Suspected nerve problem

[Hostile0311]

Hello,
I have never posted a thread in this forum before nor do I have any medical expertise. I hope I am not stepping on my crank here by asking for some advice. I realize the internet is no substitute for a clinical diagnosis but I thought I would inquire to the readers and QP's of this site who have a vast amount of knowledge of which to glean information & advice. I am a 30 yr old prior sevice Marine living on the island of Malta in the Med. Recently, I have been suffering from a pain in my in my upper back between my scapula and T-5/T-6 vertebrae. The pain also seems to radiate thru my chest to the left side of my sternum. It ranges in intensity from not at all to very painful depending on the activity. I can best describe it as a burning knife sensation between the shoulder blade and spine. It seems my arm/hand gets tired and cramped more easily when exerted and I also get pins & needles sensation at night. There is also a signifigant amout of audible 'popping' when i rotate my shoulder. I have seen the company I work for's physician and he gave me a cursory exam (no x-rays or anything) and told me it was a inflamed/impinged nerve and wrote a scrip for an anti-inflammatory as well as a muscle relaxer and sent me on my way. I was contemplating going to see an orthopedic specialist or a physio-therapist but the wait to see one here is a month or sometimes longer. The healthcare here is free hence the long waiting list. Also, the standard of care here is a bit lacking since the docs have to see a large number of patients since it is free. The only way to get seen right away is go to the ER and complain of severe pain. The meds seem to have a little effect (been on them now for 3 days) but the pain still persists. Does this malady sound strange? Does anyone have any advice/similar circumstance/previous experience/measures to take with this type of pain? Should I treat it as serious and get help at the ER ASAP or just suck it up and drive on? Again, please forgive me if I have posted out of my lane.
Thanks & Regards

[Sdiver]

Here, I'll throw my $.02 out.

Instead of focusing on the Cure, look for the Cause, especially when it comes to the back.

Did you lift something, w/o using your legs, or did you bend at the wrong place when picking up a pen or piece of paper, or something similar?

Also look at your shoes, how you sleep, what type of pillow you use when sleeping, the chair you sit in at work, does it have some type of support for your back? all these and many more could be underlying problems for your back.

The Doc could/can prescribe pain pills and muscle relaxers, all the live long day, but it's what you're doing to your back while taking the prescriptions, that may be the underlying problem. Look at that/those and work it form there.

Yes, it does sound like you've just pulled a muscle in your back, if I would harbor a guess, I'd say it was a major pull/strain in your Trapezius muscle.

So my advice to ya Marine.....take the muscle relaxers the Doc gave ya, put on a clean pair of socks, and put on some new shoes.....then get back to work. :D

[SeanBaker]

First of all, I am not a doctor, and as Sdiver has said there's more to this than just treating the symptoms.

That said, I'll throw out the one relevant fact that I do know - if you've only been on the meds for only three days, you've got a ways to go. NSAIDs (anti-inflammatories) take between one and two weeks to have an effect on your system. Take them religiously, just like the doctor ordered for your best chance of improvement.

If you see no change within two weeks, go back and ask that he reassess you more thoroughly. Of course, if there's a long wait to get in, maybe you should get on his schedule now just in case ;) .

[Doczilla]

Understand that I'm trained more to look for things that can kill you rather than that which is most likely, and therefore may be seen as an alarmist.

I agree with the others as far as what is most likely at the root of the problem, but there are a couple of red flags here. You describe cramping/early fatiguability of your hand and arm with activity. This suggests a vascular compromise to the arm rather than a nerve problem. Parasthesias at night can be caused by vascular insufficiency as well as nerve impingement. Here's the thing: the nerves in your arm come from C5-T1, not T5/6, so if there is a nerve problem with the arm, it's not where you are describing your pain. The little hairs stand up on the back of my neck when someone says back pain radiating through to their chest with activity.

Not knowing your family history or having examined you, I think you need further workup. I'd go to an internist (internal medicine specialist) before I'd go to the orthopedist. If your pain has only been going on a few days, it's worth a trip to the ER for a chest x-ray, EKG, and enzymes. Otherwise, call the internist's office, describe the above symptoms as I have, and they may find a little room in their schedule for you.

'zilla

[Hostile0311]

Thank you Doczilla, SeanBaker & Sdiver,
I appreciate you taking the time to post and give me your .02. As 'zilla said though, anytime chest pain is present it should not be taken lightly. There is a family history of High BP, Type II diabetes and heart problems later on in life so I guess I'm pre-disposed to these conditions. I wasn't counting on them at 30 though. I'm in good shape from running & training although I smoke almost a 1/2 pack a day and drink too much coffee at work which I'm sure doesn't help matters. I was admitted in Feb last year for a bad cough, shortness of breath & night sweats and they did a complete work-up (CBC, chest X-ray, sonogram, EKG, viral, bacterial & tox screen and a few other tests I cannot recollect) but found nada except a virus called Epstein-Barr. The physicain said I had nothing to worry about and sent me on my way. I guess a lot can change in a year since then though. Hell, I thought I had TB since on my last med exam upon returning from Iraq in '03 before discharge from the Marines my TB skin test said I had been exposed to the bacteria. But upon further tests (chest x-ray, blood test, etc the Navy doc said I was clear but I had in fact been exposed as were others in my unit). They didn't put me on the prophylactic antibiotics though (should they have?). At any rate, the docs here said that wasn't it either when I was examined. Anyway, thanks again to you all for your input. I guess another trip to the ER to get seen is in my future. Otherwise I'll get seen sometime next year if I make an appointment.
Thank you kindly & best regards,
J