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Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for shoulder pain

I m having left shoulder pain on the top of the shoulder. When I inhale, the pain radiates down my left rib cage and I feel a sharp stabbing pain beneath the last rib. The shoulder and rib pain increase in the sitting position and unbearable in the supine or left lateral recumbent position. My vitals were R-22 and regular, Pulse 64 and regular, BP 112/64 SPO2 98% on room air. No shortness of breath or respiratory distress. I do have a history of DVT s in my calves. Last one was last month.
Fri, 15 Apr 2016
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Physical Therapist or Physiotherapist 's  Response

Thank you for providing the brief history of you.

As you mentioned you have a stabbing pain in the shoulder which radiates to the rib cage and also your heart checkup was done which is all fine.

You need a thorough neuromuscular assessment which will help us if the pathology is in the Cervical region, Shoulder region, Rib cage or abdomen?

Also, with the orthopedic and Neurological special test we can come closer to the root cause. Also, pain in the shoulder which is stabbing is related to either a shoulder joint pathology or cervical spine pathology. The pain in the rib cage for which chest examination is required. May be pathology of the lungs which is very uncommon to predict also, since pain cannot be because of it as well.

The pain in the lower part of the rib cage for which an ultrasound scan of the abdomen will help assist further.

The pain in the shoulder and rib cage can be not connected as the nerve supply ,blood supply and the muscle innervation are totally different.

So both pathologies are different. For stabbing pain in shoulder the pathology will be related to either the cervical spine or the shoulder.

And for pain in the rib cage, the pathology can be related to chest or abdomen.

both needs a different assessment and different approach to diagnosis.

I will recommend to undergo a Neuromuscular assessment by which we can differentiate both the pathologies and help you better.

For shoulder pain, with proper rest, medication and physical therapy things fall into place.

Jay Indravadan Patel
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