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Chronic Subscapular Pain
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Chronic Subscapular Pain

I am a 31 yo female that has been dealing with chronic subscapular pain for approximately ten years.  I have no history of injury but was a competitve gymnast and played collegiate volleyball.  Initially, the pain seemed to be in my neck but after some basic postural modification and discontinuation of certain activities it has localized subscapular (right side only) with some radiation into my right upper arm when it really flared up.  I had my first MRI in 2002 which was of my shoulder, not my neck (not too sure why it worked out that way).  I was told the MRI was normal and given an rx to PT.  I went to PT as directed w/ no relief.  I have been to a chiro, had accupuncture, massage, used ice and heat.  In late 2006 I saw another doc that recommened the postural changes (mentioned above) and dispensed cervical traction.  The pain continued to get worse so I had a C-spine MRI in 1/07.  I was told there was a lateral disc herniation at C6-7, otherwise not much to comment on.  At that point I was referred to Pain Managment and had my first injection in 4/07.  It did help although the pain did not totally subside.  Gradually it returned with a few additional symptoms.  Occasional numbness in both pinkies, pain with coughs and deep breaths and radiation to the lower rib cage.  I have taken Flexaril, Valium, Voltaren and Celebrex.  I have sat in cervical traction until it no longer makes a difference.  I have had multiple trigger point injections and two epidural steroid injections (most recent in Jan. 2008).  The second injection didn't help at all.  I had another MRI (cervical and thoracic) as well as a scoliosis series on plain film.  I don't have the official read but the basic summary is that there is nothing there...make an appointment with physical therapy.  Ironically, I have access to high quality healthcare but no one can seem to find a way to relieve the pain (I refuse all narcotics).  I have greatly modified my level of activity and try to avoid any lifting or long periods of bending.  However, my job is fairly physical and does require a certain amount lifting, bending, etc.  I have pain trying to clean house, trying to fold laundry, driving, flying on a plane, chopping vegetables, etc.  I can't simply sit on the couch and watch television.  I have to lie down.  I have gone from moderate activity to minimal activity (recently joined a gym to try to jog or cycle and sit in the sauna).  I would like to start a family but fear I will be unable to lift children to care for them.  I am very discouraged and depressed about this situation.  I have avoided writing on a message board like this because I don't want to sit around having a "pity party" for myself.  At this point I would appreciate any suggestions or advice, I just want my life back.
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Avatar_m_tn
have you had an emg to see where the nerve is injured or compressed...bone spurs often don't show up on an mri..sounds like you might need to see a neurosurgeon..get at least 2 opinions..good luck
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427845_tn?1204178030
Thank you for the comment.  The official MRI report mentions spurring at C5/C6 and a hypodense area in the vertebral body of T1.  Ironically, I am married to a neurosurgeon.  The MRI was ordered and read by a colleague.  I agree with you about the EMG, however, it has not been mentioned as an option at any of my appointments.  I did have a deep tissue massage that relieved my pain for approximately 48 hours.  Any thoughts on Myofascial Release?
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Avatar_n_tn
I have exactly the same story, on my left side. It ended my wrestling career at 25. I'm now 39 and have been dealing with this all these years.  I've had the MRI, cortisone, traction, chiropractic etc. The docs say I have a compressed nerve at C6-7 but I'm not convinced.  I have found limited relief from self myofascial release. I use a tennis ball to work the knots out of the muscles that spasm. I use some stretches and release strategies from a book - The Art of Body Maintenance: Winners' Guide to Pain Relief by Blatman. It is simply written so you can skip much of it and go directly to the massage and stretching exercises. This has allowed me to participate in Judo (not completely w/o pain - and not in competition).  I am thinking of going to a Myofascial  specialist. Good luck -
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Avatar_n_tn
I have had TOS(thoracic outlet syndrom (syndrome)) for about 5 years now. My back and neck would lock up and i would get referred pain to my shoulder, ticep, and numbness and tingling in my fingers/hand. I think it is a similar problem. I fixed my posture and stretched every muscle in my body like mad every day for about 3 months. I finally am pain free. From what i read TOS is a life-long problem and i still get occasional stiff muscles when i wake up but a little stretching puts me back on track.
   I would recommend some rolfing. Rolfing also known as structural integration is deep tissue work(painfull) but effective, its aim is to rebalance the soft tissues and boes. I just remember that when you are in pain, a little more pain is well worth the relief. Thats my two cents

