Adam Rufa - 6/6/2006

Question
About 1 1/2 years ago I heard a popping noise in my side after reaching too far with my right arm followed by pain in my side under my ribs and up through my shoulder blade which got severe over the next hour.  I have seen multiple doctors and had multiple tests without a conclusive diagnosis.  I don't think I have ever been examined for a muscle tear.  After 1 1/2 years I am still experiencing pain, although not as severe, which definitely limits my activity, especially lifting, reaching, andything that involves abdominal strength or shoulder strength.  Is it possible for a muscle tear to go for that long without healing?  What should I do now?

Answer
Hollie,

It is common to not get a definitive diagnosis with musculosketal complaints. Even when people do get a "definitive diagnosis" it mat not be correct. The problem is that in many cases their is no one test that can tell you what the problem is with certainty.

Pain in the area you describe can be caused by a number of things. Some of the potential causes are not 100 percent proven and there are no definitive tests.

        One possibility is a rib dysfunction. Some clinicians feel that a rib can get pulled or pushed slightly out of place. There can be stiffness and pain when the rib is pushed on. This can sometimes be successfully treated with manipulation of the rib. Thoracic, cervical and shoulder problems can also cause pain in that area. Muscle tears can occur but are not as common with that mechanism of injury and are more likely to happen in people over 60.

If you have not seen a PT who specializes in manual therapy I would recommend trying that.


Adam