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Having Shoulder Pain And Pain In Rhomboid Area. X-ray Showed Stiff Neck. Help?

Posted on Thu, 25 Jul 2013

Question: Desperate Dental hygienist. I have chronic pain which started top and back of shoulder I now have severe pain in rhomboid area right side also feels like deep ache under shoulder blade which lots of grinding/popping sound sometimes when I breathe in also. Sometimes feels like the levetor scapula muscle is going to spasm and then I have right side mid neck pain.Had Xray/MRI of neck 3 years ago which showed a very straight neck but no other findings.I've seen a shoulder specialist who said it wasn't the shoulder joint it'self and referred me for neuro assessment. The neuro guy thought it may have been suprascapula nerve impingement but tests where inconclusive so referred me to physio. Have had lots of massage/physio but not improved symptoms. I continue to try to correct my posture but feel I'm not getting anywhere and something doesn't feel right at the back/top of shoulder blade also in mid upper rib area. Hard getting diagnosis and breaking down this web of pain. Many thanks in advance for any help. Emma

Answered by Dr. Dr. Praveen Tayal (1 hour later)

Hello,
Thanks for posting your query.
From the description that you have provided, this seems to be a muscular spasm due to incorrect body posture during your working hours.
Since no nerve impingement has been detected, there is no serious pathology likely.
The repeated popping sound can be due to a decrease in the joint lubricants in the shoulder joint.
The first step is to ensure that you maintain an appropriate posture while working. Take frequent stretch breaks and drink lots of water. Discontinue using pillow while sleeping straight. Do not lift heavy objects, especially after bending down. Eat a healthy wholesome meal which should satisfy your minerals and proteins requirement.

The most essential and long lasting remedy is exercises. There are certain back strengthening and neck isometric exercises that you must learn from a physiotherapist and perform them at home or work whenever possible. You can also undergo a weeks session of traction at your physiotherapist's clinic. Swimming is an excellent exercises and is recommended in such muscle spasms.

Last but not least, if its unbearable take muscle relaxants prescribed by your orthopedician. And if it has been long standing illness visit your orthopaedician and clinically-radiologically establish a diagnosis to commence definitive treatment. He may advise you to have MRI scan of thoracic spine and neck again.

I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Please accept my answer in case you do not have further queries.
Wishing you good health.
Regards.
Dr. Praveen Tayal.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Praveen Tayal (31 minutes later)

Thank you for your reply. I will take on board the advise. When I try to exercise and stretch etc I get inflamed discomfort near shoulder blade/rhomboid area grating/popping from rib/under shoulder blade area. Do you have any experience with Scapula Bursitis? I've read about another hygienist being treated for this??

Kind regards

Answered by Dr. Dr. Praveen Tayal (13 hours later)

Hello.
Thanks for writing again.
Scapula bursitis is also a likely possibility. Such inflammatory lesions can be best treated with regular hot fomentation and anti inflammatory medicines.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar