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My current health condition 3: nerves

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I’ve been to see a physiotherapist/sports medicine specialist, on the advice of a couple of people, and I’m happy with the result. It won’t mean an immediate cure, but the session has provided me with hope and a pathway to recovery.

Today and yesterday, the pain has been fairly minimal, after an excess of pain the day before. It seems to be about managing the medication.
So, to the physio. I described my situation in minute detail, describing as best I could the type of pain I felt, its sudden onset, how it responds to head movements and so forth. He very quickly conjectured that it was a nerve problem, which in fact had been my first intuition before I began researching the problem. He described the ‘queerness’ of nerve injury, or nerve impingement as it’s often termed – how damage in one place can be felt in another seemingly unrelated region. Interestingly, it was my description of how, since this condition has struck me, I’ve had difficulty moving my head back (this causing my shoulder pain to increase), and so not being able to gargle with mouthwash – which I do because of my bronchiectasis – it was this description which made him feel more certain that it was a nerve problem. He could be wrong but I think he’s right.

He did a lot of physical manipulation of the shoulder region and gave me advice. Keep up the medication, maintain activity of the shoulder and arm regions – not too much but not too little – and keep the area warm. He gave me some shoulder exercises to do, and assured me things would come good in time. I’ll revisit him next week.
Now, on this concept of impingement. It’s a term that comes up in the literature, and it was used by the physiotherapist today, so I asked him about it. He obliged by giving an explanation that was complex and difficult to follow, much like the material I’ve been reading online about the subject. So I’ll have a go at explaining it to myself.
Nerve impingement is one term among many (e.g pinched nerve, nerve compression, nerve entrapment), which indicates the trickiness of the condition and its description. In my case the suprascapular nerve is probably involved. As Wikipedia puts it ‘the nerve passes across the posterior triangle of the neck parallel to the inferior belly of the omohyoid muscle and deep to the trapezius muscle.’ I don’t know exactly what this means, but it seems to explain the pain at the back of my neck, left side, when I throw my head back.

The posterior triangle of the neck is a technical term with its own Wikipedia page. Here’s an image of it. As can be seen, it connects the omohyoid muscle and the massive trapezius which goes well down the back.
So nerve impingement/compression/entrapment is what it implies – something is impinging on the nerve, entrapping it, compressing it, pinching it. It could be bones, muscles, tendons, ligaments, cartilege, and that just about exhausts the possibilities. Carpal tunnel syndrome, for example, generally involves a pinched nerve in the wrist. The causes of course, are various. It could be a particular injury – but I can’t trace my own sudden onset to a particular injury (which doesn’t mean that no injury occurred) – or physical stress from repetitive work or sports activity, or some rheumatoid problem (which presumably would’ve shown up as some sign of inflammation, and I’ve never shown any signs of rheumatism) – or obesity.

The possibility that this was caused by lawn bowling remains real, if remote. Fascinatingly, when I told the physiotherapist that the only sports activity I’d taken up in recent times was lawn bowling, he asked me if I played at Walkerville – it turns out that he recognised me as he played in the competitions there too – out team had thrashed his only a few weeks ago! He agreed that bowling as a cause seemed unlikely – but being a bowler himself, he would say that, wouldn’t he?

But whatever the cause – and I won’t be bowling again for a while, if ever – the diagnosis and cure are the things, and it’s amazing what a seemingly effective diagnosis can do to calm the – nerves! I feel I can cope much better now, and I’ve had the humbling experience of knowing what severe pain is like. This is important as I’ve tended to be dismissive of the pain of others, with thoughts of ‘low pain threshold’ and ‘get over it’. So, it’s a lesson.

I’ll be returning to the physiotherapist next week, hopefully for the last time. His feeling was that just one more session would be enough, that if I simply followed the light exercise regime he suggested, things would come good. The pain has risen and fallen since then, but there’s been no relapse into anything agonising. I worked at Eynesbury yesterday, a relief day, but hopefully there won’t be any work for a while. In any case Covid-19 means we probably won’t be getting many, if any, students coming in from overseas over the next few months.

Of course, it’s not all back to normal, though I’ll try to get back to regular reading, writing and the like. Here’s a final quote from the Mayo Clinic on my situation:

If a nerve is pinched for only a short time, there’s usually no permanent damage. Once the pressure is relieved, nerve function returns to normal. However, if the pressure continues, chronic pain and permanent nerve damage can occur.

We’ll have to wait and see.

References

https://www.mayoclinic.org/diseases-conditions/pinched-nerve/symptoms-causes/syc-20354746

https://www.healthline.com/health/nerve-compression-syndrome

https://orthoinfo.aaos.org/en/diseases–conditions/cervical-radiculopathy-pinched-nerve/

https://en.wikipedia.org/wiki/Suprascapular_nerve

Written by stewart henderson

March 18, 2020 at 2:02 pm