[31F] Experiencing severe shoulder blade pain and neurological symptoms

Patient Description

A 31-year-old female has been experiencing severe, deep-seated pain in her right shoulder blade, rated 8-9 out of 10 in severity, for at least six months. The pain is described as a constant pinched and swollen feeling, worsening over time, with no specific movements identified as triggers. Additionally, the patient reports waking up with numbness in the arms lasting over an hour, persistently cold hands, general weakness, excessive tiredness, clouded thinking, forgetfulness, and an inability to focus. There is a significant family history of blood clots, Huntington's disease, brain cancer, and breast cancer on the paternal side. The patient does not have any known pre-existing conditions, has not experienced recent injuries, and is not currently on any medications.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are some possibilities:

  • Thoracic Outlet Syndrome (TOS): This condition occurs when blood vessels or nerves in the space between your collarbone and your first rib (thoracic outlet) are compressed. This can cause pain in your shoulders and neck and numbness in your fingers. You mentioned this condition in your description, and your symptoms of shoulder pain, arm numbness, and cold hands could be consistent with this diagnosis.

    • Treatment for TOS typically involves physical therapy and pain relief measures. In some cases, surgery might be needed.

  • Cervical Radiculopathy: This condition occurs when a nerve root in the cervical spine becomes inflamed or damaged, resulting in a change in neurological function. Symptoms can include pain that spreads into the arm, neck, chest, upper back and/or shoulders, numbness or tingling in the arms, and weakness.

    • Treatment for cervical radiculopathy might include physical therapy, medications to reduce pain and inflammation, and in some cases, surgery.

  • Fibromyalgia: This is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. Your symptoms of constant pain, fatigue, and cognitive difficulties could potentially be consistent with this condition.

    • Treatment for fibromyalgia typically involves a combination of medications, exercise, stress management and healthy lifestyle habits.

What you can do

You should definitely seek medical attention given the severity and duration of your symptoms. Here are some steps you can take:

  1. Schedule an appointment with your primary care provider. They can perform a physical examination and potentially order imaging studies to further evaluate your symptoms.
  2. Keep a symptom diary. Note when your symptoms occur, what you're doing when they occur, and how long they last. This can be helpful information for your healthcare provider.
  3. Try gentle stretching exercises to see if they help relieve your shoulder pain. However, stop any activity that increases your pain.

What you should look out for

Please seek immediate medical attention if you experience:

  • Sudden onset of severe pain
  • Difficulty breathing or chest pain
  • Weakness or numbness in your arm or hand
  • Changes in vision or speech

Please remember that while I strive to provide accurate information, I'm not a doctor and this advice should not replace a consultation with a healthcare professional.

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7 mo ago

People Also Ask

What is Thoracic Outlet Syndrome and how is it treated?

Thoracic Outlet Syndrome (TOS) occurs when blood vessels or nerves in the space between the collarbone and the first rib are compressed, causing pain in the shoulders and neck, and numbness in the fingers. Treatment typically involves physical therapy and pain relief measures, and in some cases, surgery may be necessary.

What are the symptoms and treatment options for Cervical Radiculopathy?

Cervical Radiculopathy is a condition where a nerve root in the cervical spine becomes inflamed or damaged, leading to pain that spreads into the arm, neck, chest, upper back, or shoulders, along with numbness or tingling in the arms and weakness. Treatment may include physical therapy, medications to reduce pain and inflammation, and sometimes surgery.

How does Fibromyalgia affect the body and what are the treatment options?

Fibromyalgia is a disorder characterized by widespread musculoskeletal pain, fatigue, sleep disturbances, memory issues, and mood problems. Treatment usually involves a combination of medications, exercise, stress management, and healthy lifestyle habits.

When should I seek immediate medical attention for shoulder pain and numbness?

Immediate medical attention should be sought if there is a sudden onset of severe pain, difficulty breathing or chest pain, weakness or numbness in the arm or hand, or changes in vision or speech.

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