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Arthritis  (Expert Forum)
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left shoulder/shoulder blade pain
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD Boston - MA
This forum is for questions and support regarding arthritis issues such as: Arthritis, Autoimmune Disease, Bursitis, Fibromyalgia, Gout, Juvenile Rheumatoid Arthritis, Lupus, Myositis, Neuralgia, Osteoarthritis, Polymyalgia Rheumatica, Rheumatoid Arthritis, Sciatica, Tendinitis, Vasculitis.
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MedHelp Member's Question

left shoulder/shoulder blade pain

by terri456, Mar 24, 2005 12:00AM
about 1 year ago, i started experiencing pain that started beside/behind left shoulder blade. arthrogram showed tear in the supraspinitis tendon in upper left shoulder. a surgeon told me it was not worth repairing and to try physical therapy. it only made the pain worse. i have since developed pain in entire left side, including the shoulder (which produces a "popping" or grinding sound when rotated), extreme pain (burning sensation) on the inside of left shoulder blade about halfway down, muscle spasms in neck and collarbone and increasingly bad headaches.  spinal mri's all show mild degenerative disc disease but nothing significant enough for this to be spine related. myelogram and bone scan both came back normal. i have tried every kind of anti-inflammatory known with no relief. pain meds help relieve severe pain but i know it is only masking the problem. i have questioned doctors if this is related to rotator cuff disease, brought on by the torn supraspinitis tendon going unrepaired, but they look at me like i'm crazy or something. it is possible that i have developed more tears in rotator cuff. please note that there was no known injury to the shoulder, but has gotten increasingly worse over time.  PLEASE HELP!
Doctor's Answer

by Kevin Pho, MD, Mar 27, 2005 12:00AM
You have had a pretty comprehensive evaluation, including bone scans, MRIs and myelograms.  With the MRI scans it would be unlikely that more tears on the rotator cuff would be missed.



When it comes to chronic pain, there are a couple of options.  The first would be to obtain several opinions - i.e. from other orthopedic surgeon - to ensure that there is indeed no surgical options.



If that has been done, I would consider a referral to a pain management specialist.  If anti-inflammatories don't help, I would consider other modalities (i.e. other classes of pain medications) that can help manage the discomfort.



Followup with your personal physician is essential.



This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.



Kevin, M.D.

Medical Weblog:

kevinmd_b
Member Comments (40)

by terri456, Mar 24, 2005 12:00AM
this is terri456 again. just wanted to add that i also get pain in left forearm and it feels as if i have developed tendonitis in my left elbow. had emg done about a month ago, and it came back normal too.  these doctors make me feel like i'm crazy!

by Christie2004, Mar 27, 2005 12:00AM
I'd like to know the answer, too!



I have had shoulder tendonitis for years!  It waxes and wanes, but there is never a minute when I am not in pain.  Like you, anti-inflammatories don't help much and tear up my stomach.  I don't take narcotics--I don't want to go down that road.



Icing the shoulder 4 times a day for 20-30 minutes seems the most helpful thing, and simply resting it as much as possible when it is bad.  Heat feels good, but can make tendonitis worse.



No injury or tear shows up on tests, and they look at me like I am crazy, too--like it can't hurt THAT bad...



But it does.

by terri456, Mar 27, 2005 12:00AM
To: kevin md
but my question remains- what is causing the popping in my shoulder and the burning sensation under the shoulder blade?  also, would simple ultrasound show if any additional tears have developed since arthrogram was done (that was about 5 monthes ago)? the arthrogram only showed what was wrong with my upper shoulder, not what the problem was in my shoulder blade. the best way to describe it is as if i'm being stabbed or poked in that area of my back (its quite constant). if i put my hand down by my shoulder blade and pull upwards, i can feel a bump, as if the tissue (muscle) is rubbing over something swollen. a few monthes ago i was given cortisone injections (2 on different occasions) in that same spot that hurts by the shoulder blade. is it possible that a tendon was ruptured? so many questions it seems noone can answer. thanks for helping me. i am going to see another surgeon tomorrow, but so far my track record with doctors has not been very good. starting to get very discouraged to say the least.

by CEW1, May 11, 2005 12:00AM
Hello,  I have been experiencing pain on the left side of my neck, at the edge of my left shoulder blade, left shoulder, left elbow area, and left wrist for 10 yrs.  



I had a cortisone injection at c4 that provided no results in addition to cortisone injections in my shoulder blade bursa, shoulder, and elbow.  I have had MRI work done of the shoulder and it showed no problems.  Neck MRI showed some broad based disc protrusions at C4-5 producing minimal indentation of the thecal sac but no compression of the cord or encroachment upon the lateral recesses or the nerve roots. Does this mean the problem does not stem from here?



Has anyone had similiar pain and found relief with injections at C4-5, C5-6 or alternative methods?



Thanks for any advice.

by cakestar, Jun 12, 2005 12:00AM
I have the EXACT same symptoms you describe, only on my right side. It is very painful, and causes a lot of headaches also. Doctors seem baffled, and If I am in too much pain, ER docs dont want to seem to help me. I am not afraid to take narcotics, as it is the only thing that gets me through my day, and allows me to work on a daily basis. It is very frustrating I know, when doctors dont seem to know whats going on. I actually had one doctor ask me what I wanted him to do. Isn't that why I pay them, so they can tell ME what to do. Sometimes I feel like I ave more knowledge and curiosity about things than they do. I should have been a doctor. I hope we can both get a solution to our problem soon.

by terri456, Jun 12, 2005 12:00AM
sorry to hear about anyone else who experiences what i do but glad to know im not alone on this. have seen so many doctors i'm sick of them. like you, they ask me what should be done or if the diagnosis they give me sounds good to me! we live in a modern medical society and you would think it's the dark ages. every doctor i have seen (6 to date) has a different opinion. i've been told i have tendonitis, bursitis, arthritis, rsd, myofascial muscle pain, and that i'm simply making this up to get prescription meds.  Don't want their damn meds, just answers!  since my last posting the pain has become almost debilatating at times. i'm now also experiencing pain in my lower back and my right shoulder has started to hurt and pop just like my left. it's as if the pain is starting to spread throughout my entire back.  surgeons keep telling me theres nothing they can do, and a pain management doctor wanted me to take morphine every day and got mad when i refused it. can't exactly function on a daily basis doped up on morphine!  tried doing cortisone shots in left shoulder/shoulder blade region with absolutely no results.  my pcp has even told me ther's nothing more he will do for me! thanks for letting me vent and hope to hear from others who can provide us with any answers!

by DLMoore, Jun 13, 2005 12:00AM
In the last two years, I have experienced muscle spasms & severe burning pain in my left shoulder & neck. I could not reach into the medicine cabinet. I have seen a Chiropractor, 2 Orthopaedic Surgeons, 2 Neurologists, 1 Radiologist, 1 Physiatrist & 3 Physical Therapists. In the last year I have had 2 MRIs (one of the cervical spine showing moderate disc bulge at C5-6; the other of the shoulder, showing mild tendinitis), 3 EMGs (first one came back moderate-severe carpal tunnel in both wrists, second & third came back normal), 1 CT guided cervical steroid epidural (helped with the severe burning pain