[22M] Experiencing sharp shoulder and arm pain

Patient Description

A 22-year-old male has been experiencing sharp pain under the right shoulder blade, radiating down the arm for the past three weeks. The pain, rated as a 7 out of 10 in severity, worsens with movement. The patient also reports neck pain and stiffness, and difficulty sleeping, requiring him to sleep sitting up. The patient is currently taking Methocarbamol, a muscle relaxant, before sleep. He has been engaged in activities involving repetitive arm or shoulder movements. There is no history of recent injury, no numbness or tingling in the arm or fingers, and no known allergies or adverse reactions to medications. The patient is not on any other medications, supplements, or vitamins.

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Arora's Assessment

What might be happening

Based on your symptoms, here are a few possibilities:

  • Rotator Cuff Tendinitis or Tear: This is a common cause of pain and disability among adults. In fact, about half of people over 65 have tears in their rotator cuff and many don't even know it because they don't have pain. The rotator cuff is made up of four muscles that stabilize the shoulder. When these muscles are injured, it can cause pain and limit the shoulder's range of motion.

    • Treatment typically involves rest, physical therapy, and possibly corticosteroid injections. In severe cases, surgery may be necessary.
  • Cervical Radiculopathy: This condition occurs when a nerve in the neck is irritated or compressed as it leaves the spinal column. This can cause pain that radiates down the arm, and can be accompanied by numbness and weakness.

    • Treatment typically involves physical therapy, medications to reduce pain and inflammation, and in some cases, surgery.
  • Thoracic Outlet Syndrome (TOS): This condition is caused by compression of the nerves or blood vessels that pass through the thoracic outlet (an area between the base of the neck and the armpit). It can cause pain in the shoulder and neck, and numbness in the fingers.

    • Treatment typically involves physical therapy, pain relief medications, and in severe cases, surgery.
  • Frozen Shoulder: This is a condition that limits your range of motion. When the tissues in your shoulder joint become thicker and tighter, scar tissue forms and there's less room for your shoulder to move. It's more common in people with diabetes and those who recently had to keep their shoulder immobilized for a long period, such as after surgery or an arm fracture.

    • Treatment typically involves physical therapy, medications, and sometimes surgery.

Please note that this list is not exhaustive and there could be other causes for your symptoms. It's also possible that more than one condition could be causing your symptoms.

What you can do

  • Rest your shoulder and avoid activities that make your pain worse.
  • Apply ice to your shoulder for 15 minutes at a time, a few times a day.
  • Over-the-counter pain relievers such as ibuprofen (Advil, Motrin IB) or acetaminophen (Tylenol) may help.
  • Gentle stretching and strengthening exercises can help to improve your range of motion and reduce pain. Physical therapy may be beneficial.

What you should look out for

  • If your pain is severe or if it's not improving after a week of home treatment.
  • If you have difficulty moving your shoulder.
  • If you have redness or swelling in your shoulder.
  • If you have unexplained weight loss or a fever.

Please consult a healthcare professional who can examine you and give you a proper diagnosis. This information is intended for informational purposes and should not replace a consultation with a healthcare provider.

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9 mo ago


People Also Ask


What are the common causes of sharp pain under the shoulder blade that radiates down the arm?

Common causes of sharp pain under the shoulder blade that radiates down the arm include rotator cuff tendinitis or tear, cervical radiculopathy, thoracic outlet syndrome, and frozen shoulder. These conditions can result from muscle or nerve issues in the shoulder or neck area.


How can repetitive arm or shoulder movements contribute to shoulder pain?

Repetitive arm or shoulder movements can lead to overuse injuries such as tendinitis or bursitis, which can cause inflammation and pain in the shoulder area. These movements can also exacerbate existing conditions like rotator cuff injuries or cervical radiculopathy.


What are the treatment options for cervical radiculopathy?

Treatment options for cervical radiculopathy typically include physical therapy to improve neck and shoulder strength and flexibility, medications to reduce pain and inflammation, and in some cases, surgery to relieve nerve compression.


When should I see a doctor for shoulder pain?

You should see a doctor for shoulder pain if it is severe, not improving after a week of home treatment, if you have difficulty moving your shoulder, or if you experience redness, swelling, unexplained weight loss, or a fever.


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