About a month ago I had a slight twinge in my shoulder one Saturday evening. I’d been doing my usual crewing of hot air balloons during the week and while some of it was a little more strenuous than normal, there hadn’t been any moments of pain or recognisable “oh shit” moments. Not until I was sitting at the computer, chatting on Skype with Steve, my co-host in the Plane Crazy Down Under podcast. I reached back to get my beer off a table beside & behind me but, becau&se I was chatting into the microphone in front of me, I didn’t turn my upper body.
That, I think, was when I felt the slight strain, almost like stretching a muscle after exercise. Gentle, no twinge, just a bit of resistance.
By a few hours later, it was rather sore and by Sunday morning it was all locked up & painful. On Sunday arvo I was applying heat creams and a friend of ours who does sports massage came over and worked up my shoulder. I could barely get on the massage table let alone turn myself over.
We figured I’d over-exerted myself and my muscles & tendons were registering their protest. I was only getting a few hours of sleep at a time on Sunday night and the pain was as bad (if not worse) on Monday morning, so I started taking some Ibuprofen & pain killers to see if that would make things bearable while my arm sorted itself out.
On Tuesday, I made an appointment with the doc as things just weren’t getting better. The lady I saw thought it was my tendons, put me on Voltaren and sent me for ultrasounds. She wanted to check that there weren’t any tears. The ultrasound revealed bursistis in the shoulder area (inflammation) and fluid in the sheathes around the tendons. Yup, nasty, but not a surgical situation. Whew!
A few days later I called the doc as the images & report should have been in. Reception told me she’d read them and marked my case as closed ‘cos it’d be fine within a few days. Erm, no, pain persisting and in some areas getting worse. I came back and wound up seeing a different doctor who examined me and asked “What’s this lump here?” pointing at the spot where my clavicle meets my sternum.
It takes me a few days to get scheduled (maybe I was kidding myself it would settle down of its own accord? :) but then I’m back for more ultrasounds & x-rays of that spot. This time the radiologist said “Don’t wait a few days for the results to go by courier, take them now and go see your doc again ASAP.” She said she thought I might have popped my clavicle out of its joint with the sternum. Yup, that makes you feel a LOT better, doesn’t it? :)
The next day the doc took a look at the results and immediately sent me off for a CT Scan. Later that afternoon I was having my first ever CT Scan and got to see seven sheets of little images that all said I had a real issue, apparently :)
Back with my doc and the assessment is that while I’ve not dislocated or fractured anything in there, the left sterno-clavicular joint has expanded and the surrounding tissues are swollen. She finds a good orthopaedic surgeon who specialises in shoulders and writes me a referral. I call the clinic and am told they’re booked out until September but can take urgent cases by the end of August (I was calling in early August). The lady gets me to work through what happened, where I’m at and what movement/pain I’m experiencing. On hearing the news, she double books me for the next week and tells me to come with lots of reading material as I may be waiting a while.
The day comes and I’m in reasonably quickly. The surgeon checks it all out, runs me through the what/how/etc and sends me for blood tests. We meet again two days later and he confirms the likely diagnosis:
Costochondritis / Tietze Syndrome
Costchondritis is where the rib/sternum joints get inflamed and swell, causing localised sore spots and some pain. The Tietze Syndrome is associated with it and leads to referred pain through the nerves, typically around the chest wall and into the arm. This can often lead to reports of pain similar to angina/heart attack. Charming.
In my case the costochondritis is in the clavicle joint and top one or two ribs. It was probably brought on through a series of micro-traumas built up over time (eg: from crewing/flying hot air balloons (packing away especially), lifting stuff and generally over doing it a few times). As a result of this I’m getting pain under my shoulder blade, in the front of my chest, up into my neck, across the top of my shoulder and down my arm – all on the left side.
Coughing, sneezing and yawning can lead to rather intense pain in those areas while moving the arm feels similar to when your muscles are protesting after a hard workout. If I try to do anything against resistance (eg: lift the shopping, pull/push a door, change gears in the car, etc) then pain can be experienced too, often associated with a “nerve tingle” and/or numbness immediately afterwards.
Not pleasant at all :(
The only real solution is rest and not aggravating things by doing any lifting. As such, I’m grounded from any form of ballooning for three months or so. Not happy about that at all! :(
We’re trialling some new anti-inflammatories and I’m off the pain killers as we see where things are at. So far, not good. The pills are helping a bit but not doing a lot for removing the pain when I move my arm, etc. Will have to check with the surgeon re: taking other pills as well (would prefer not to), using a sling, etc.
This sort of thing is all very new for me as I’m normally a pretty active person and enjoy running around being involved in lots of things, doing IT work and being outside working with aviation. I’m now coming to grips with the fact that even just sitting at the computer all day is painful, let alone travelling into the city to an office. As to flying, the surgeon’s asked me to wait a while before I try going off flying fixed wing with friends (let alone aerobatics) and I shouldn’t contemplate setting up or packing up a balloon until this has all cleared up.
Watch this space for more news as things develop.