Good luck
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Avatar_n_tn
you may want to consider a subscapular cortisone injection, pain and inflammation in this area can produce numbness in your 5th digit and can cause pain along the scapula and up into the neck
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Avatar_f_tn
I think looking into TOS is a good idea.  Have you seen a chiropractor?  I had MRI of Thoracic spine one year ago, showed nothing.  Saw chiropractor, and now am in alignment and had another MRI of T-spine showing compression of my cord.  I toally believe it was there last year, but wasn't able to be seen.  Best of luck to you.
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Avatar_m_tn
I have trouble with back pain that has settled in my subscapular region lately. Help me please?
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Avatar_f_tn
I have had a subscapular pain for about 6 months.  I was seeing a chiropractor from November to April and he couldn't 'fix' my shoulder pain.  After getting into the world of Orthopedic doctors, I've had 3 MRIs (upper spine, scapula area and shouler), X-rays, CT Scan (upper and lower to check for referred pain) have all turned up negative for anything unusual.  (*they said that problems with the spleen and I think another organ can have referred pain in the upper left shoulder*).  I've been through Physical Therapy, had a nerve study done by a Neurologist and a Bursa Sac injection of Cortizone by a radiologist.  I've also had a bunch of other cortizone shots into trigger points by an orthopedic doctor.  I'm currently on my second doctor and visisted the ER a week and a half ago because the pain was so bad when I took a breath and it felt like someone was stabbing me in the back with a knife.  I get numbness and tingling in my hand and fingers and shooting pain down my elbow/arm.


I had a Bone Scan done last week and will talk with my DR tomorrow morning...if that turns up nothing, I'm going to talk to him about scapulothoracic bursectomy (http://www.ncbi.nlm.nih.gov/pubmed/11845154) I saw a posting on a forum (http://forums.wrongdiagnosis.com/showthread.php?t=11853) look for the posting by Unregistered Guest who posts about a surgery that they had.

I hope that helps someone.  If you have anything to share with me please let me know!
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Avatar_m_tn
I also have  similar problem to what SWEETHOME HAS, I am an orthopaedic surgeon, If there is no injury or electrical shock then you have to differentiate between muscular or vascular pain, other one is thoracic outlet syndrome which is common is females.Shooting pain, radiating pain, Muscle cramps, numbness of forearm n fingers are the symptoms.Inability to sleep in right lateral position is most disgusting n uncomfortable thing associated with it. I underwent series of investigations but all normal. I had been suffering since 6yrs. I took exercises, ( no alterations in daily activities) streching and neck exercises along with muscle relaxants at night, it did wonders. Try it, it will definately work, But pain in left forearm means cardiac pain referring to forearm, for pain in left forearm consult a cardiologist.
Mail me if it worked. Do let me know even if it didnt work --  ***@****
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Avatar_m_tn
Thank you all for sharing these insights.  I have had a hard time trying to pinpoint my chronic neck and back problems and would love someones opinions on what to do next.  In 2005 I injured my neck and had generalized neck pain on one side with some minor parasthesia down my right arm.  An MRI showed narrowing in the C5-6 and 6-7 space but nothing conclusive.  5 years later, I am now 32, after losing a few pounds, regular cardio, chiro, acupuncture, regular yoga, strength training, and anti-inflammatories, I can usually abate all the symptoms but they are becoming less managable.  I have almost a permanent spasm in my upper trapezius and almost permanent scalene tightness. Only after finding a genius deep tissue masseuse, can he "unlock" the supscapularis which in releases everything else.  I work in healthcare and am terrified of surgery.  What would some of you suggest?  I've heard great things about rolfing but haven't found a local practitioner yet.
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Avatar_m_tn
Just to add one more thing, I am a recently diagnosed and treated hashimotos thyroiditis patient, and now am taking synthroid that has abated all symptoms.

I've read that chronic localized inflammation near the thyroid can trigger this autoimmune problem.  Anyone with these problems have anything related happen?  thanks!
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