question-icon

Suggest treatment for nausea, stomach pain and discomfort in the shoulder

default
Posted on Wed, 20 Jul 2016
Question: For several weeks, sometimes while eating and especially drinking cold water, I briefly feel sensation on the inside of my left shoulder blade as food or water passes. Lasts just a second or two- no real pain, just a mild sort of tugging sensation. Absolutely no dysphagia or stomach pain...no vomiting or nausea....no weight loss. no discomfort behind breastbone, normal bowel/urine. I can pretty much duplicate the feeling by squeezing the skin behind the shoulder blade or "flexing". I can also feel similar sensation in same location when sitting for an extended period as the chair back presses on the inside of my left shoulder blade. Not sure why swallowing seems to trigger, but it does feel muscular. I do have a history of some GERD.

My concern is esophageal or pancreatic cancer. Does this symptom suggest to you any real risk here? I can eat meat, bagel, bread, etc. with no problem swallowing or chest/abdominal discomfort.

Called my doctor and he said most likely muscular.

He is not a gastroenterologist, so I'm looking for counsel and confirmation.
----------------------------------------

Just to add.......if I've been sitting and that results in the shoulder blade sensation, drinking cold water will very briefly (a second or two) cause a very moderate increase in the sensation. This is far and away representative of the vast majority of the condition.
doctor
Answered by Dr. Tayyab Malik (1 hour later)
Brief Answer:
Cancer is extremely UNLIKELY

Detailed Answer:
Hi,
Thanks for posting your query at HCM.

firstly, the tingling sensation does sound "muscle and/or nerve" associated symptom to me, but definitely NOT a presentation of cancer.
It is not a symptom of Esophageal or pancreatic cancer.

Progressive dysphagia, "sudden" loss of weight and painful swallowing are some of the symptoms that point towards esophageal cancer.

Pancreatic Cancer presentation usually includes : Abdominal pain, sudden loss loss of weight and jaundice.

Your advised to visit a "rheumatologist" and discuss your symptom - paticularly whilst drinking cold water.

Health professionals aim to diagnose properly and manage patients according to their limited knowledge. Cure is blessed by the ONE who Created us, whose power and knowledge is unlimited .

hope to answer your concern.
Any further questions are welcomed.
If no further questions, kindly rate answer, leave a review and close the dialogue box.

Wish you good and sound health.
thank you.
regards,
Dr Tayyab Malik
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
default
Follow up: Dr. Tayyab Malik (21 minutes later)
Thank you.
Is it possible the act of swallowing could affect an already strained trapezius or a nerve related to the muscle?
Thanks again.
You've helped relieve my anxiety.
doctor
Answered by Dr. Tayyab Malik (37 minutes later)
Brief Answer:
Evaluation of tingling sensation at the Shoulder blade

Detailed Answer:
hi.
thank you for getting back to me.
you have put a very important question.
i would reply in the best of my capacity.

Trapezius muscle is NOT directly involved in the swallowing process. However, pharyngeal muscles involved in swallowing may have an anatomical association with trapezius muscle.

Cranial nerve XI (11) controls motor activity of trapezius and many swallowing muscles. Excitation due to any reason in this nerve may cause pain in the shoulder blade.
therefore, as advised earlier, you may visit a rheumatologist and discuss the muscular pain.

putting together, symptoms associated with swallowing maybe SECONDARY to damage at trapezius or nerve without any lesion in the gastrointestinal tract.

hope to answer your concern.
Any further questions are welcomed.
If no further questions, kindly rate answer, leave a review and close the dialogue box.

Wish you good and sound health.
thank you.
regards,
Dr Tayyab Malik
Above answer was peer-reviewed by : Dr. Priyanka G Raj
doctor
default
Follow up: Dr. Tayyab Malik (35 hours later)
You were so helpful, thought I'd follow up with the following. Not sure if it's related to my original question. Feel free to charge as appropriate....

