Mystery pain in shoulder, shoulder blade and arm

[kelsey_t]

I am a 21 year-old female.  I am active and not over-weight.  I played softball and volleyball in the past, and I run.  In May of this year I started noticing an odd hot/cold pain in my left shoulder blade (I am right-handed) that would come and go at random times.  Then it started being consistent.  The pain traveled up to the top of my shoulder and my neck and sometimes down my arm. A little background: I can pop my shoulder in and out of place by myself with no pain.  I could do that since I was little.    
During summer, (June and July) I had x-rays and an MRI done of my neck.  The doctors thought I could have something on my spine by my neck causing the pain to travel down. They didn't find anything wrong so they tried steroids one week, didn't work, and then muscle relaxers the next and that didn't either.  I was on my own from there once again.
The pain subsided all through August but started up again in mid-September.  Most of the pain is located in my shoulder/rotator cuff area (and front part of the shoulder.)  It sometimes burns or stings.  Tingles go to my fingers sometimes and to my neck, which is why I figured part of the problem was with my nerve pinching.  I was sitting one day on the couch and out of nowhere it started hurting, and to the point of me wanting to go to the ER.  A lot of the pain goes to my shoulder blade again and sometimes under my arm and my ribs.  It’s hard to take breaths when the pain goes there.  It hurts to type, run, and cook, basically everything.
Now I went to an OFC and he said I have a lot of ‘instability’ in my shoulder.  I meet with a physical therapist once a week to get exercises I do the rest of the week.  The smallest exercises hurt and make my shoulder burn.  I’m on Trama-dol and Tylenol for pain, although I don’t want to take it every day.  Ice only helps at certain times, but not all the time.  My physical therapist thinks it’s something else besides instability.  How could an active 21 year-old female be that weak?  I shouldn't be this young and in so much pain constantly.  I want a diagnosis and I’m getting sick of no answers.  Someone please help or give me an opinion!!  Thank you :)

[kelsey_t]

Thank you for your answer!  I will definitely bring this up to my doctor.  Any type of answer or lead at this point is highly helpful.  :)

[Dr. Kokil Mathur]

Hi!
What you have is probably Scalene Myofascial Pain Syndrome. When scalene muscle is the cause of pain, the pain is referred from neck to (either all or a combination of) chest, inner lining of scapula (shoulder bone), shoulder, posterior and lateral sides of the arm right up to the thumb and index finger. When this muscle shortens, this can press on brachial plexus (bundle of nerves and blood vessels in the armpit) and the subclavian artery and can compress or irritate these structures and cause symptoms such as abnormal sensation, cold extremity, spasms of pain, and lymphedema (swelling of lymph channels causing swelling of arm or leg), burning, tingling etc in the involved extremity. Treatment is by physiotherapy that involves indentifying the trigger points, and massaging them, and other exercises to relieve the muscle tension. Do discuss this with your doctor and get yourself examined. Take care!