Left Shoulder Blade Pain and Hand Numbness: A Guide

Pain in the left scapula accompanied by hand numbness?

Hello doctor, I started experiencing back pain six months ago.
Since I have a sedentary job, I began exercising and stretching to improve the situation.
However, over two months ago, I started to feel numbness, tingling, and weakness from my left elbow down to my ring and little fingers.
I went to an orthopedic specialist who took an X-ray of my left shoulder.
The doctor said everything looked fine and prescribed anti-inflammatory medication, but there was no improvement, and my symptoms worsened.
I also started to feel soreness and tingling in various parts of my upper arm, and occasionally I experience a stiff neck.
I then consulted a neurosurgeon who took an X-ray of my neck.
He mentioned that the spaces at levels C4, C5, and C6 are slightly narrowed, but the condition is manageable.
He prescribed medication and recommended a nerve conduction study.
After taking the medication, I noticed some improvement, but the nerve study did not reveal significant issues.
My back pain persists, radiating from the area around my scapula, sometimes closer to my neck and other times towards my arms.
During the nerve conduction study, the doctor mentioned that our hospital's testing equipment is somewhat outdated, which might have led to some limitations in the results.
I am feeling quite distressed and would like to know what is going on with my left scapula.
Which specialist should I continue to see? The pain is really uncomfortable every day.
Thank you.

yun, 20~29 year old female. Ask Date: 2012/10/24

Dr. Ding Xianwei reply Neurosurgery

Based on the information provided, it appears that there may be issues with your cervical spine.
However, just because the examination did not reveal any problems does not mean that there are none.
What you should focus on is treatment rather than further examinations.
Since you are aware that prolonged standing and sitting are your issues, you should address these problems directly by reducing the time spent in those positions and minimizing screen time.
If you cannot change your lifestyle or work habits, these issues are likely to worsen over time.
As for the diagnosis, it is degeneration due to overuse of the cervical spine, so the goal should be to slow down the degeneration.
I recommend that you make these changes as soon as possible.

Reply Date: 2012/10/24

More Info

Understanding left shoulder blade pain and hand numbness can be quite complex, especially when multiple symptoms are involved. Based on your description, it seems that you have been experiencing a range of issues, including pain in your back, left shoulder, and numbness in your hand, particularly affecting the ring and little fingers. This could indicate a few potential underlying conditions that may require further investigation and treatment.

Firstly, the pain in your left shoulder blade and the numbness in your hand could be related to a condition known as cervical radiculopathy. This occurs when a nerve in the neck is compressed or irritated, often due to herniated discs or degenerative changes in the spine. The fact that you have been diagnosed with some narrowing in the spaces between the cervical vertebrae (specifically at levels 4, 5, and 6) suggests that this could be a contributing factor to your symptoms. The pain radiating from your shoulder blade down to your arm and fingers aligns with the typical presentation of cervical radiculopathy.

Additionally, your symptoms may also be indicative of a condition known as thoracic outlet syndrome, where the nerves or blood vessels between your collarbone and first rib become compressed. This can lead to pain, numbness, and weakness in the arm and hand. Given that you mentioned the onset of symptoms after prolonged sitting and working, it’s possible that poor posture could be contributing to the compression of nerves in your neck and shoulder area.

In terms of management, it is crucial to continue seeking appropriate medical care. Since you have already consulted with orthopedic and neurosurgical specialists, it may be beneficial to follow up with a neurologist or a physical medicine and rehabilitation specialist (physiatrist). These specialists can provide a comprehensive evaluation of your symptoms and may recommend further imaging studies, such as an MRI of the cervical spine, to assess for any disc herniation or other structural issues that may not have been visible on X-rays.

Physical therapy is often a cornerstone of treatment for both cervical radiculopathy and thoracic outlet syndrome. A physical therapist can work with you to develop a tailored exercise program that focuses on improving posture, strengthening the muscles around your neck and shoulders, and increasing flexibility. This can help alleviate pressure on the nerves and improve your overall function.

In addition to physical therapy, you may also benefit from pain management strategies. This could include non-steroidal anti-inflammatory drugs (NSAIDs) to help reduce inflammation and pain, as well as potential corticosteroid injections if conservative measures do not provide sufficient relief. In some cases, if conservative treatments fail and significant nerve compression is confirmed, surgical intervention may be considered.

Lastly, it’s important to address lifestyle factors that may be contributing to your symptoms. Since you mentioned being a sedentary office worker, incorporating regular breaks to stretch and move throughout the day can help prevent stiffness and reduce the risk of further injury. Ergonomic adjustments to your workstation can also play a significant role in alleviating discomfort.

In summary, your left shoulder blade pain and hand numbness may be related to cervical radiculopathy or thoracic outlet syndrome, and it’s essential to continue seeking specialized care. A multidisciplinary approach involving neurologists, physical therapists, and pain management specialists can provide you with the best chance for recovery. Remember to advocate for yourself and ensure that your concerns are addressed thoroughly by your healthcare providers.

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