pain beneath right shoulder

[Fishponds50]

Hello and Happy New Year to this wonderful community. I posted a short while ago to say that I have additionally been diagnosed with osteoporosis of the spine (I have PMR and GCA) and sorry but here I am again. For the past 6 weeks I’ve had a pain in the area below my right shoulder, back. It isn’t sore to touch and can ease at time and then come back and isn’t influenced by anything I do with my arm or side. It isn’t swollen or red. I thought at first that it was the start of a flare of PMR so upped my prednisone by 5mg (I’m currently on 4.5mg) for 5 days however this made no difference so I’ve gone back to 4.5mg. Any thoughts greatfully received. Thank you xx

[PMRpro Ambassador]

Sounds more like a muscular source. When you say shoulder - shoulder, shoulder blade, upper. lower back?

Have you tried heat?

[Fishponds50 in reply to PMRpro]

Thank you as always for your speedy reply. I’m useless at describing pain and where it is, to pinpoint it is the area where my bra strap goes across my back meets just under my right shoulder blade. I did get a similar pain or ache to this when my PMR started so thought it could be a flare but increased prednisolone didn’t help. I have tried heat, muscle gel and a muscle massager we had for Christmas that gives temporary relief. I will keep on with the heat. Thank you x

[PMRpro Ambassador in reply to Fishponds50]

Ah yes - I know exactly what you mean!!!

[jls93]

Try reviewing "serratus.. anterior pain distribution: as a potential source. .. scapula is the anatomical name of the shoulder blade. That being said, the scapula has 8 movements ! Absence of strength and smooth coordination of all the "para -scapulae musculature" is not unusual (very common actually:"anterior tilt" maybe an issue) I agree with PMRPro.. I suggest google image for "serratus anterior muscle pain distribution and "Para scapula muscle pain" and you will have the opportunity to dig a bit deeper and discover a better understanding of the source of your discomfort . "Scapulae dykinesia " is a fancy technical term when there is dynamic imbalance caused by a combination of postural , strength and muscle length ( flexibility).

Sounds complicated but it's very common to a physio if they know what they are doing . Our "shoulders" and the infinite combinations of reach is a symphony of over 2 dozen muscles and 4 joints performing with "just the right movement at just the right time .. Amazing !

Indeed...

If musculo-skeletal and non-traumatic restoring strength, coordination and posture may serve you very well

Sorry if too wordy or technical no offense intended.. no worries please, I would only wish you to pursue your health and do some targeted education to demystify a potential source of your issue... Google and some u-tube may help...

Picture =thousand words

Pursue your health for sure..

Sincerely jls

[Fishponds50 in reply to jls93]

Gosh thank you so much for your very thorough, informative and helpful response I am very grateful to you. I am out now (just sobbed my way through the film One Life) so will have a look and research when I get home and get back to you. Thank you again xx

[Fishponds50 in reply to jls93]

Hello thank you again for your helpful reply, I have had a good look on line at various articles on serratus anterior pain and a number of You Tube videos and this is certainly a possibility although I can raise and move my arm without pain? As you mentioned a physiotherapist I have decided to try this route and will find a qualified, local practitioner as no doubt they could help with this and exercises for my recent osteoporosis diagnosis too. Thank you again. X

[jls93 in reply to Fishponds50]

Thankyou for your kind words glad it helped. Having full motion is fine. Musculo-skeletal pain patterns are rarely a single issue. Conceptually,clically and functionally ; appreciating that our "upper 1/4" includes head, neck,mid back scapula etc. Horizontal ish discomfort maybe thoracic,rib cage and scapula issues . Recognize all these bones are attachment sites for many muscles.

Posturally as we all "mature" we tend to become forward bent which sets up a n the progressive cascade of issues . Mechanically muscles become tight in the front and arm pit "Axilla " regions; like a very tight turtleneck garment.

Concurrently our spines and rib cage also adapt into a less than optimal position which would eventually make them "unhappy ". This would effect the muscles anchored on them.

Soooo most likely your situation some structures are;

1. angry - discomfort

2. Tight

3. Weak

Leading to compensatory situation your body doesn't like.

Angry structures are typically (in this scenario)

Are that way because they are/ have been doing something or being loaded in a manor they don't like (or can't handle) for an extended period of time. This disadvantageous position impairs thier funtion.

Your serratus may just be angry because of something else or it's in a position it can't do its job.

Can be pretty tricky to discern/evaluate .

I hope this helps to provide a different/open perspective so that you may pursue your health actively.

In this case, your circumstances maybe. an accumulation of alot of small issues adding up and the angry structures are that way because other things are not doing there job.

Not an unusual presentation . Pursue your health with the correct efforts. Best to you

That's all I have ; D

[Fishponds50 in reply to jls93]

Thank you so much for your invaluable thoughts and knowledge. Very much appreciated x

[Thelmarina]

I have similar pain in my right shoulder especially and my neck. It is eased by very gentle stretching. An x-ray showed it was due to osteoporosis so increasing dosage wasn’t necessary.

[Fishponds50 in reply to Thelmarina]

Thank you for your reply Thelmarina and I’m so sorry that you’ve received this diagnosis. I have feared my pain could be due to the recent osteoporosis diagnosis. I’m trying heat and exercise to see if that helps as the increased dosage didn’t make a difference. Take care of yourself. Thank you again.

[Thelmarina in reply to Fishponds50]

Keep the exercise -alternate days good. It could be worse, I’m 77 but I don’t know how old you are, you expect something like this at this stage of life 😀xx