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Left shoulder blade pain for 2 years, still undiagnosed
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Left shoulder blade pain for 2 years, still undiagnosed

This pain started in February 2008. It was not caused by injury or accident. One morning while driving I noticed a pain in my left shoulder blade. It was a dull somewhat aching pain like I had slept wrong. However this pain never went away. Now some history of this pain. The pain is located on the side of the left shoulder blade. Sometimes the pain feels somewhat "underneath" the shoulder blade. The pain will also extend to between the shoulder blade and spine as well as up to the shoulder or down to the tip of the shoulder blade but always "feels" localized to the side or underneath the blade. Very seldom it will radiate to the front of the chest.

The pain is a constant dull ache with occasional "spikes" of sharp pain. The oddity of the pain is that I am for the most part unable to make the pain worse intentionally. Some movements, such as sitting down, and then arching my back forward and my head down will intensify the pain slightly. Pulling my left shoulder forward while leaning forward while breathing deeply will intensify the pain as well. However, sitting up straight will most of the time provide some relief. Deep breathing sitting up straight provides no pain. Over the last two years the pain has never become worse, it has always remained as explained above. On the 1-10 pain scale, the pain all the time is a 2-3 with the quick spikes being a 4-5. The pain doesn't interfere with regular activity, exercise, or lifting. Although after some activities (like painting) the pain seems to become aggravated, raising the dull aching pain to a 4-5 for a day or two. Range of motion is not affected and no normal movements, push ups, extending the arm ect do not make the pain worse.

This pain actually led me to quit smoking. I smoked on and off for about 8 years, at most 1 pack per day. However when I was smoking, smoking a cigarette in the morning would make the pain worse within a few minutes which led me to quit.

Dealing with this issue over the last two years has given me a certain level of anxiety as well, not knowing exactly what it is. Since February of 2008 I have seen multiple doctors. I saw my primary doctor who did a bi-lat chest xray as well as a back x-ray which were clear. She said muscular-skeletal issue and put me on ibprophen and muscle relaxers with no relief. Tried another doctor, another chest x-ray, clear. He then sent me off for an MRI. MRI of the cervical spine had to findings. Doctor suggested physical therapy. One session seemed to make the pain worse. I refereed myself to a spine specialist. The specialist sent me for another MRI of the thoracic spine. Results were all normal except he noted a "left renal cyst - likely simple" Again, left without answers, the specialist told me that he says this some sort of small muscle group within the back left shoulder blade that is muscular skeletal and that there really is nothing that could be done. Now 1.5 years into the issue with no real answers, I kept having anxiety about the pain and its cause, and of course the horror stories you read on the internet about back and shoulder pain could be lung cancer. The imaging center was offering free chest screenings so I went for one. The low dose, helical CT scan was normal. Radiologist only reported mild fatty liver, no suspicious nodules, and no adrenal gland issues.

Now that you know the history, my basic questions.

What is this pain and its cause? I have had 3 chest/back x-rays, 2 MRI's, and a Chest CT all with normal findings, yet I still freak out about cancer. I do suffer from mild OCD and sometimes think all these scans have missed something, or the tech's mixed up my results with someone else, is that possible?

My doctor keeps telling me that two years with a pain - if serious - would have developed into something something more by now. True?

Probably unrelated but I also suffer from constant clearing of my throat, and the feeling of having something stuck in the throat. Worse in the morning and after I eat.

Is there anything that I have not tried that I should?
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5 Comments
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351246_tn?1379685732
Hi
Welcome to the MedHelp forum!
Pain under the left shoulder blade is usually a referred pain from abdomen like stomach ulcers, pancreatitis, or from the chest like in heart attack, pericarditis, pleuritis, pneumonia, and pulmonary embolus. Pericarditis, pleuritis, pneumonia, lung cancer etc would have been caught on MRI and CT scan. Get pancreatic enzymes and liver function tests done too.
Well lung cancer is more or less ruled out. The symptom which you have and which used to become worse after smoking could be due to GERD or even hiatal hernia. These can cause pain under left shoulder blade. Apart from lung cancer acidity and ulcers are a common problem with smokers. This needs to be excluded by endoscopy. The simplest thing you could do is take Omeprazole which is a good drug to combat this. Along with it you can try over the counter antacids. A number of times a single drug does not help and you need to try a combination of acid reducing drugs along with antacid gels for complete relief. Avoid heavy meals and eat frequent small meals. Avoid too much of caffeine, tea, fried food and drinks both alcoholic and non alcoholic fuzzy ones. Avoid heavy exercises within 4 hours of a heavy meal. Raise the head end of the bed by pillows to 30 degrees. Go to bet at least 2 hours after food. Maybe these tips will help you. You should see a gastroenterologist (a specialist who looks after the diseases of our digestive system) or a physician for this if these tips reduce your symptoms.
Hope this helps. Please let me know if there is any thing else and do keep me posted. Take care!
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Avatar_m_tn
Thank you for the input. I do have a question. Does referred pain respond to movement? For instance, moving my back or arm in a certain way will make the pain hurt worse...would referred pain respond like that as well?
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351246_tn?1379685732
Hi
Welcome to the MedHelp forum!
Referred pain from inflammation of lining of lungs (pleurisy) can respond that way. It could also be a muscular pain or pain due to costochondritis (inflammation of the joint between rib and sternum. The inflammation around the joint area gives sharp pain on taking a breath. This can also cause tenderness on pressing the area which pains.
Pericarditis too causes referred pain that can become worse with movement.
Hope this helps. Please let me know if there is any thing else and do keep me posted. Take care!
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Avatar_m_tn
Hello, and thank you again for your input. I have been doing quite a bit of research over the last few days after finding some other people with some very similar symptoms. I have come across costovertebral inflammation and chronic rib pain or out of place rib. It seems that these conditions can also be difficult to diagnose as well as present on xrays or MRI. These two conditions also respond to heat therapy such as taking a hot shower (which in my case, taking a hot shower provides relief while in the shower). And finally these conditions also become worse on twisting or stretching movements.

I have also noted that sleeping sitting up seems to provide relief in the morning. Usually in the mornings the pain is not there but there is a noticeable (tightness) over and around the shoulder blade.

What do you think about this?
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Avatar_m_tn
A related discussion, left shoulder pain pain & anxiety was started.
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A related discussion, Left shoulder pain was started.
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