When the Pain Just Won’t Go Away

Are you dealing with a crick in your neck that seems to linger forever? Do you wake up with shoulder discomfort that lasts throughout the day and sometimes disrupts your sleep in the middle of the night? You're not alone. Millions of Americans suffer from these common issues, but there are ways to ease your pain.

When patients visit Derrick Randall, M.D., a part of Roper St. Francis Physician Partners, the first step is to determine why they are hurting. One contributing factor is getting older and all that goes along with it, including arthritis and wear and tear on the body. Pain also can be brought on by a single event like an automobile accident, a fall or a long-term issue: being overweight, sleeping on a bed or laying on a pillow that isn't quite right for you or spending the bulk of your day staring straight ahead at a computer screen.

"If you have a problem sleeping, it's probably a pillow issue. You need to experiment and find one that works, such as a contoured pillow that adjusts perfectly for your neck and head," he said. "Not having an ergonomically correct chair and looking at a computer for four to six hours a day can be an issue as well."

Dr. Randall said there are various reasons for neck and shoulder pain, but the treatment protocol is much the same. Once he discovers the root of his patient's problem, the first step to treating the issue may be as simple as over-the-counter medications or small lifestyle changes. Warm heat can be used to loosen up the muscles. He might also prescribe a muscle relaxant when the muscles are in spasm and over-the-counter medications have already been tried for an extended period of time.

If those options aren't successful, physical therapy - a combination of exercises and nerve stimulation - might be the next step. Contrary to what you've been told, gentle exercise, rather than rest, can help get joints and muscles moving again but this may take some time for a muscle that has been overused.

Dr. Randall pointed out that he also may inject a local anesthetic with an NSAID-type medication to help relax the muscles that are causing the pain.

If the pain is coming from a joint that is arthritic or irritated from overuse or strain and if medications aren't working, then steroid injections may be the answer.

If none of this is successful, Dr. Randall may have to move on to a more serious procedure, using an electromagnetic pulse into the suspect nerve to deaden it. The nerve regenerates in six to eight months.

"Finally, he said, if nothing else makes the pain go away, he might inject the patient with a cervical epidural. The epidural will help relieve pain coming from the spinal cord or spinal nerves.

He concluded that there are ways to help avoid neck and shoulder pain. Those who are chained to a desk all day should stand up and walk around for 10 minutes out of every hour, and he added that looking up and down all day but not left and right probably will add to a person's discomfort.

"Most of all, you want to keep your muscles loose," he said. "Basic stretching for your neck and upper back will suffice."

Are you suffering from pain in your neck and shoulders? Roper St. Francis Physician Partners might be able to help.

To learn more, visit www.rsfh.com/partners/neurosurgery or call 843-723-8823.