A 35 year old executive complained of shoulder and neck pain radiating into his fingers along with difficulty using his fingers. His MRI showed bone spurs in his neck which were causing compression of the nerves going into his arm. A neurosurgeon had suggested that he have surgery to remove the spurs and to fuse the vertebra in his neck.

He was given cervical spine epidural steroids and after the 2nd injection his pain and difficulties in his hand were eliminated, but the pain in the region of his shoulder blade persisted. He felt that it was time to revisit the neurosurgeon, but I told him that pain only in the shoulder isn't typical for a problem in the spine.

Examination of his muscles with the Muscle Pain Detection Device found that the pain was coming from the muscle under the shoulder girdle, the Subscapularis, and injecting it and following up with three days of therapy eliminated the pain. The two lessons are: 1. There may be multiple reasons for your pain and therefore more than one of type of treatment may be necessary. 2. Prior to considering surgery, unless there is a true surgical emergency, always seek a more conservative treatment approach.
 

August 12, 2010 - 4:28pm — Posted by Dr. Norman Marcus