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5648368 tn?1371624264

Shoulder Blade Pain and Trigger Point Injections

Following a trigger point injection over two months ago of lidocaine and Markane that did not improve the muscle pain and spasms in my shoulder, neck and back, I was left with a painful knot that I can physically feel under my skin at the point of injection in my upper back just under my right shoulder blade.  Prior to the injection, I could barely raise my right arm up four inches without increasing severe pain that feels like heavy numbness to the point of feeling paralyzed and painful spasms at the same time.  Although the existing pain in my right shoulder, neck and back increased substantially following the injection (as the pain always does, especially right at the point of injection), my pain level has returned to the regular 5 to 7 on a scale of 1 to 10.  My question is related to the knot formed at the trigger point injection site and what I can do about it.  That time it was different because when the Physicians Assistant injected me there, it was the first time I'd received a trigger point injection and I felt the needle inserted into the muscle, then pulled back, angled differently and reinserted again in an agonizingly painful manner.  While trying to find out what happened to me and potentially find some relief, three different doctors (pain mgmt., rheumatologist and internist) have said they'd never heard of this situation (i.e., my lingering pain at the point of injection so long after the occurrence).  I would like to know if there is anything I can do to help myself and whether or not my lungs could be involved?  In my quest to find a cure/treatment and improve the quality of my, I have been diagnosed with fibromyalgia, myofascial pain syndrome and degenerative disk disease of the cervical and lumbar spine (although the doctor indicated that this condition is minimal and not uncommon for 52 year old women), and most recently moderate Lupus.  Between the fatigue, depression, countless sleepless nights spent with never-ending pain and muscle spasms that ebb and flare with no rhyme or reason one day to the next, I am at my wits end to to find some relief very soon.  Until recently my pain medication cocktail consisted of twice daily doses of Tramadol, Neurontin, Baclofen, Vicodin, and the most recently added Plaquenil, all of which were not helping much and often to the point of uselessness.  Due to stomach cramping, diarrhea and nausea, I was instructed today to discontinue the baclofen and Plaquenil and add Cymbalta.   I am very interested in finding out if there is anything I can do to relieve this pain?
2 Responses
351246 tn?1379682132
I am sorry to hear about your situation. You could ask your doctor about patches of pain relief medications which you can apply on skin and which can bypass the stomach and hence the side effects due to it. Along with pain killers, you can also look for alternative therapies. Manual therapy, hydrotherapy, exercises can all help reduce pain.

The lump you feel could be muscles bunched up due to pain or damaged subcutaneous tissue or damaged fat. An ultrasound or ct may be able to diagnose the lump. Do discuss this with your doctor and get yourself examined. Take care!

The medical advice given should not be considered a substitute for medical care provided by a doctor who can examine you. The advice may not be completely correct for you as the doctor cannot examine you and does not know your complete medical history. Hence this reply to your post should only be considered as a guiding line and you must consult your doctor at the earliest for your medical problem.
5648368 tn?1371624264
Thank you very much! I will explore your suggestions in search of pain relief. I appreciate your help...
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