Shoulder Blade Pain: Is It Related to Spinal Injury?

Q: Shoulder Blade Pain: Is It Related to Spinal Injury?

Hello： Based on what you have described, it seems to be an orthopedic issue. <br>If the pain persists, you may visit the outpatient clinic to see if further examination is necessary. <br>Best wishes.

Localized pain in the scapula?

Hello Doctor: My spinal injury is located at the fourth vertebra above the pelvis, which was discovered through X-ray examination following a car accident twelve years ago (no surgical intervention was performed).
Over the years, I have only experienced occasional pain around the injured area (not frequent).
Recently, during follow-up visits to an orthopedic specialist, I was informed that I have a 15-degree scoliosis and that my cervical spine is straighter than normal, but this does not affect the frequency of the aforementioned pain.

My question is: About eight years ago, I began to experience localized pain between my left shoulder blade (approximately one-third down from the top) and the spine (closer to the shoulder blade), which is more intense and frequent than the pain at the site of my spinal injury.
In the past three years, the frequency of this shoulder pain has increased, while the pain from the spinal injury has decreased.
However, starting around April of this year, the pain in my shoulder has intensified unusually (almost daily), and the muscles in my left shoulder feel abnormally tight and seem to be contracting and bulging.
Sometimes, the pain is so severe that it makes it difficult to lift my left arm or causes pain in the chest area.

I have seen specialists in orthopedics, traditional Chinese medicine, rehabilitation, and neurology over the years (ultrasound examinations of the muscles around the shoulder were normal), but none have been able to clearly identify the cause of the pain.
I would like to ask if this could be pain referred from the spinal injury affecting the nerves to the shoulder? Or have I possibly chosen the wrong specialty for follow-up? Are there any other diagnostic tools (such as MRI) that could help identify the cause of this pain? I would greatly appreciate your insights.
Thank you!

Yuan, 30~39 year old female. Ask Date: 2008/06/12

Dr. Qiu Yushu reply Neurosurgery

Hello: Based on what you have described, it seems to be an orthopedic issue.
If the pain persists, you may visit the outpatient clinic to see if further examination is necessary.
Best wishes.

Reply Date: 2008/06/12

More Info

Shoulder blade pain can indeed be complex, especially when there is a history of spinal injury. In your case, the pain you are experiencing in the area between your left shoulder blade and spine, which has intensified over the years, could potentially be related to your previous spinal injury from the car accident twelve years ago.
The spine is a critical structure that supports the body and protects the spinal cord, which is responsible for transmitting signals between the brain and the rest of the body. When there is an injury, such as a fracture or a herniated disc, it can lead to a cascade of issues that may affect surrounding muscles, nerves, and connective tissues.
In your situation, the history of a spinal fracture and the recent findings of a 15-degree scoliosis could be contributing factors to your shoulder blade pain. Scoliosis can lead to uneven distribution of stress on the spine and surrounding muscles, potentially causing muscle fatigue, strain, and pain. Additionally, the stiffness and abnormal contraction of the muscles around your shoulder may indicate a muscular or myofascial issue, which can often arise from compensatory patterns due to spinal misalignment or injury.

The pain you describe, which has become more frequent and severe, could also be a result of nerve involvement. The nerves that exit the cervical spine innervate not only the shoulder and arm but also the muscles in that region. If there is any irritation or compression of these nerves due to the spinal injury or degenerative changes, it could manifest as referred pain in the shoulder blade area.
It is also worth noting that the shoulder blade pain could be related to conditions such as rotator cuff injuries, tendinitis, or even referred pain from the neck or upper back. Given that you have undergone various examinations, including ultrasound, which showed normal muscle condition, it may be beneficial to consider further imaging studies, such as an MRI of the cervical spine and shoulder, to assess for any underlying issues that may not have been captured in previous evaluations.

In terms of whether you have chosen the correct specialty for your follow-up, it may be worthwhile to consult with a specialist in physical medicine and rehabilitation (PM&R) or a pain management specialist. These professionals can provide a comprehensive approach to diagnosing and managing pain, including physical therapy, medication management, and potentially interventional procedures if necessary.

In conclusion, while your shoulder blade pain may be related to your spinal injury, it is essential to consider a multifaceted approach to diagnosis and treatment. Further imaging studies and a thorough evaluation by a specialist could provide more clarity on the underlying causes of your pain and guide you toward appropriate management strategies. It is crucial to address these concerns promptly to prevent further complications and improve your quality of life.

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