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Experiencing severe shoulder pain. Taking Advil. No numbness. Help?

Jul 2013
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Answered by

Orthopaedic Surgeon, Joint Replacement
Practicing since : 1996
Answered : 2148 Questions
I'm awake now for the third night in a row with severe left shoulder pain that radiates down my left arm, and up into my chin on the left side. After three days I don't think it's heart related. Think it may be a pinched nerve. Woke up hurting on Wednesday. I've been taking 400 mg. of Advil at night every 6 hours. The pain is much worse at night, it seems better during the day when I'm vertical and standing at work (I'm a pastry Chef so we stand all day). The pain seems somewhat positional in nature (worse when I lay down) and the shoulder has full range of motion with no particular pain during movement. There is no numbness or tingling of my fingers or hands. Can you help? I'm female, 54 non-smoker, very light drinker.
Posted Wed, 31 Jul 2013 in Bones, Muscles and Joints
Answered by Dr. K. Naga Ravi Prasad 44 minutes later
Hi, thanks for writing to XXXXXXX
At the outset, let me put few points on pain of cardiac origin
* Generally present over the front of chest wall and can be felt as gripping pain, constricting pain , or sometimes tightness in chest
* pain usually radiates into the shoulder, inner side of arm, forearm, neck and jaw at times
* pain is usually associated with profuse sweating , fast heart beat and fear of impending death
* Pain will get worse with exertion like walking, running and climbing stairs
* pain will be present even at rest and will not be related to any specific body movements.

So,if you dont have any of the above symptoms, then cardiac cause can be ruled out.

There are a few conditions that will produce symptoms similar to your description and a detailed evaluation is necessary to pin point the diagnosis.
(1) ACUTE SOFT TISSUE STRAIN - resulting from an unnoticed trivial injury during daily activities
(2) INFECTIONS IN THE CERVICAL SPINE - presents with severe pain and spasm of the neck muscles. Generally xrays will show up vertebral erosions.
(3) ROTATOR CUFF LESIONS - this is unlikey as your shoulder movements are normal without any pain
(4) THORACIC OUTLET OBSTRUCTION - A CERVICAL RIB usually presents with similar symptoms
(5) NEURALGIC AMYOTROPHY - presents with sudden and severe pain especially in the shoulder region
(6) CERVICAL DISC DISEASE - commonly seen in your age group
(7) CERVICAL TUMOURS - the only symptom that goes infavour of this is nocturnal pain (pain at nights)

I advise you to consult an orthopedic surgeon for a detailed workup.

Hope I have addressed all your issues. Happy to help in case of further clarifications. Good day
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