Discussions By Condition: I cannot get a diagnosis.

Shoulder pain, cracking, popping - extends to neck and jaw

Posted In: I cannot get a diagnosis. 0 Replies
  • Posted By: Jewelweed
  • September 4, 2010
  • 00:50 AM

Hello everyone,

I am hoping you can help interpret an ongoing shoulder, neck, and jaw problem. Even if you cannot suggest a diagnosis, I would appreciate hearing about similar experiences and what techniques you have tried to alleviate the pain and cracking and popping noises. As a college anatomy instructor, it is ironic but all the more frustrating that I can’t figure out what is going on. :-(

I am 27, active, and otherwise healthy. For three years I have had chronic pain in my right shoulder, posterior and right lateral neck, left and right TMJ, and muscles of the entire face, including around the temples, eyes, and forehead. The pain is worst along the upper portion of the right trapezius, though the problem may not be the muscle itself but something else in that area.

My shoulder cracks and pops every time I move it. This occurs both when I move the humerus in any direction, and when I pull or push on the right shoulder blade with my left hand. The cracking does not seem to be from within the glenohumeral joint, but along the scapula itself. I have taken to “massaging” the trapezius and pulling and pushing on the shoulder blade what must be hundreds of times a day, because the constant pain makes me want to just tear off the entire area. The cracking and popping noises do not cause additional acute pain; rather, there is constant ache and burning in the area whether or not I have cracked the shoulder at that moment.

Another odd thing is that my trapezius area does not feel like a muscle. It seems incredibly hard, almost like cartilage. Pressing on that area is extremely painful.

Nearly every time I crack the shoulder there is a concurrent cracking in the TMJ. Often, massaging the trapezius area induces cracking along both the shoulder and the TMJ. I am also constantly pressing in to my temples and pulling up on the muscles around my eyes due to the pain, and sometimes this force causes the jaw to make a cracking sound as well.

The pain is constant, but if I extend my arm for long periods of time (such as when working with a computer mouse on a desk), there is also numbness radiating down the entire arm.

I asked the director of my school’s physical therapy program to look at the shoulder. She said nothing seemed misaligned and recommended doing rowing exercises to increase the strength of the rhomboids. She did not seem alarmed by the horrid cracking sounds and said they could just be due to snapping cartilage. She told me to practice rowing for a week and things should improve.

They did not.

I went to a professional massage therapist who is also the athletic director of one of the Big 10 University track and football teams. He attempted to find trigger points, but I did not experience any (perhaps because the background pain is always so strong that I would not notice anything less). His conclusion was pretty much the same as the other: nothing is wrong, I should do rowing exercises, and I should be sure to sleep on my back.

The chronic pain makes it difficult to fall asleep and makes me tired, irritable, and upset much of the time. I have put up with it for a few years but my quality of life is really suffering lately. Due to not having health insurance and due to having bad experiences with doctors in the past, I am hesitant to begin an expensive wild-goose-chase and am hoping someone here might be able to provide some guidance.

Here is some more information and speculation that may or may not be relevant in determining the cause:

- When I was a teenager I had a large overbite corrected by wearing an orthodontic appliance that forced my lower jaw to grow forward. Both jaws were also widened to make room for wisdom teeth. I wonder whether the excessive pressure and bone growth then could lead to jaw problems now. I wonder if TMJ disorder could cause pain and popping that seems like its origin is primarily in the shoulder?

- Both my left and right acromioclavicular joints seem enlarged. Despite being thin and having large bones, the AC joints still seem unusually prominent. (The left side seems larger than the right, though, and my left side does not usually hurt.) Although there is no pain in this joint, could some kind of AC misalignment cause problems in the rest of the shoulder?

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- I have ruled out rounded shoulders. When standing in a relaxed position, as shown above, my arms do not overpronate, nor does my neck hunch particularly forward, as shown below.

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- My posterior flexibility is limited with the right shoulder. I can reach much further across my back with my left arm than I can with the right arm. Although this stretch is not particularly painful, the limited flexibility is marked; this is as far as I could reach.

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Well, that’s all I can think of to say right now! Please let me know if other details would be relevant. This constant pain is getting really unbearable, and I sincerely hope someone can offer at least a glimmer of hope toward resolving the mystery and ending this misery!

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