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I've had a knot/tension in my left neck and shoulder for…

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I've had a knot/tension in...
I've had a knot/tension in my left neck and shoulder for over 6 months. I've had deep tissue massages and have tried over the counter creams (Bengay) to help relieve the tension and pain and none have worked. They don't even relieve the tension a little. I feel the same. No pain when I'm in a neutral position (facing forward). I have pain with leaning my head towards my right shoulder, while sleeping, and when when I apply pressure to the area. What should I do? What are some possible treatments I will see if I go to a physician?
Submitted: 8 years ago.Category: Medical
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Answered in 2 minutes by:
6/19/2010
Doctor: Dr Jones, Board Certified MD replied 8 years ago
Dr  Jones
Dr Jones, Board Certified MD
Category: Medical
Satisfied Customers: 3,907
Experience: MD-Post graduation.10 years in handling and helping patients.Expert in emergencies and diagnosis.
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Do you mean you have left neck pain radiating to shoulder?
Is there associated left arm pain?
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Customer reply replied 8 years ago
The pain is where my neck and shoulder meet. It doesn't effect my left arm. I have no pain with the arm movement.
Doctor: Dr Jones, Board Certified MD replied 8 years ago
In view of location and duration of pain I would like to arise possibility of cervical rib causing compression of nerve roots leading to pain. A xray can help to confirm or rule out this. A cervical rib is accessory rib seen in few people which cause pain in the region you are describing.

I think you should get a primary evaluation done by doctor who can guide you further.Meanwhile analgesic like ibuprofen can help in reliving pain.

Please ask if you have any further questions or if you want me to explain anything.
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Customer reply replied 8 years ago
Relist: Inaccurate answer.
The doctor gave a diagnosis not consistent with my symptoms. If I had nerve pain it would radiate it doesn't. He did not address the fact I have a knot and tension in the area. I've tried pain relievers.
Doctor: DrRussMD, Board Certified Physician replied 8 years ago
DrRussMD
DrRussMD, Board Certified Physician
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Hello from JA
While I think the other expert had a good thought with cervical rib, or thoracic outlet syndrome, this classically causes arm pain and other arm symptoms and can even be associated with phenomena such as raynaud's, a cold hand, etc.

However, in the other experts favor, a difficulty with a disc at C5/C6 rather than C7 [cervical rib], or even a very specific anomaly at C7 might cause this tension. Only an MRI, in my view, would give enough information to rule out a problem particularly if you have ever had any injuries, car wrecks, sever falls, etc.

In any case, the problem is structural, clearly, and the best MD to see for this is a physiatrist or a doctor who has had training in physical medicine and rehabilitation [PM&R} this way you will get a structural diagnosis and the physical therapy ordered will be specific to that diagnosis.

Deep tissue work will not necessarily help this if there is ligaments and/or bony involvement [again the MRI will show]. Often problems are very whole body as well regardless of a specific focus.

A good chiropractor will have a specific diagnosis for this and might help you. He/she will probably want x rays.

To me though, the best manipulation is done by DOs who have the same training and qualifications as MDs but some of whom specialize in OMT...osteopathic manipulative therapy. This is far more gentle than chiropractors put creates movement in places that movement has been frozen, often freeing up tissues so that then the massage will work. See www.cranialacademy.org for what this is about and for practitioners.

If I were you though, I would be very curious about cervical MRI findings.
Good Luck
Please find me for future questions and to let me know how this goes.
dt
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