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Old 11-29-2005, 02:17 PM
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Default Re: crazy pains on my shoulder blades, neck, especially my right side

It sounds like the muscles are going into spasm; it can stem from the computer posture and lack of breaks, but it can also have more significant causes. I have flare-ups from bad posture at the computer, but my dominant cause is from two herniated discs in my neck (from many years ago -- when it happened, I didn't realize how bad a fall it was). So the discs pinch the nerves to my upper back and arms, leaving them prone to spasming. I'm fine if I maintain posture and keep going to the gym. If I stop gymming or slack off on posture, it's just a matter of time before I have another episode, and the pain and spasms lead to worse posture and an inability to sleep, which make the spasms worse -- think vicious cycle!

If the pain is SEVERE, do this (caveat: I AM NOT A DOCTOR)

1. Stop doing what you were doing! Shifting the weight of your arms might help. Try crossing your arms high on your chest.

2. Take the 1,000 mg of ibuprofen. This is a high dose; it is not recommended for over-the-counter applications, but this is the therapeutic does used for serious cases when you get prescription ibuprofen. Same stuff, more per caplet. Afterwards, take another 600 mg in two hours. After that, take 400 mg every two hours. Just before bed, take 800 mg and set your alarm for four hours later. Get up and take another 800 mg. In the morning, take a dose as appropriate for your level of pain, and taper back to 400 mg every 2 hours. Ibuprofen has a very short refractory period in the blood -- the circulating dosage will be cut in half in two hours. In small doses, it is not very effective at killing the spasms and acting as an anti-inflammatory, which you need. You need to dose up. However, avoid having more than 4,000 mg per day; processing the ibuprofen is tough work for the liver. If you've had ANY liver problems, DON'T take ibuprofen.

The reason for taking 400 mg every two hours instead of taking 1,000 mg every six hours is simply a matter of keeping more in your bloodstream; just six hours after a 1,000 mg dose, the level in your blood is equivalent to having just taken a 125 mg dose. Spreading it out keeps the blood level up without forcing you to take even bigger doses. The first 1,000 mg jolt brings your relief; after that, keeping the blood levels up keeps the situation under control. If you can go with 200 mg every hour, great. . . But don't let is slip back into the pain/spasm zone, or you'll need another big hit to break the cycle. Take as big a hit as necessary, and then taper off to maintain. AGAIN: if you've had liver trouble, don't touch the stuff.

3. After your first 1,000 mg dose, get in the shower. Pour hot water on the spasming area. At the end of your shower, make the water hotter and hotter until you can't take it any more; turn off the water and towel off. (Do not cool off with cold water.) Immediately put some warm clothes on; think two sweatshirts, or leave a dry towel on your back under the sweatshirt. You want to keep the back muscles warm and relaxed. This will help a lot.

4. The ibuprofen in (2) is a short-term coping mechanism to get you time until your doctor's appointment. You gotta go to the doctor. The doctor will likely prescribe something for inflammation and something for spasms. The drugs prescribed will have much longer refractory periods than ibuprofen, so you won't need to bomb your liver with massive doses of ibuprofen to keep the spasms and pain under control.

5. Starting exercising the area; your doctor may prescribe physical therapy, but you should get to work even if you don't have a therapist. Light weights with exercises for the upper back and shoulder girdle are the thing. If you've been spasming freqeuently, the muscles in the area will have develpped improper firing patterns, as they're accustomed to dodging pain. The exercise keeps the juices flowing (good for healing) and helps the firing patterns return to normal. The strength will also improve your posture. Again, no heavy weights; use therapy weights, and go for a bit of a burn.

6. Items 1-5 are all about coping with episodes of spasming. Now fix the root cause. Do you have an underlying problem, like my discs? Maybe -- you have an older neck problem. Get that checked out. If the underlying cause is repetitive stress at the computer, fix your posture, fix your ergonomics, and learn to take frequent breaks. Stop the MOMENT you feel it coming on; do not work through it. The deeper you work into the pain, the longer it takes to recover; spasming is like a snowball you don't want to start rolling down the hill.

Lastly, read what I wrote hear about down time; this post was about carpal tunnel, but the same logic applies: http://forumserver.twoplustwo.com/showth...359#Post4045359

Good luck!
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