Patient D was in middle of a four day pain attack in his upper right shoulder blade when we came into my office. He had experienced pain like this before, but not to this degree of severity.
The pain was in his upper back, just to the middle of of his scapulae bone, below the trapezius muscle. It radiated pain up into his neck. He experienced a lot of pain trying to rotate his head to look to the right. His mobility to the right was very limited.
Patient D’s story is important to anyone who deals with chronic pain between the tip of the shoulder blade to the top of the shoulder.Why? Because D’s story reveals why people with this sort of chronic pain – especially those that have to use their arms constantly (dental hygienists, hair stylists, painters, etc.) – often can’t find help…Until the neck is expertly corrected.
He could barely move his head back to look at the ceiling.
He experienced at least one minor headache on a weekly basis, with occasional mid- back pain.
So to review:
- Four days of intense pain in his upper back, near his right shoulder blade, with a history of a similar pain
- At least one headache weekly (which the patient did not necessarily find significant)
- A history of physical trauma, particularly in the head and neck
Patient D’s exam showed significant breakdown in his spinal structure:
- Right head tilt
- Cervical rotation (turning of head left/right): decreased to right
- Cervical lateral bend (leaning side to side): decreased to right
- Cervical Extension (looking up): very limited
- Neck Tissue Changes: Hypertonus and trigger points in right scalene muscles (top front of chest), right above scapula (shoulder blade), with tension dominant down the right spine
- Dominant shoulder tension: Tension on right, with elevated right scapula, with forward rotation
- Short Functional Leg: left (tight Achilles tendon on left leg)
- The most important finding for this patient came from his x-rays, which revealed that he had a head-to-neck misalignment (chiropractic subluxation), and his neck was locked into a reverse cervical curve
Based on his posture, and his x-rays, Patient D’s neck was unlocked using several specific and gentle movements of my hands with the patient laying on his side.
The protocol used for this patient is called QSM3.
Patient D left after his first correction process still in pain. Even after resting for 20 minutes after his first correction he still hurt.
While this wasn’t ideal from Patient D’s perspective, I knew that any lasting relief would probably only come after his lower neck started shifting.
As it turns out, Patient D had a very extreme response to his first correction, as his neck began to unlock out of the reverse cervical curve almost immediately.
What happens when the injured neck moves very quickly?
Patient D experienced a few hours of temporary relief followed by 36 hours of pain and exhaustion. He literally stayed in bed for an entire day, he was so tired from the changes taking place in his spine.
Two days after his first correction process, he regained some energy and finally saw a drop in his resting shoulder pain. From that point on the extreme pain near his shoulder blade would gradually decline and disappear over the next four weeks.
Occasional flare-ups would only happen after Patient D started playing hockey again, and took a few hits into the board from an aggressive player.
The results of upper cervical chiropractic care
- Patient D’s neck went from an extreme reverse curve into a straight neck – not ideal yet but still better than reverse – and it may be his “normal” based on the level of trauma he has experienced in his spine
- Patient D was able to regain full range of motion in his neck, including most of his ability to look up toward the ceiling
- Patient D was able to return to working his full work day, and playing hockey, without worrying about the appearance of any extreme pain
- Patient D’s headaches became less frequent
The long term benefits
I can’t say conclusively that Patient D avoided a future of poor health because his neck shifted. But we can speak in probabilities. Reverse curves in the neck are associated with a number of health problems. And since Patient D’s neck shifted after being unlocked – it’s definitely probable that he’s going to avoid a future of annoying to debilitating symptoms just so long as his neck stays healthy.
He may also be more resilient to injury with his neck in a healthier alignment.
Important take-away lessons from Patient D’s case
- Without x-rays, it would have never have been known that this patient had a reverse cervical curve, or that that curve improved, letting us know that Patient D’s painful flare-ups were a constructive sort of pain
- Sometimes the pain gets worse before it gets better, especially as alignment changes rapidly
- Shoulder and mid-back issues are directly related to neck alignment, and trying to correct mid-back issues or shoulder issues without accounting for mechanical issues in the neck can be very frustrating for patients who will not get stable changes in their shoulder or mid-back
- Treating recurring headaches without treating the mechanical breakdown in the neck can also be missing the true source of the problem
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