Joe A Shaw PA-C - 3/10/2008

Question
Hi Dr. Shaw,

Over the past month or two I have had a tingling sensation around my left shoulder blade.  It's really annoying and I think it might be getting worse.  I'm only 17 so I'm not sure what it could be.  I should also mention that I landed really hard on my back while snowboarding a couple months ago.  It's still sort of sore and I can't stretch it without a little pain.  The doctor that I went to right after the accident took an x-ray and said I might have pneumothorax but it was very minor so I should be fine.  I was wondering if something might have happened to my spinal chord?  Thank you so much.

Answer
Kevin,
As my bio says I am a PA, but I do think you will now need further work up. The xray is something that is always done for cases like these but they usually don't help a lot..unless there is a fracture.

First you need to determine if there possibly was a hairline fx present..they are sometimes difficult to see.
Second you need to rule out some type of nreve damage around the scapular region (shoulder blade) You should probably get an MRI eventually of the shoulder and and scapular area and spine.

More than likely you tore some muscles and this causes inflamation and swelling and even scar tissue which can compress nerves that are in the same area.

Initially the ortho will want xrays again..then he may offer you a cortisone injection if you are tender in a specific point or NSAIDs, or a medrol dosepak. If these don't help then he probably will get an MRI and look further. You could have a ruptured disc or a compression type fx of the vertebrae..for the latter theres not a whole lot to do other than time and maybe some physical therapy anyway. Same for a torn muscle..unless it is in the shoulder/rotator cuff area which they can scope and repair fairly easy.