Expert: Gerald Anzalone, D.C. - 9/6/2009

Question
Hello my name is Jesse I am 16 average height and weight. I am not sure if your specialty is the one I am looking for but I need to ask someone. I have a spot that is located on my left shoulder blade that goes numb or develops a tingling feeling if i sit in a certain position or stand in a certain position. I didn't have any accidents or any reason for a fracture, it never hurts it just goes numb. It has been going on for about a few months and I had hoped it was just bad posture or something but it is not going away and it is getting slowly worse. I really hope I'm not wasting your time and thank you very much.

Answer
Thank you for your question.

While I can't give you a specific diagnosis over the Internet, in general, considerations for numbness and tingling in the shoulder blade region should include cervical radiculopathy (irritation of the spinal nerves in the neck which control the arm and shoulder muscles, especially C6 and C7), rotator cuff problems, myofascial trigger points (painful nodules located in bands of tight muscles), and cervical spondylosis (degenerative arthritis).  

In cervical radiculopathy, patients often experience a generalized ache in the scapular region that radiates into the arm. In addition to the pain, patients often report numbness that radiates into the arm. In a less common genetic disease of the peripheral nervous system known as neuralgic amyotrophy, there is a characteristic acute onset of intense sharp or throbbing pain localized around the shoulder or scapular region. Rotator cuff pathology (tendonitis, tendonosis, or tear) presents with an acute onset of pain, often associated with a certain activity, as in this case. Myofascial pain is often aggravated by activity, especially overuse or strain, and this can produce localized trigger point nodules. Adhesive capsulitis can be a cause of scapular region pain, although there is usually a history of immobility prior to the pain. This condition is not as likely in this case since the pain is associated with a specific activity and is acute in onset.

Additional information that would be helpful to know include whether or not the patient had associated numbness or weakness, what the progression of the pain has been for the last 8 months, if any certain movements aggravate or alleviate the symptoms, and family medical history of any similar symptoms.

I would recommend seeing a musculoskeletal-based chiropractor who is trained in soft tissue manipulation (to deal with the trigger points) as well as joint manipulation. If your problems are muscular in nature, it should only take a few treatments to correct the problem. Usually, however, muscular and joint problems go hand in hand, so both might need to be addressed to provide you with the best results. If cervical radiculopathy is involved, manipulation of the neck and upper back might provide significant relief of your symptoms.

I hope that this helps to answer your question.