Pain Between the Left Shoulder Blade and Spine: Causes and Solutions

Pain between the left shoulder blade and the spine?

Hello, Doctor:
Pain location: Pain is located in the area between the left scapula and the spine (like a "point," not a widespread pain).

Duration of pain: One year (the symptoms have remained the same for this year).

Nature of pain: Approximately 6-7 episodes of sudden sharp pain occur throughout the day, lasting about 10-30 minutes before subsiding.

Other symptoms:
1.
Recently, I have been more prone to waking up with a stiff neck; when I turn my head suddenly without warming up, I feel a clicking sensation at the junction of the cervical and thoracic spine.

2.
Even when the pain occurs suddenly, I can still move freely, engage in weight training, and stretch without issue.

3.
During painful episodes, pressing on the painful area does not relieve the discomfort, but rolling my back on a tennis ball does not increase the pain either.

4.
Mild spinal curvature (thoracic spine protruding to the left).

5.
No numbness in hands or feet.

6.
No pain at night.

I would like to ask the doctor: Is it possible that there is a herniated disc, bone spur, or neuropathy? I have seen several doctors; some mentioned inflammation at the junction of the scapula and ribs, one suggested adhesions, and another indicated poor posture of the neck muscles.
However, I have been consciously maintaining good posture by keeping my chest up and chin tucked for the past year, but there has been no improvement.
What should I do? Do I need to get an MRI? Thank you, Doctor.

Yuanhua, 30~39 year old female. Ask Date: 2016/11/29

Dr. Shi Guozheng reply Orthopedics

It is advisable to consult a physician for shoulder and neck pain to determine whether further examinations are necessary.

Reply Date: 2016/11/29

More Info

Understanding pain between the left shoulder blade and spine can be quite complex, especially when the symptoms have persisted for a year without significant improvement. Based on your description, it seems that you are experiencing intermittent sharp pain localized between the left shoulder blade and the spine, which occurs several times a day and lasts for about 10 to 30 minutes. Additionally, you mentioned that you have recently been experiencing stiffness in your neck, particularly when turning your head suddenly, and that you have a slight spinal curvature.

Possible Causes of Your Pain
1. Muscle Strain or Overuse: Given that you are able to perform weight training and stretching without significant discomfort, it is possible that the pain is related to muscle strain or overuse, particularly in the muscles surrounding the shoulder blade and upper back. Poor posture during activities can exacerbate muscle tension and lead to localized pain.

2. Referred Pain: Sometimes, pain in the shoulder blade area can be referred from other structures, such as the cervical spine or thoracic spine. Conditions like cervical disc herniation or degenerative disc disease can cause referred pain that manifests in the shoulder blade region.

3. Nerve Impingement: Although you mentioned that you do not experience numbness or tingling in your arms or legs, it is still possible that there is some degree of nerve impingement occurring in the cervical or thoracic spine that could be contributing to your pain.

4. Costovertebral or Costotransverse Joint Dysfunction: The joints where the ribs attach to the spine can sometimes become irritated or inflamed, leading to localized pain in the shoulder blade area.

5. Postural Issues: You noted that you have been trying to maintain good posture by keeping your chest up and chin tucked. However, if this is not done correctly, it can lead to muscle imbalances and discomfort.

Recommendations for Management
1. Physical Therapy: Engaging in a structured physical therapy program could be beneficial. A physical therapist can assess your posture, muscle strength, and flexibility, and develop a tailored exercise program to address any imbalances or weaknesses.

2. Postural Training: Continue to focus on maintaining good posture, but also consider incorporating exercises that strengthen the muscles of the upper back and improve shoulder blade stability. Exercises such as rows, scapular squeezes, and thoracic extensions can be helpful.

3. Heat and Cold Therapy: Applying heat to the affected area can help relax tense muscles, while cold therapy can reduce inflammation if there is any swelling.

4. Ergonomic Adjustments: If you spend a lot of time sitting, ensure that your workstation is ergonomically set up to reduce strain on your neck and back. This includes having your computer screen at eye level and using a chair that supports your lower back.

5. MRI Consideration: Given that your symptoms have persisted for a year without improvement, it may be worthwhile to consider an MRI of the cervical and thoracic spine. This imaging can help rule out any structural issues such as herniated discs or other abnormalities that may be contributing to your pain.

6. Consultation with Specialists: If your symptoms do not improve with conservative management, consider seeking a second opinion from a spine specialist or a neurologist. They can provide further evaluation and determine if there are any underlying conditions that require more specific treatment.

Conclusion
In summary, while your symptoms could be related to muscle strain, postural issues, or nerve impingement, a thorough evaluation by a healthcare professional is essential to determine the exact cause of your pain. Engaging in physical therapy, maintaining good posture, and considering imaging studies like an MRI can help you find relief and improve your quality of life. Remember to listen to your body and avoid activities that exacerbate your pain.

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