Question
hi keith, i have been having this shoulder blade pain off and on for months now. at first it was so painful i had to lay on my bed once in a while. the pain started when i would lower myself in a bathtub using my left arm. apparently i used my weight on my left shoulder. i've been to two chiropractors about this, one massaged my left shoulder blade but the pain came back and the other said it was a pinched nerve near the scapula. the pain subsided for a while but it does still hurt. what is the best treatment for this condition so i will have no more pain. i would really appreciate your help in this matter. thanks.

Answer
It is impossible for me to tell you what the best treatment is because I don' know what the diagnosis is.  A diagnosis is formed by doing a complete consultation, physical examination, and then any needed imaging or other tests.  All I have to go on is your brief description.

Scapular pain can be caused by rotator cuff muscle strains, rib subluxation, shoulder degenerative arthritis, C6 radiculopathy from disc herniation, disc desiccation, cervical spine osteophytes, cervical lushka joint hypertrophy, facet joint hypertrophy, heart conditions, lung conditions, etc...

Lets assume (huge assumption) that this is a rotator cuff muscle strain based only on your description of it beginning with shoulder exertion (Please be aware, this is not an accurate assessment of your case).  Strain means muscular tearing. This can be mild, moderate, or severe.  Trigger point work and therapy on the scapular/rotator cuff musculature might give you some relief, but should continue for a period of  1-2 month.  As the pain subsides (as the muscles heal) then additional exercises should be introduced to strengthen and stretch the injured muscles. Muscles require a minimum of 1-2 months to heal. Sometimes they are so damaged that they never quite heal right.

Lets assume another possibility, that the pain is the result of a cervical spine/neck problem. The C6 nerve root often with radiate pain into the scapular/shoulder blade region. The neck should be evaluated for discopathy and spondylosis or other conditions.  If the neck is the cause of your pain, then perhaps C spine manipulation, decompression traction, stretching and strengthening exercises, etc, is the proper course of treatment. Again, without a good examination and diagnosis, this is all just a shot in the dark.

If this is a heart/lung referral pain, then you need to see a pulmonologist and/or cardiologist.

This can be a very complicated diagnostic work up.  I hope that this sheds some light on the process, and gives you some things to think about.

Keith Biggs, DC
Arrowhead Health Centers, Mesa, AZ