Left Shoulder Pain: When to See a Neurologist - Neurology

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Based on your description of the sudden and intense pain in your left shoulder blade area, it seems that you may be experiencing a combination of muscular strain and possibly nerve-related issues. Given your work environment, which involves prolonged periods of sitting at a computer, it is quite common for individuals to develop muscle tension and discomfort due to poor posture. This can lead to muscle spasms or even nerve irritation, particularly if you are carrying a heavy bag on one shoulder.

The fact that you experienced a sharp, stabbing pain that improved somewhat with rest and muscle relaxants suggests that there may be a muscular component to your pain. However, the persistence of pain during certain movements, especially when reaching or twisting, raises the possibility of nerve involvement. Conditions such as thoracic outlet syndrome, where nerves or blood vessels are compressed in the space between the collarbone and the first rib, could also be a consideration, especially if you have a history of carrying heavy bags on one shoulder.

When to see a neurologist? If your symptoms persist despite conservative measures such as rest, over-the-counter pain relief, and gentle stretching, it would be advisable to consult a neurologist. They can perform a thorough neurological examination to assess for any signs of nerve compression or dysfunction. This may include checking for reflexes, muscle strength, and sensory changes in your arm and shoulder.

Additionally, if you experience any of the following symptoms, you should seek medical attention promptly:
1. Radiating Pain: If the pain spreads down your arm or into your hand, it could indicate nerve involvement.

2. Numbness or Tingling: Any sensations of numbness, tingling, or weakness in your arm or hand should be evaluated.

3. Persistent Pain: If the pain does not improve with rest and over-the-counter medications, further investigation may be necessary.

4. Changes in Function: Difficulty with daily activities, such as lifting objects or performing tasks that require shoulder mobility, warrants a professional assessment.

In the meantime, consider implementing ergonomic adjustments to your workspace. Ensure that your computer monitor is at eye level, your chair supports your lower back, and your arms are at a comfortable angle while typing. Additionally, try to alternate the shoulder on which you carry your bag to prevent uneven strain on your muscles.

Physical therapy may also be beneficial. A physical therapist can provide exercises to strengthen the muscles around your shoulder and improve your posture, which may alleviate your symptoms and prevent future occurrences.

In summary, while your symptoms may initially seem related to muscle strain from poor posture, the persistence and nature of your pain suggest that a consultation with a neurologist could be beneficial to rule out any underlying nerve issues. Taking proactive steps to adjust your work environment and seeking professional guidance will help you manage your symptoms effectively.