Question
10 days ago, a muscle just to the left of my right shoulder blade tensed up... I felt it when it happened (was in a tense discussion at home at the moment, and had started a new, stressful office job the week before).  I tried massaging it myself (I am well familiar with shoulder tension due to stress), and took some ibuprofen and a hot shower in the middle of the night when it wouldn't go away -- was able to sleep, but still felt it somewhat in the morning.  Over the week, the tension came and went, and sometimes showed up in a few different places around my back.  I'm getting through the worst of the stress over the new job, and things are fine at home (other than stress of 2 kids getting back to school in middle school).  Over the last couple of days, what feels like a knot, is just stuck in that spot to the left of my right shoulder blade.  Yesterday, the pain started going down the inside of my right arm.  Now the back muscle knot, and the pain on the underside of my right forearm seem to be "stuck".  Are there exercises I can do?  Is this just a muscle spasm that needs to be worked out.  It seems that the more the tight knot stays, the more other muscles in my neck, arm and general back want to tighten up.   I've tried stretching every way I can, heating pad, walking, swimming, relaxing my mind.

Answer
Hi Laura,
  It is a well known fact that the longer (and tighter) muscles 'lock up' the more they want to stay that way (and put peer pressure on the surrounding muscle to join them). I know that seems odd since it is really against their natural state but it is true.
As you obviously already know, usually heat (heating pad and hot showers),stretching and relaxing work well but since it has been almost 2 weeks, probably the best way do deal with the problem is to see a pain management specialist for 'trigger point' injections. Trigger point injections are a series of about a dozen tiny injections that put a small amount of medicine directly into the tightened up muscles. The injections do not really hurt much (although the general rule is the more it stings when the medicine goes into the muscle the better it is going to work), just small pricks from a tiny needle and then a stinging feeling that lasts about 2-3 seconds. Within a few hours after the injections the muscles will start to relax and by 24 hours you should be completely back to normal. With people that have ongoing problems with back pain and muscle tightness they do these injection every 1-3 months but since this is not an ongoing problem for you the injections will probably be a one time thing. You will likely have to see a pain management specialist to get these injections since it is not within the scope of practice for most other doctors (most pain specialists are certified anesthesiologists with special training and certification in pain management).

One other thing you may need to talk to the doctor about is a condition called 'frozen shoulder' (not a very impressive medical term, I know, but that is what it is called). The treatment for that requires medication and specialized exercises.

I hope this helps. If you have any questions or need additional information please don't hesitate to ask.
     Thanks
       Tracy