to muscular antalgia and/or vertebral subluxation complex
-this means you have muscular antalgia ---- a muscle pain that kept you from being straight.
vertebral subluxation complex --- slipped disc.


regardless... the person that read and reported on this film, is weak at reading them. as he cannot make his final answer an answer. Either you have a slipped vertebrae or not. ( suspect it was read by the chiro himself.)

go see your md, not the chiro .. ask for a ct or mri if you can afford it, then ask for a neurosurgeon consult.

Just to clarify, the "radiologist" was some other chiropractor, in Colorado, to whom my chiro here in Chicago mailed my x-rays.

In any case, a lot to think about . Thanks for the reply.

Just some personal point of view- how do you sleep? On your stomach, on your side? I've developed a heck of a discomfort in my neck from sleeping on my stomach and side. Then I started to try to sit up straight and not let my neck and ching just forward (better posture) and my neck was cracking constantly. I now try to sleep on my back, although been doing more on my side lately. I don't ever sleep on my stomach anymore and my neck has gotten better.

[Jeff Evans]

Originally Posted by Camille Lore

Just some personal point of view- how do you sleep? On your stomach, on your side? I've developed a heck of a discomfort in my neck from sleeping on my stomach and side. Then I started to try to sit up straight and not let my neck and ching just forward (better posture) and my neck was cracking constantly. I now try to sleep on my back, although been doing more on my side lately. I don't ever sleep on my stomach anymore and my neck has gotten better.

I have wondered about this a lot. I used to sleep on my stomach up until about 6 years ago. But since then I have focused on side or back. Even now I mostly sleep on my side, but only laying on my right (on my left, it hurts and I can't fall asleep). I'd say it's 75/25 right side/back now - at least falling asleep - sometimes I wake up in the opposite position.