Nerve-Related Symptoms: Itchy, Numb, and Painful Left Shoulder Blade

Itching, numbness, and pain in the left scapula?

Hello Doctor, I have been experiencing a tingling sensation near my left scapula for some time.
It later developed into itching, and when I scratch it, I notice that there is little sensation in the scapula itself, only a feeling of numbness.
Over the past two weeks, in addition to the itching, I have also experienced intermittent sharp pain, which lasts for varying durations—sometimes as short as 1 to 2 minutes, and other times up to around 10 minutes.
Initially, I sought help from a dermatologist due to the itching, but they ruled out any skin issues.
I would like to know what might be causing these symptoms, as the overall duration of this condition has been about three weeks.
Thank you.

Niming, 20~29 year old female. Ask Date: 2021/02/21

Dr. Cai Zongzhang reply Neurology

It is recommended to visit the neurology outpatient clinic for an examination.

Reply Date: 2021/02/21

More Info

The symptoms you are experiencing around your left shoulder blade—tingling, itching, numbness, and intermittent sharp pain—are indicative of a potential nerve-related issue. Given that you have already ruled out skin conditions with a dermatologist, it is essential to consider the possibility of nerve compression or irritation, which can manifest in various ways, including the sensations you described.

Possible Causes of Your Symptoms
1. Nerve Compression: The symptoms you describe could be due to compression of the nerves that innervate the shoulder and upper back area. This can occur due to various reasons, such as poor posture, muscle tension, or even a herniated disc in the cervical spine that may be affecting the nerve roots.

2. Cervical Radiculopathy: This condition occurs when a nerve in the neck is compressed or irritated, leading to pain, tingling, or numbness that can radiate down the arm or into the shoulder blade area. Given your symptoms, it would be prudent to consider this as a potential diagnosis.

3. Thoracic Outlet Syndrome: This syndrome involves compression of the nerves or blood vessels between the collarbone and the first rib, which can lead to similar symptoms in the shoulder and arm.

4. Peripheral Neuropathy: Although less common in the absence of other systemic symptoms, peripheral neuropathy can cause tingling and numbness in localized areas. This condition is often associated with diabetes, vitamin deficiencies, or other systemic diseases.

5. Muscle Strain or Tension: Sometimes, muscle strain or tension in the upper back and neck can lead to referred sensations in the shoulder blade area. Stress and poor ergonomics can exacerbate this issue.

Recommended Actions
1. Consult a Neurologist: Since your symptoms are nerve-related, a consultation with a neurologist would be beneficial. They can perform a thorough neurological examination and may recommend imaging studies, such as an MRI or CT scan, to assess for any structural issues.

2. Physical Therapy: Engaging in physical therapy can help alleviate symptoms by strengthening the muscles around the shoulder and neck, improving posture, and reducing nerve compression.

3. Pain Management: If the pain becomes more severe or persistent, a pain management specialist may be able to provide interventions such as nerve blocks or medications to help manage your symptoms.

4. Lifestyle Modifications: Consider evaluating your daily activities and ergonomics. Simple changes, such as adjusting your workstation, practicing good posture, and incorporating regular stretching and strengthening exercises, can significantly impact your symptoms.

5. Stress Management: Since stress can exacerbate muscle tension and pain, incorporating stress-reducing techniques such as yoga, meditation, or deep-breathing exercises may also be beneficial.

Conclusion
Your symptoms of tingling, itching, and pain around the left shoulder blade are likely related to nerve irritation or compression. It is crucial to pursue further evaluation with a healthcare professional who specializes in neurology or musculoskeletal disorders. Early intervention can lead to better outcomes and help prevent the progression of your symptoms. Remember to take care of your overall well-being, as managing stress and maintaining a healthy lifestyle can contribute significantly to your recovery.

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