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I have been having painful bouts of pain between my shoulder…

Customer Question
I have been having...

I have been having painful bouts of pain between my shoulder blades and jaw. I keep saying its stress but it won't go away.

Doctor's Assistant: How long have you had the pain? What seems to make the pain better or worse?

For about 5 days. The latest is Im sitting and trying to relax and it just creeps up to the point of being intolerable.

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

When it started last week i checked blood pressure and it wasn't too bad heart rate was at 102 so i just thought it to be stress. no heart problems in past hypertension controlled with meds

Submitted: 2 months ago.Category: Cardiology
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Answered in 16 hours by:
12/13/2017
Cardiologist: Dr. Arun Phophalia, Doctor replied 2 months ago
Dr. Arun Phophalia
Category: Cardiology
Satisfied Customers: 37,227
Experience: MBBS MS. Post doctoral fellowship in Sports Medicine. General surgeon and sports medicine specialist
Verified

Welcome to Just Answer.
Answers here are for education and information.
I will respond shortly with an answer, or further information request.

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Cardiologist: Dr. Arun Phophalia, Doctor replied 2 months ago

Your symptoms are very likelihood to be myofascial trigger point. 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. 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

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.

Pinched nerves in neck can be concomitant.

This can be due to;

1) Herniated/degenerated disc in neck

2) Cervical spondylosis; bone spurs in the neck vertebrae pressing on the nerves.

Following investigations would be required;

1) X-ray of the neck spine

2) MRI of the neck

3) Nerve conduction velocity (NCV) study

4) Electromyography (EMG)

Following measures would be helpful;

1) Neck care in the activities of daily living.

a) No working on computer for more than half an hour in a single stretch. Same for TV.

b) Monitors and televisions exactly in front (180 degrees).

c) Contour pillow: Should fill the hollow when lying on back or straight. Available over the counter.

2) Cervical Collar or Brace

3) Cervical traction

4) Anti-inflammatory analgesics like Ibuprofen

5) Some physicians do give oral steroids in severe radiculopathy cases, in which pain / numbness / tingling is quite significant.

6) Physical therapy: gradually increasing exercises from passive stretching to active against resistance regime.

7) Electrotherapy in the form of TENS, interferential and laser and ultrasound.

8) Hot fomentation

9) Local analgesic patch / ointment / spray

You can consult following specialists;

a) Orthopedist

b) in Physical medicine and rehabilitation.

You may get an EKG to categorically rule out heart disease. Though these symptoms are unlikely of heart issue.

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Cardiologist: Dr. Arun Phophalia, Doctor replied 2 months ago

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Experience: MBBS MS. Post doctoral fellowship in Sports Medicine. General surgeon and sports medicine specialist

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