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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 33545
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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Been getting stabbing pains in between my shoulder blades for

Customer Question

Been getting stabbing pains in between my shoulder blades for 6 or 7 years on and off now. Recently my diet was poor and I drank quite a bit of alcohol and the next day had pain on upper right side of abdomen under the rib cage. I also had blurred vision and dizziness that has lasted now for the last 2 weeks. Worried that this could be my gallbladder or liver. I have also had high blood pressure for years with 150/90 being typical. Due to this dizziness and blurred vision I also changed my diet completely over the last 2 weeks and cut all alcohol and reduced sodium to bare minimum and added lots of fruits and veggies to diet. I am 6’1 and 236 pds and now after these changes my blood pressure is now around 107/70 ranging to 125/80 and weight at 228. I also have fluttering in the upper right side of my abdomen and feel very tired or fatigued. No vomiting or nausea but had constipation and gas/bloating, when went to bathroom the stool was a mixture of brown and yellow.. Can you please provide some insight into what this might be? Thank you
Submitted: 3 years ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 3 years ago.


My name isXXXXX and I will be helping you today.

You should get the following investigations by your primary care physician;

1) Ultrasound and a CT scan for the abdomen; to rule out gall bladder stone or chronic pancreatitis (rarely a small kidney stone may also be responsible which would be found out by these investigations). A fatty liver disease also is not uncommon for your symptoms. These are the most likely possibilities for your manifestations.

2) Upper gastrointestinal endoscopy; to rule out acid reflux (GERD / gastroesophageal reflux disease).

3) Echocardiography; this is mandatory with the past high blood pressure readings.

4) Lipid profile; Cholesterol and triglycerides are done for the routine check up.


The stabbing pain shoulder blades can be due to gall bladder stone, but it can be muscular. This is called as myofascial pain syndromes. Muscles of the neck and shoulder girdle, namely; trapezius, scalene, sternocleidomastoid, levator scapulae etc can develop myofascial trigger points. These are hyperirritable tender spots in palpable tense bands of skeletal muscle that refer pain. This can be associated with degenerative disc disease in neck causing pinched nerves. 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. The treatment is following;


1) passive stretching of the affected muscle after application of sprayed vapocoolant.

2) physical therapy; simple muscle stretch, augmented muscle stretch, post-isometric relaxation.

3) deep electrotherapy; iontophoresis, phonophoresis, short wave diathermy, electrical stimulation, high voltage galvanic stimulation, biofeedback.

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.

I would be happy to assist you further, if you need any more information.

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Expert:  Dr. Arun Phophalia replied 3 years ago.


I mentioned about the myofascial pain syndrome above by editing my answer, which you may have not read, as it was added later..

I also want to mention about one condition called as irritable bowel syndrome, which too may be causing your symptoms.


Lastly all these symptoms can just be due to anxiety, which affects the autonomic nervous system and consequently the functions of the gastrointestinal tract.

It is privilege assisting you.

Dr. Arun