Patient: I’ve had a problem that has been around on and off for eight years. My right deltoid has a very intense stabbing pain, which isn’t illieviated by any type of movement, position or massage. It comes and goes as it wishes. I started off with just one “stab” pain per night which would often wake me up, but I have had two episodes where the pain would happen around every three minutes. The last episode was six years ago, my GP said they were growing pains and put me on co-drydamol. As soon as that course of treatment ended the pain was back, I had to visit A&E twice because the pain was so incredibly bad, and actually missed Christmas that year because I passed out from the pain.The second episode started two days ago. I’m currently on holiday and the nearest doctor is 60 miles away. The pains are all the same, again no type of movement or positioning of my arm or shoulder lessens the pain, nor does it trigger it. It seems to be worse at night and I can’t sleep for more than an hour because of the pain. The “stabs” again feel like they happen once every two to five minutes. It’s a very dull but intense, stabbing, burning pain which feels like it radiates up my neck and down my arm towards the elbow.
Doctor: Hello,Thank you for posting your query at ATD.I have gone through your history and understand your concern.Y ou have mentioned about your condition in a absolute detail but no information is given about the question. I would recommend you should follow up without any formalities. If you are facing any doubts or seek a second-best opinion, don’t hesitate, just remember your doctor is just a call away.Coming to your question-Please mention your age group?What treatment have you received?Mention these details:-Are there any other symptoms as well?-What investigations have been carried out so far, provide them along with your clinical examination notes.Feel free to discuss further.Regards
Comments / Follow Ups
My question is just to see if you possibly know what it is, or even just how to allieviate the pain. I’m taking ibuprofen and codeine tablets for the pain but they’re not very effective. I have been to four different doctors and they all said they do not know what it is, the last one said “it’s probably just growing pains” but I’m 24 years old now and have never felt such an excruciating pain like this in my life.
No investigations on my shoulder/arm have taken place, I was told to finish the course of co-drydamol and to massage and stretch the deltoid. It is frustrating because I mentioned multiple times to the doctors that stretching/movement/massage does not help.
The only other symptom is that the entire deltoid area feels constantly hot and slightly achy, but touching or massaging the area doesn’t create any more pain. There is no weakness/numbness/tingling in the area, no extra discomfort or sounds when I roll my shoulders and move my arm.
From your history most probable diagnosis in your case can be
Acromio clavicular joint pathology
Myofascial pain syndrome (deltoid trigger points)
Rotator cuff pathology
As these conditions are associated with sharp, stabbing pain. With no relief after massage, streching exercises. They are not associated with tingling, numbness, or radiation of pa in from neck. Although there can be radiation from the shoulder to neck or arm/forearm.
To diagnose them, clinical examination is must. Sometimes the examination don’t yield any positive findings and due to clinical suspicion, MRI is advised to confirm/ rule out the condition. If even MRI is inconclusive MR arthrography is advised. Myofascial pain is a clinical diagnosis of exclusion. When other factors are ruled out and specific pressure points can be demonstrated on examination.
Analgesics have a temporary role and the underlying condition has to be addressed for pain relief.
You’ll have to discuss this with your treating doctor.
For any more doubts or any further information, please write to us.