winging scapula, ischemic and nerve pain?

by Andreas


I've been struggling with winging scapula, pain in upper trapezius, levator scapula, scalenes, SCM for about 8 years now. The pain is hard to point out exactly, it's across all upper back a discomfort and pain on the inner side and top of shoulderblades. The trapezius and levator scapulae is more of a ischemic pain. The pain over scalenes feels like it's deeper in, same thing in pec-minor, shoulder. Also nerve pain inside of biceps, armpits down through arms to hands and fingers in certain positions.

I also have numbness and tingling to fingers in certain positions. When I do Roos test, I get in pinkyfinger and ringfinger. If I do cornerstretch I get numbness in thumb and next 2 fingers. Been to several doctors, fysiotherapiests during the past years.

It all started after a divorce. I got a deep depression and started to get bad posture. Along with that I sat all days long in front of the computer with head in forward position. In that time I had been weightlifting for 5 years with no problem. I trained 4 times a week with pretty heavy weights. I always have had good posture, breathing etc until my depression and poor posture came into the picture.

I then started to develop bigger muscles on the front side, Pecs, anterior shoulder and lost contact with my back. I got extreme short muscles in front that my whole posture got really skewed with. Got a really bad case of upper cross syndrome and also lower cross syndrome. I continued to lifting weights for 3 years before I stopped.

All fysiotherapiests has given me exercise programs which I've been doing the last 3-4 years with minimum result. I feel how hard I try to get contact with rhomboideus it feels like it's dead. I do the exercises perfect but seems it´s only parts of trapezius that is working.

I´ve been doing exercises for serratus anterior but don´t get much contact also.

Last week I got an injection to the trapezius, and levator scapulae and I got an relief for a few hours, but next day the pain was back. The same thing with trigger point acupuncture, it only lasts for a day maximum.

I´m waiting now for a MRI on the neck.

I´ve read about dorsal scapular nerve entrapment, it seems like all fit into description, also some parts of long thoracic nerve entrapment.

What do you think?

Hello Andreas,
It's obviously complex but I go along with the likelihood of the dorsal scapular involvement; it's primarily a C5 nerve I believe, hence the pain in the arm too.

However, the fact that it effects all fingers suggests a thoracic outlet syndrome. Look up TOS at Chiropractic Help. It's usually caused by a first rib fixation though there are other causes.

The key sign is increased pain with raising the arm. And a positive Adson's test.

Time to see a chiropractor?

Dr B


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Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I've left alone. After seven treatments his pain and stiffness is 50 percent better, and he's happy in the circumstances. He can sleep through the night now and that makes a huge difference.

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