Patient: For about a month now, I have had what feels like muscle strain in my left shoulder blade which radiates up to my low neck area. It also come down over my left breast area and a little under my arm. I don’t remember doing anything to cause this pain, and there are times when it hurts really bad, just sitting still. It also hurts more when I lift my arm up high. I can’t lean on anything with my left arm, because the pressure causes the upper shoulder area to have a lot of pain. I’ve tried heat and rest, but nothing is helping. Could this be more than just a muscle problem. I had this pain in the past also, and went to doctors for it. They seemed to think it was just muscle strain at the time too, but this hurts worse now. Also, about 5 months ago, I had all kinds of tests to rule out heart problems/heart attack, and they came back normal. Any advice would be helpful.
Doctor: There are several causes of arm-shoulder pain; one of the most common is the Rotator Cuff tendinitis and this seems to c orrespond with the description that you made of your pain. The rotator cuff is a group of tendons that support the shoulder. These tendons can be injured during weight lifting, when playing sports with a lot of throwing, after repetitive use over a long time or simply suffer degenerative changes with the aging process. Typically, presents with an activity or not related dull ache in the upper outer arm and shoulder. Activity is commonly more difficult and painful above the shoulder level (more than 90 degrees). There is little or no discomfort with below-shoulder-level activities (less than 90 degrees) such as golf, bowling, gardening, writing, or typing. But, tennis, baseball/softball, basketball, swimming, and painting are more problematic and painful.Conservative treatment of the Rotator Cuff tendonitis involves: physical therapy to control pain and keep range of motion of the shoulder, avoidance of painful movements and activities; anti-inflammatory drugs (i.e.: Advil, Aleve). If the patient shows poor or no improvement, then, local corticosteroid injection may be considered.
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