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Question

I have chronic pain in my upper back around T1-T3 that radiates to my right scapula and sometimes my right posterior shoulder. MRI showed "tiny" C6-C7 herniation and "tiny" T3 bone spur. There is a palpable firm band-like "band" stretching from my T2/T3 area to the medial border of my scapula. I've seen a neurosurgeon, orthopoedic surgeon, pain specialist, chiropractor, massage therapist (and many more I won't bore you with). None of them want to consider surgery since the MRI result showed only tiny abnormalities. My EMG showed only slight abnormality with the suprascapular nerve. I am desperate for any ideas as the pain is ruining my life. As the day goes on, it gradually feels like a knife in my back. I am 36 years old, 140 lbs, and 5' 7". Thank you in advance for any ideas or help you might be able to provide.

Submitted: 1307 days and 20 hours ago.
Category: Health
Value: $15
Status: CLOSED
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Optional Information:
Male , Age: 36

Already Tried:
Physical therapy Massage therapy Accupuncture Chiropractor Trigger point injections Cervical epidural Suprascapular nerve block Heat/Cold therapy

Accepted Answer


You may have tight scalene muscles ("a palpable firm band-like "band" stretching from my T2/T3 area to the medial border of my scapula"). A "band" is a group of muscle fibers and the specific muscle fibers that stretch from the T2/T3 area to the medial border of your scapula are the scalene muscles. A tight scalene group will cause pain in your scapula and shoulder. Test by laterally flexing your neck and noticing where the motion is restricted.

Patients with suprascapular nerve injury or entrapment present with severe shoulder pain which localizes to the scapular and parascapular regions and occasionally to the suprascapular notch. Depending on the duration of the condition, atrophy of either or both muscle groups can eventually follow. The factors leading to entrapment include stretch mechanisms associated with shoulder movements, suprascapular nerve liability, and mechanical lesions.

I recommend that you be evaluated and treated by a sports medicine/physiatrist who is a specialist in treating shoulder/scapular neuromuscular pain.

In the meantime, apply ice for 20 minutes on and 40 minutes off. Soak in a warm jacuzzi once daily for at least 30 minutes and most especially prior to going to bed at night so it helps you sleep without pain. Take Motrin or Advil (unless you have a history of GI bleeding) at regular intervals to relieve muscular inflammation e.g. every 6 hours throughout the daytime so that your scapular pain doesn't have an opportunity to take hold. This should help you so that you can function during the day and sleep better at night. Don't wait until you have pain to take an NSAID.

Use a TENS unit

unit.http://www.promedproducts.com/s.nl/sc.2/category.31/.f

Expert: Dr. Hanson
Pos. Feedback: 99.0 %
Accepts: 823
Answered: 7/12/2006

Doctor (MD)

Diplomate, American Board of Quality Assurance & Utilization Review Physicians

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