Chronic neck pain after using 2 arms not 1 (Ask me anything!)

Ask me anything (AMA) or tell me what you think it is? Beyond frustrated trying to deal with the chronic pain. Thanks!

Summary: 36yo male, desk job, decent posture and exercise technique

Symptoms:

• Chronic neck pain/ shoulder pain when performing any overhead or lateral arm exercise with both arms (but not just when using one arm) or any "push" (eccentric) exercise with both hands.
• Pain even comes in when I do very light overhead movements (2lbs dumbbell overhead press, putting arms outstretched at chest height or above in opposite directions).

Description of pain:

• Pain is delayed - will appear a day later and last for 2 days and i cannot "switch" the pain off completely once it comes in. Sometimes the pain does not come in at all - cannot detect a pattern.
• Pain feels like a deep ache. At it worst, the pain becomes sharper and deeper and i cannot move the neck beyond 30 degrees.
• Pain ranges from 5 to 8/10 (sometimes need to medicate instantly. Pain can get to the point where even looking at the phone intensifies it.
• Not a shooting pain

Hypothesis: Upper cross syndrome. Smudged neural mapping where the neck/ shoulder is being recruited to perform movement, instead of the bigger muscles. Thoracic outside syndrome (TOS)

Imaging: MRIs and CT scans- Small bulge left C5-6, some narrowing L4-5 left; no obvious evidence of nerve impingement. No rotator cuff injuries.

Other possibly relevant info: Extremely tight hamstrings, extremely tight muscles in general (stretching/ yoga feels like torture)

Treatments:

• Surgery administer paravertebral block, peripheral nerve block, intra-articular shoulder injections, platelet rich plasma
• Dry needling
• Osteopathy manipulations
• Physical therapy
• Stretching

Current symptoms:

Current triggers:

• Working out at the gym (doing v light exercises)
• Using handphone while seated in toilet or first thing in the morning
• Forced stretching (e.g. by a physiotherapist)
• Bad pillows
• Tight t-shirts
• Two handed overhead movements
• Lack of sleep

• Any two-handed exercises that “push” away from the body (eccentric exercises)
• using exercise bands overhead or laterally with both hands at the same time

Current ways to soothe pain (nothing ever works completely)

• Avoid all shoulder, trap and overhead exercises
• Neck support brace
• medication: Arcoxia, Anarex, Lyrica 75mg, Clonotril 0.5mg, Venlafaxine 75mg and Celebrex 200mg

• Sleeping/ lying down
• Stretches; (Prayer Stretch, Standing chin tuck against wall)
• Foam rolling
+ Pain relief gel (Volatren)
• Doing heavy bicep curls
• Heat (hot showers, sauna)

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