Chronic Pain in Left Shoulder/Scapula Area and Left Upper Back

[mel714]

Hi,  I am thirty years old.  I have been suffering from chronic pain which seemed to start in my neck.  In recent years the pain is moved into my left upper back and shoulder/scapula area.  The pain has progressively gotten worse. I have been to many specialists not only to treat the pain, but also to help me diagnose exactly what is causing it. I have a prominent winged scapula on the left side, which has been noticeable longer than the pain in that area.  A few theories have been made by doctors, but none of them are exactly the same.

The first one is that this is an injury caused from Patent Ductus Arteriosus surgery I had as an infant, after being born 3 months premature.  It is thought that the surgeon may have clipped my serratus anterior muscle and/or caused damage to my thoracic nerve.  This type of injury would consequently cause the winged scapula and pain associated with it.

The second theory is that my thoracic nerve is being compressed by the scalene muscle, cutting off communication to the serratus anterior, which holds your scapula in place.  This would be the reason for my pain and the winging.

I've had an EMG and the test shows increase activity on the left and right bicep and a decrease on the left serratus anterior muscle/long thoracic nerve. The results from this test are why a doctor has recommended decompression surgery of the thoracic nerve. I, however, know this particular EMG test is prone to error.

I'm not sure what to do at this point because of the conflicting information and am reluctant to go forward with surgery without knowing exactly what is causing this pain.  I'm hoping someone can provide me with more information and answers based on the details I provided as to what would cause the winging scapula and what the cause of my chronic pain I'm experiencing, so I can begin treatment and feel better.  

[Diamant2450]

I know I am about a decade late but I thought I'd reply because this is the first time I've read a first hand account that mirrors my own. I have a long history of left shoulder injuries including a torn labrum, several dislocations and a fall years later so it's difficult to pinpoint what event caused irreparable damage to my long thoracic nerve and years of suffering. 

Over the course of several years, I went to a number of specialists, acupuncturists, chiropractors, etc. in search of treatment for pain in between my left shoulder blade and spine. I found temporary relief in the form of trigger point injections from an anesthesiologist. The relief usually lasted for around 4 to 6 weeks until I inevitably returned for more treatment. Eventually, the injections became less effective and would only provide minimal relief for short durations. I progressively spiraled into a life altering chronic pain that made me desperate to find answers. 

It's difficult to write succinctly about this traumatic ordeal so I'll just skip ahead to say that I also had an EMG / nerve conduction test that confirmed that I had neuropathy of the long thoracic nerve. I learned that the injury is not altogether rare but it usually heals on its own. If it hasn't healed after six months, it likely never will. I ended up traveling to Boston to undergo a pectoralis major transfer performed by the nation's leading expert, Dr. J.P. Warner. The procedure involves transferring the pectoralis major muscle from the chest to the lower part of the scapula so it can substitute for the serratus anterior. The surgery has helped A LOT. I still have some pain and restrictions today but it doesn't control my life like before. If you haven't found relief, I suggest you schedule a consultation with Dr. Warner. It could change your life. 

Here is a link to his website. It explains the etiology and treatment options in greater detail. Best of luck!    

https://bostonshoulderinstitute.com/patient-resources/modules/scapulothoracic-winging/

[Mshadenuff11]

Iam so happy i found someone else experiencing the same symptoms as myself. Only difference is mines on my right side. My neck seems to be the trigger spot. Chronic pain on the right side of my neck that than starts under my right shoulder blade and down my right arm. Im 30yrs old and was in an accident 1 yr ago, and been having this pain ever since. Had pt and it did nothing but cause the pain to increase. Im on tramadol for pain and flexeral for a muscle relaxant. No one has yet to tell me whats going on, and im scared. I hurt everyday, im starting to feel depressed and anxiety. I cry all the time because i cant enjoy my life due to this pain. Ive been to the emergency room 3 times and still no mri emg or anything. Im hoping this monday my private doc could fit me in to prescribe a mri, i just want this to end. Ive even begun to have crazy thoughts of suicide, between the pain and all that i have lost due to this accident including my 3 kids. If anyone out there has any suggestions on what to tell my doc so they will do the mri i would appreciate it.

[mel714]

Thank you for responding to my post!  I'm sorry that you are also dealing with the same pain.  My pain has also become so severe, which has really pushed me to start doing research on my own and trying to find doctors that can help me.  In the last 2 weeks I started having pain in my left arm on to my wrist and along my left side, starting at my underarm area.  Chiropractors haven't helped me much either.  Doctor's also recommended massage therapy.  It only seems to help my pain during the massage and it relaxes me, which I really need, but hasn't provided any long term relief.  I've done physical therapy in the past and it didn't help me at all either.  One of my doctor's has recommended starting physical therapy again.  They're saying that physical therapy will strengthen the muscles around the scapula and help alleviate some of pain that I'm having.  At this point I'm really wanting a permanent fix.  I am on so many paid meds and don't want to be taking these the rest of my life.  

An EMG is a test that's done when a doctor believes that a nerve could be related to pain and symptoms.  It is called a "Nerve Conduction Study."  An EMG measures the electrical activity of the muscle.  It also measures how well and how quickly the nerve communicates with a particular muscle.  Here is a link that explains the whole thing.
http://www.webmd.com/brain/electromyogram-emg-and-nerve-conduction-studies
It was a painful test to have done.  Part of the test actually sends electrical impulses through the body at particular muscles area.  The 2nd part of the test they stick a needle into a particular muscle and have you move that part of your body some to see how the electrical signals in our body reacts.  

The results of my EMG showed a decrease in the activity between my left serratus anterior muscle and my thoracic nerve.  I've had a couple doctor's review the results of my EMG and I'm not getting the same answers from any off them.  One doctor thinks I could have a pinched nerve in my neck, which would cause the pain and winging.  With the different answers I'm getting I am feeling so overwhelmed and I'm not sure what to do at this point.  

I have another MRI scheduled this Monday and am praying that it will confirm that I do have a pinched nerve or provide us with a clear cut answer as to what is going on.  I will also keep you posted on my progress.

[efriendly]

I'm so sorry I don't have any advice or info for you.  I am in the same boat!  I have had pain in the same exact area plus the winging for two years or so and it has progressively gotten worse.  I have only recently began aggressively investigating what is wrong because for the longest time I thought it was just a pulled muscle or something and then I was on bed rest during my pregnancy and it stopped bothering me.  I've tried chiropractors, had an MRI which showed nothing unusual and am now in physical therapy but it's not helping at all. I'm getting desperate. I was wondering if you've found out anything else.  I will keep you posted if they diagnose me with anything.  Do you have pain anywhere else?  I started also having pain in my mid back spine.  What is an EMG test?