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  1. #1
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    Brief Medical History Overview

    Age: Twenty-eight, Male, Presenting Problem Since: Three years., Symptom Behaviour: Worse, Symptoms Worse (24hr Behaviour): The symptoms are worse at the end of the day., Aggravating Factors:: Standing or sitting., Easing Factors:: Nothing much helps., Investigations: X-ray of shoulder - just showed nothing was broken, which I already knew., No Diabetes, No history of High Blood Pressure, No Medications, No Osteoporosis, No Hx of Cancer, No Unexplained Weight Loss, No Bowel/Bladder issues, Other Info: I had one steroid injection in my left shoulder but it didn't do anything to relieve the pain.

    Major problem / Symptomatic Areas

    Thoracic Spine

    Lumbar, Spine - Posterior

    Shoulder - Posterior - Left

    Injury between left shoulder and spine

    Physical Agents In Rehabilitation
    Three years ago I messed up a muscle in between my left shoulder blade and my spine. I believe this injury is from sitting in a slumped posture for too long. It was as though the muscle was stuck in a tight, contracted position and was very painful. I thought it would heal on its own but it never did. Within a year it had spread to other muscles around/under my scapula. In two years it spread to my other shoulder. Any movement of my left shoulder now produces loud crunching sounds. I am in constant pain and my quality of life has suffered greatly. I would have seen a specialist much earlier but I have been unable to due to circumstances. My questions are:

    1. Is this likely to be a serious case of trigger points or could it be something worse?
    2. The soonest I can see a specialist is in a year. What are my chances of a complete recovery after having this condition for four years?

    The good news is that I have full range of motion. I just canít deal with this constant pain. Thank you for helping me to understand this condition better.

    Similar Threads:

  2. #2
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    Re: Injury between left shoulder and spine

    Hi Kscorder
    Sorry to hear you have such lingering pain in your shoulder.
    A couple of questions - does the shoulder movement/crunchin correlate with the pain you feel around your shoulder blade? Does one noticeably bring on the other?
    There is a good chance it may be postural as you say but another area worth looking into is referral from you neck.
    This is pretty difficult to figure out online so it would be worth booking in with a physical therapist or equivalent profession over there to check this side of things out.. especially if gradually worsening. In the mean time try improving your posture for short periods of time and set reminders on your phone/screen in front of you to 'reset' every now and then. If the pain decreases with this change then you know you are on the right path.

    Hope this helps

    D

    Physiotherapist with an interest in Sports Performance, Sports Medicine and Manual Therapy.
    Experience in Full Time Professional Sport - Rugby and Motorsport
    Now owner of Private Practice in Surrey, UK - Physica Health - www.physicahealth.co.uk

  3. #3
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    Re: Injury between left shoulder and spine

    Thank you for your reply to my post. To answer your questions: No, the shoulder movement/crunching does not correlate with the pain I feel around the shoulder blade. I find myself rolling my shoulder throughout the day out of habit and it's as though I can feel my scapula being pushed through layers of tight muscle and that's where the popping comes from, although I'm not sure. It hurts whether I move my shoulder or not.


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    Re: Injury between left shoulder and spine

    Aircast Airselect Short Boot
    The snapping scapula is related to a bursa under the scapula - often the medial edge called scapulothoracic bursitis.
    A good free online review including non-operative treatment is here:
    Manske, Robert C., Michael P. Reiman, and Mark L. Stovak. "Nonoperative and operative management of snapping scapula." The American journal of sports medicine 32.6 (2004): 1554-1565.
    http://www.drskedros.com/wp-content/...ng-Scapula.pdf

    causes include any boney spicules (osteophytes) and "anterior angulation of the medial scapula in the axial plane"
    Treatments include:
    physical therapy
    anti-inflammatory medications
    activity modification (see above article)
    steroid injection

    Recent article on operative management:
    Menge, Travis J., et al. "Arthroscopic treatment of snapping scapula syndrome: outcomes at minimum of 2 years." Arthroscopy: The Journal of Arthroscopic & Related Surgery 33.4 (2017): 726-732.
    Arthroscopic Treatment of Snapping Scapula Syndrome: Outcomes at Minimum of 2*Years - ScienceDirect

    includes arthroscopic bursectomy of bursal hypertrophy causes significant improvement
    revision is a possiblility
    This is fairly new concept so you need surgery, you may want to contact the clinic for suggestions of where to go for arthroscopy (or go there):
    Contact info in 2016 was
    Peter J. Millett, M.D., M.Sc., Center for Outcomes-based Orthopaedic Research, Steadman Philippon Research Institute, 181 W Meadow Dr, Ste 1000, Vail, CO 81657, U.S.A. E-mail:drmillett@thesteadmanclinic.com



 
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