Over the last month or so, maybe 3 or 4 times, I have experienced pretty severe,almost stabbing pain pain in my "upper" back - basically moves between my shoulder blades. it can last for several hours and seems to move around some - left blade, right blade, center. Usually in the evening. Don't think it's cardio, as I do aerobic walks - 15 minute miles for about 50 minutes. Up and down hills - absolutely no symptoms.
Again, no weight loss or unusual stomach other than my GERDS. Adjusting my position seems to help with, even alleviate the pain. For example if I'm lying on my side and feel the pain, if I move to lie on my back it pretty much stops.....but may return if I move back to my side - but can move from 1 side to the other, depending on position. But wen it comes on, can be very painful.

Could this pain be caused by gas, ulcer, gall bladder?? I am a terrible hypochondriac - any likelihood this could be cancer?

When it has happened, it takes place a few hours after dinner, and is always gone by early morning when I arise.

Thank you.

Almost feels like very sharp gas pain......is that possible?
doctor
Answered by Dr. Tayyab Malik (11 minutes later)
Brief Answer:
Further evaluation needed but CANCER is still very UNLIKELY

Detailed Answer:
hi.
pleasure to be of help.

according to your clinical presentation, it might be related to gall bladder pathology, OR GERD OR Aorta pathology (if you have a history of hypertension), OR a muscular spasm.

further evaluation needed. Cardiac investigations are just routine examination to rule out cardiac causes. Your symptoms necessarily do NOT point towards cardiac pathology.

1. ecg 2. echocardiography 3. CT chest 4. endosocopy
5. three simultaneous reading of blood pressure within consecutive 2 to 3 days

however, be certain , that cancer is extremely unlikely as a cause of the pain.


Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar
doctor
default
Follow up: Dr. Tayyab Malik (6 hours later)
Last question.......Thanks so much.......any chance it could be gas or "gas bubbles" trapped" in my upper back.
Sort of feels like severe gas pain when it happens.
doctor
Answered by Dr. Tayyab Malik (6 hours later)
Brief Answer:
Surely,NO Gas bubbles in your back.

Detailed Answer:
hi.
thanks for getting back to me.

air/gas is usually found in two tracts in the body.
1. gastrointestinal tract. 2. respiratory tract
gas can only escapse from these sites to abdomen or thorax; when there is perforation in these sites which is a "emergency" presentation.
you have none of perforation symptoms and NO such presentation.
so surely, NO gas bubbles in your back.

wish you good and sound health.
any further queries are welcomed.

if no further questions, kindly rate answer and close the box.
thank you.
regards
Dr Tayyab Malik
Above answer was peer-reviewed by : Dr. Priyanka G Raj
doctor
Answered by
Dr.
Dr. Tayyab Malik

Gastroenterologist

Practicing since :2009

Answered : 819 Questions

premium_optimized

The User accepted the expert's answer

Share on
Suggest treatment for nausea, stomach pain and discomfort in the shoulder

Brief Answer: Cancer is extremely UNLIKELY Detailed Answer: Hi, Thanks for posting your query at HCM. firstly, the tingling sensation does sound "muscle and/or nerve" associated symptom to me, but definitely NOT a presentation of cancer. It is not a symptom of Esophageal or pancreatic cancer. Progressive dysphagia, "sudden" loss of weight and painful swallowing are some of the symptoms that point towards esophageal cancer. Pancreatic Cancer presentation usually includes : Abdominal pain, sudden loss loss of weight and jaundice. Your advised to visit a "rheumatologist" and discuss your symptom - paticularly whilst drinking cold water. Health professionals aim to diagnose properly and manage patients according to their limited knowledge. Cure is blessed by the ONE who Created us, whose power and knowledge is unlimited . hope to answer your concern. Any further questions are welcomed. If no further questions, kindly rate answer, leave a review and close the dialogue box. Wish you good and sound health. thank you. regards, Dr Tayyab Malik