T Nation

Chronic Neck and Shoulder Pain


Hey gang, a lifter friend recommended me this site as a good knowledge base so I thought I'd fish for suggestions.

My medical history:

2004: Diagnosed with http://en.wikipedia.org/wiki/Paroxysmal_kinesigenic_choreoathetosis. It's a weird, rare and basically causes muscle contractions and movements out of your control like a seizure everytime I quickly change my state of movement (standing, running, etc), although you retain consciousness. Thankfully I was treated more or less successfully with carbamazepine, an anti-convulsant, although I often forget to take it because such a miniscule dose is required to help deflect the attacks.

The interesting part is, to some extent you can control it with your mind. I know that last bit sounds crazy, but there's been situations where I could have gotten into a car accident because I felt an attack coming on and my brain was just like 'NOPE, YOU CAN'T TARD OUT HERE'. When I was brought before a neurologist and asked to replicate anattack, I literally could not for hours. It still happens sometimes on dates though when I don't take my medication. Lol.

2008: Had a mysterious incident(I was 17, now 21). Finished a max bench test for sports performance, picked up a grip test, squeezed, bam was on the floor with a severe muscle spasm. Ended up in the ER, they just babbled nonsense at me about a 'slipped disc' which I realize now means absolutely nothing before further investigation and told me to go to physio. Good times, although sitting next to a girl with cystic fibrosis in the ER has ironically made me realize how small my problem is in the big picture.

I go to physio, physiotherapist tells me I have to stop lifting for a while and also stop skiing. Because I am quite thin in my default state and was playing school rugby at the time, I am all like, "But I am invincible", go skiing, keep lifting...recovery seems to reverse itself. A true moment of young man idiocy.

2008 - 2009: Despite physio and continued physical activity condition worsens. During first year and second of uni I could not turn my head, had to speak quietly because the muscles around my neck and throat were so constricted.

Eventually I stop exercising because the smallest thing seems to throw my neck into spasm, riding my friends speedboat around triggered crazy stiffness and pain. At this point I started waking up with numb pinky and ring fingers or numb hands in general and there were trigger points breaking out all over my upper body, basically deep tissue nerves felt all twisted and torn up under my skin along my arms, into my shoulders and outer pecs.

2009-2010: Doctors and I ride out on the great hunt to find out what is wrong with me. Apparently nothing. MRIs show mild stress and strain but nothing that should be causing constant pain. X-rays and blood work are similarly inconclusive. My rheumatologist, my impression of whom is a slightly sloppy, stressed out man put me on Cymbalta because I suggested my symptoms were fibromyalgic and asked if I should consider tricyclics.

For those of you who don't know or might be suffering a similar problem, Cymbalta is an SNRI that seems to work on certain pain complexes, fibromyalgia and diabetic neuropathy. It can be expensive in the States, but I live in Canada and it produced results for me although the side effects can be pretty bizarre.

2011-2012: Since there is no magic band-aid solution to chronic muscle pain (besides heroin, which I can't afford on a student budget) I decide to find ways to manage the pain and try to improve it via therapy and light exercise. I got into therapeutic yoga and semi-regular swimming, lifting light (and I mean light, like the sort of weight you He-Men use to smash up your tuna rather than actually lift) weight.

During this time period I got diagnosed with TMD http://en.wikipedia.org/wiki/TMJ, and the specialist I saw who diagnosed me suggested that this probably had a lot to do with my jaw, neck and shoulder pain.

Basically TMD reflects an abnormality in the way one holds their jaw, particularly during sleeping. Let me tell you, I grind my teeth like MAD when I sleep. I spent this summer wandering around India with my friends and they all went bonkers listening to it, apparently it sounds like a train trying to run over a cow.

Girls I have been with have woken up thinking somebody is trying to break into the house when it's actually just me grinding and clenching my teeth like a madman. So, I'm gonna try and get that fixed but it will be a slow and uphill battle no doubt. I am currently cutting back on the Cymbalta to one 30mg pill once every few days, this has been going on for weeks now and by some miracle, I haven't plunged back into the same level of pain I was in several years ago.

It is worse without the medication no doubt but it's not the same hell I was in during 2nd and 3rd year university. I have gingerly gotten back into a regular gym routine since late December and found I actually feel (WTF, BETTER?) the day after lifting light weight, I usually pair it with cardio and a swim.

TLDR version: Sore points all over my upper body with concentrations in the cervical, jaw and deltoid region, possibly injury related, possibly neurological, medication and therapy seem to be improving my situation very slowly. I'm not discounting there is a psychological element, but I was a pretty happy kid before I went and hurt myself.

A few questions for you folks:

-Has anyone else found lifting to be beneficial to a chronic pain situation? Any tips on where I should look at for form (I have no doubt my form has gotten very sloppy, and I do not want to lift heavier weights without some sort of guidance) what kind of therapy goes well with this approach?

-I understand you guys by and large are not professionals, but skilled amateurs. If I were to hire a personal trainer to help me, are there any specifications or qualifications I should be looking for to ensure they know how to help gimps?

-Ideally, I am hoping to build some muscle mass too and start lookin' good again. Is it possible to build muscle and attain a physique through many reps + light weight? Please understand that with my condition, it's unlikely I'll be able to get back into the 8 rep 3 set all you can eat madness for a long time.

-I have tried a lot of stuff, ART, Graston technique, acupuncture combined with sports massage, regular massage, chiro, physio, anti inflammatories, tai chi. Most of these have had relieving temporary effects but nothing sticks. I even flew up to BC and tried cryotherapy. They put me in, get this, a freeze tank that was -125 degrees as a way to combat inflammation.

Anyway it didn't really work I was just really cold but there was a sick breakfast buffet at the health spa so ... not a total bust. I am blessed with parents who are relatively well off financially and can afford to help pay for all this stuff, but my mom is an occasional believer in new agey Oprah stuff so I had to agree to try EVERYTHING. Including traditional Chinese medicine and getting bathed in 'healing lasers'. Is there anything else you guys could recommend? I heard fish oil can work wonders on people with joint pain.

Long thread but there it is, basically my story for the last 4 years. Thanks for taking the time to read (or skim-read) and hopefully y'all have some suggestions for me. Cheers.


As a trainer, I figured I'd chim in on these questions.

If you somehow miraculously could find someone who has read, and knows well, Shirley Sahrmann and her Diagnosis and Treatment of Movement Impairment Syndromes (you can look it up on Amazon) you'd be in the right direction.

However, considering the quality of a lot of trainers is horrendous this is unlikely. My next advice would be find someone who is used to working with older populations. By default they are going to be used to working with people who have a lot of limitations.

Where do you live? Might know somebody for you.


Hullo. Thank you for your advice.

I am in Alberta, Canada. Probably SOL then, aren't I? :S


Not necessarily. Her book is extremely widespread.

You may want to check out Dean Somerset's website. He is a trainer in Canada. I'd be surprised if he didn't know people in that area.


Dean Somerset and Shirley Sahrmann? I will do so. Appreciate the advice, friend.