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Our user asked: "Almost 4 weeks ago I raised my right arm and had some acute shooting pain in between my shoulder blades. The next day I noticed sensory numbness on the rear of my right arm, a small spot on my right armpit and a small line of it on extending across my right pectoral area from the armpit (although the armpit sensation loss was not connected to the pectoral loss). I went the ER and had a ton of X-rays. The Rad came up with some minimal degeneration in the C & T spine, especially C7-T1. A mild irregularity compatible with a small osteophyte in that area. I went to a chiropractor. Saw him 4 times then stopped. After the 3rd time my trigger points across the right shoulder blade were angry. I went back to the Dr. to get a physical therapy order. I saw a different, recommended Chiropractor right after the Dr. appt. He looked at my X-rays and said that my neck is straight and shouldn't be, and that my back is in spasms. He said to go to physical therapy and receive the McKenzie technique. I made an appt and saw a PT a couple hours later. She hooked me up to electrodes with a heat pack for 20 minutes, gave me 4 exercises that all involved looking down, which hurts, and I left. I'm not very satisfied with my trip to the PT. I'm 31, frustrated, have not suffered a specific injury to cause this and it just seems like I'm heading toward surgery. Which I want to avoid at all costs. Any words of wisdom? How is Yoga? Thank you for reading all of this, if you did."
Ask a PT Response: "In most individuals there is a curve in the neck/cervical spine which is called a lordosis. For some individuals who have a decrease cervical lordosis there can be some ramifications as a result of this anatomical abnormality especially when an osteophyte is present. In your case, from what you described it appears the C7 nerve is most likely affected. Since only X-rays have been taken, a disc protrusion has not been ruled out yet as this requires more detailed medical imaging such as a MRI. The McKenzie technique is used to treat disc related problems in most cases and involves exercises such as cervical retraction, extension, lateral bending or rotation. In your case, through a PT evaluation if your PT has determined that the etiology of pain does not appear to be discogenic, then he or she may not issue or have you perform McKenzie based exercises. Your first visit to physical therapy with treatment involving hot packs, e-stim, and exercises appears to be in the scope for treatment of your condition. If your therapist prescribed to you exercises where you have to look down (cervical flexion), I would assume he or she is suspecting a joint issue rather than a disc issue (cervical flexion based exercises opens up facet and foramen space which may impinge on a nerve). As far with performing the exercises, I’d recommend you address that with your PT. He or she could modify the exercises for you so that you may experience less pain. Other treatment options for a PT could also include and is not limited to joint mobilization, soft tissue mobilization, myofascial release and traction. Your PT will determine the plan of care and what is appropriate for you. Good luck with your therapy and I hope you start feeling better soon!"
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