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What Causes Stabbing Pain Below Left Shoulder Blade?
Question: My mother has been suffering from intense pain for the last 3 - 4 weeks. The pain began as stabbing pain below her left shoulder blade. After a couple of weeks, it moved around to her front, and it has now spread to her breast. She has been using pain pills extensively throughout this entire time. With pain medications, the pain is severe, without pain medications, it is almost unbearable. She went to the doctor a couple of days ago. He prescribed hydrocodone and a muscle relaxant (mexathalone, something along those lines) and she will have an MRI done tomorrow.
I believe this is due to nerve damage as it seems to run along an intracostal nerve. The type of pain she has experienced is also tell-tale. Stabbing pains, sometimes burning pains, and the general radiating nature of the pain. The pain is very internal, no tingling on the skin surface or anything like that, other than an itchy spot near the source of the pain which I will address later. Heat does bring her some relief. We tried a TENS therapy kit purchased at the pharmacy that didn't seem to work. She is very sensitive to touch in that area.
The doctor feels it could be a pinched nerve, however, we can't think of any reason that she could have gotten a pinched nerve, she hasn't overexerted herself and doesn't have any of the other suggested causes we can find online.
So, we have been entertaining the idea that this could somehow be a form of Shingles. There is a small (like 1 cm) raised area on her back that itches near the source of the pain, but nothing beyond that. She has CLL (which is currently not at a level that warrants treatment), so she is at risk of Shingles.
Could this pain be related to Shingles? Or perhaps an insect sting that has done nerve damage and left the raised, itchy area? Could it indeed be a pinched nerve and the itchy spot is unrelated? Or could it be something entirely different?
A secondary question: which of those could the MRI be able to diagnose or rule out? Would it be able to distinguish between these conditions? Or simply confirm that there is something going on with the nerve?
I believe this is due to nerve damage as it seems to run along an intracostal nerve. The type of pain she has experienced is also tell-tale. Stabbing pains, sometimes burning pains, and the general radiating nature of the pain. The pain is very internal, no tingling on the skin surface or anything like that, other than an itchy spot near the source of the pain which I will address later. Heat does bring her some relief. We tried a TENS therapy kit purchased at the pharmacy that didn't seem to work. She is very sensitive to touch in that area.
The doctor feels it could be a pinched nerve, however, we can't think of any reason that she could have gotten a pinched nerve, she hasn't overexerted herself and doesn't have any of the other suggested causes we can find online.
So, we have been entertaining the idea that this could somehow be a form of Shingles. There is a small (like 1 cm) raised area on her back that itches near the source of the pain, but nothing beyond that. She has CLL (which is currently not at a level that warrants treatment), so she is at risk of Shingles.
Could this pain be related to Shingles? Or perhaps an insect sting that has done nerve damage and left the raised, itchy area? Could it indeed be a pinched nerve and the itchy spot is unrelated? Or could it be something entirely different?
A secondary question: which of those could the MRI be able to diagnose or rule out? Would it be able to distinguish between these conditions? Or simply confirm that there is something going on with the nerve?
Brief Answer:
MRI will help to diagnose pinched nerve and confir
Detailed Answer:
Hello,
I have studied your case.
Shingles symptoms happen in stages. At first she may have a headache or be sensitive to light. She may also feel like you have the flu but not have a fever.
Later, she may feel itching, tingling, or pain in a certain area. That's where a band, strip, or small area of rash may occur a few days later. The rash turns into clusters of blisters. The blisters fill with fluid and then crust over. It takes 2 to 4 weeks for the blisters to heal, and they may leave scars. Some people only get a mild rash.
If she has similar presentation then possibility of shingles increases.
Due to compression of this nerve root there is pain in your shoulder and chest.
Due to occlusion of vessels there can be burning sensation.
I will advise you to do MRI spine, and EMG- NCV [nerve conduction study]
For these symptoms analgesic and neurotropic medication can be started.
I will advise to check your vit B12 and vit D3 level.
MRI will help to diagnose pinched nerve and confirm it.
Diagnosis of shingles is based on clinical examination and history.
Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.
Wishing you good health.
Take care.
MRI will help to diagnose pinched nerve and confir
Detailed Answer:
Hello,
I have studied your case.
Shingles symptoms happen in stages. At first she may have a headache or be sensitive to light. She may also feel like you have the flu but not have a fever.
Later, she may feel itching, tingling, or pain in a certain area. That's where a band, strip, or small area of rash may occur a few days later. The rash turns into clusters of blisters. The blisters fill with fluid and then crust over. It takes 2 to 4 weeks for the blisters to heal, and they may leave scars. Some people only get a mild rash.
If she has similar presentation then possibility of shingles increases.
Due to compression of this nerve root there is pain in your shoulder and chest.
Due to occlusion of vessels there can be burning sensation.
I will advise you to do MRI spine, and EMG- NCV [nerve conduction study]
For these symptoms analgesic and neurotropic medication can be started.
I will advise to check your vit B12 and vit D3 level.
MRI will help to diagnose pinched nerve and confirm it.
Diagnosis of shingles is based on clinical examination and history.
Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.
Wishing you good health.
Take care.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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