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I have a constant pain (over 4-5 years) in my right shoulder. It feels like a knot is under my shoulder blade. Deep tissue massage helps but they never "dig" long enough or hard enough. I am very tired of someone being able to tell me what is going on. We have checked for gall bladder, changing to a handbag and not a shoulder bag. I have seen a professional bra fitter, I have lost from 238 lbs to 203 lbs. No better. Please advise. ANY help would be appreciated.
Optional Information: Gender: FemaleAge: 44State/Country: Alabama Already Tried: Physical therapy, trigger shots, X-rays, gall bladder checks, professional bra fitter, changing to a handbag instead of a shoulderbag, losing weight, stretching in a pool, Deep tissue therapeutic massage is the only thing that gives temporary relief. I have been going every 2 weeks for over 2 years. I have been to an orthopedic doctor, general doctor and internal medicine doctor. I have not tried chiropractor. I am right handed and this is my right shoulder.
Greetings.
This is very likelihood to be myofascial trigger point. Trigger points may develop after an initial injury to muscle fibers. This injury may be a noticeable traumatic event or repetitive microtrauma to the muscles. The trigger point causes pain and stress in the muscle or muscle fiber. As the stress increases, the muscles become fatigued and more susceptible to activation of additional trigger points. When predisposing factors combine with a triggering stress event, activation of a trigger point occurs. Myofascial trigger point is a hyperirritable spot, usually within a taut band of skeletal muscle or in the muscle fascia which is painful on compression. The treatment is following;
1) passive stretching of the affected muscle after application of sprayed vapocoolant
2) physical therapy
3) deep electrotherapy; iontophoresis, phonophoresis, short wave diathermy, electrical stimulation, laser
4) local analgesic patch / ointment / spray
5) anti-inflammatory analgesics; Ibuprofen (Motrin / Advil)
6) ischemic compression therapy; pressure on the points
7) massage
8) steroid shots
9) acupuncture
Please feel free for your follow up questions.
Dr. Arun
Will this ever go away? I do feel like there is "something gnawing" underneath my shoulder blade.
Hello,
This goes away with the persistent proper treatment. A consultation with either an orthopedist or MD in physical medicine and rehabilitation would be beneficial. An MRI may be done for confirmation of the cause, though symptoms typically point to myofascial trigger points (as deep massage helps, this is further confirmatory of the diagnosis).
It is pleasure and privilege assisting you.
I hope this was helpful to you. If it was, please remember to ACCEPT the answer so I can get compensated for my work. if you have any more questions, please feel free to ask. I am truly privileged to help you, and I want to make sure that you are satisfied with the answer. Good luck!
Experience: MBBS, MS (General Surgery), Fellowship in Sports Medicine
Thank you! I will talk to my doctor and request a referral. Thanks again for your help!!
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