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desertpalm -> Shooting right scapular pain (January 14, 2007 7:48:00 AM)
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Hi everyone, I am new to the forums but thought I might post to see if I could get some speculation on my condition that has some of my providers a little stumped. I am a medical student myself, graduating this spring, and while I'm not going into physical medicine I'm very interested in the musculoskeletal system and am really striving to understand what is going on with me.
Basically, I go to the gym about every other day, and typically do mostly weights. Back in about April or May of 2006, I noticed that when I would use my *left* arm to lift a heavy free weight onto a rack (my arm was typically somewhat extended and I would lean to my right side) I would get a brief tingling sensation at the inferior tip of my *right* scapula. I thought it was strange but thought little of it until over a few weeks the sensation, when it happened, progressed to a needle like pain. Occasionally it would shoot laterally, like a lightning bolt.
Over the next few months, the frequency of the pain would increase, and it would happen with different exercises, particularly back exercises like rows. The pain was usually needle-like and shooting, but a few times the pain was so intense that it felt like I had literally just been struck by lightning. However, it was gone again in less than a second. Lately, the pain has actually progressed upward to just below my scapular spine. It has always happened on my right side, and as far as I can tell, never radiates down my arm. The severity waxes and wanes and I still go to the gym pretty much every other day, as I have learned what exercises seem to exacerbate it and which do not.
Nothing will produce the pain 100% of the time. I find that it tends to be associated with sudden movements. If I go running, it tends to happen after about 10 or 15 minutes. If I use my left arm to pull back against resistance, particularly if the arm is somewhat extended, it also tends to happen. More recently, it will occasionally happen when I don't really feel like I'm doing anything, which is somewhat distressing. It happens anywhere from never to several times a day.
I saw a neurologist initially, who ordered an EMG and MRI of the cervical and thoracic spine. On my MRI my disks are all in beautiful order, and it was read as "normal," though I do have some upper thoracic kyphosis. My EMG of my right supraspinatus, infraspinatus, and rhomboids, as well as an NCT of my right arm peripheral nerves, were all normal.
I was referred to one physical therapist who essentially had no idea what was going on. I was referred to another who I am seeing now and who specializes in myofascial pain. She found a few tender points along my thoracic spine (though lower than I would expect, around the T7/T8 area) as well as one on my right infraspinatus. These aren't really reproducing the shooting pain that bothers me, but they seem to be helping a little bit. She also said my scapulae were somewhat protracted and gave me a roller to stretch my pecs and hopefully bring those back.
If you made it this far, thank you so much for reading, and I would appreciate any other speculation you have. I had thought maybe one of my dorsal rami had gotten entrapped along my spine, but this seems to be relatively rare and I can find hardly any literature on the subject. Any help or speculation would be VERY much appreciated. Thank you!
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