MRI results vs pain symptoms

Interact

Info for Pros

Info for Athletes

Products

More About MTS...

Subscribe To This Site

MRI results vs pain symptoms

by vic
(AZ)

My Left shoulder MRI report says I have a small partial tear of the bursal surface of the supraspinatus tendon near the humeral attachment. There is a downsloping type 1 acromion which contacts the outer border of the supraspinatus consistent with bony impingement. There is a deformity of the anterior labrum consistent with a small tear.

Would this cause pain near the top inside portion (near spine) of the scapula that shoots up behind the left ear? It is very sensitive to the touch, and there is frequent and fairly consistent pain not touched by anti inflammatories. I am assuming that this is the origin since on occasion it does not throb, if i touch that segment of the scapula it shoots the pain up the same path to behind the ear.

I fell about 6mo ago (actually taken down in MA training) landing on the outside of my arm causing direct blow to the left upper arm / shoulder. Heard a crack and felt a strong burning sensation between the AC joint and neck followed by extreme ache and difficulty moving arm. MRI (which my primary physician just recently ordered after 6 mo of letting him know it interferes with sleep, work, etc in spite of plain x-rays showing nothing) showed the above issue but the it did not cover the part (inside top portion of the scapula) that seems to be what shoots pain up behind the left ear.

Do you have any directions that would help me talk to my doctor better if the initial MRI results do not explain the additional symptoms? (Initially the AC joint area was extremely sensitive to the touch also. Now it just aches, sometimes into the collar bone and shoulder movement sounds like bones are colliding with each other and causes increased pain.)

Comments for
MRI results vs pain symptoms

Average Rating

Click here to add your own comments

Sep 26, 2010
Rating

thank you
by: vic

thank you so much for your reply. I go back to my primary this thursday and your explanation of the other painful areas makes sense =). Most of the medical community in my area is geared toward elder care, so i will do some research to find some sports medicine doctors before my appointment. Thank you again so much, it will greatly help in communicating with my primary.

Sep 26, 2010
Rating

Shoulder Pain
by: Mitch - MTS

It sounds like you did a pretty good number on your shoulder. Based on the way that you injured it and your MRI results, everything seems pretty consistent. Obviously without seeing you myself, I can't say for sure what is going on, but I think I have a pretty good idea.

First off, with regards to the AC pain you experienced originally (and still feel at times), they are likely due to an AC Sprain. When you fell on the outside of your shoulder, you jammed everything in the shoulder together. All that force has to make something give. It found its way out at the AC. This is where the Acromion on the front part of the scapula meets the clavicle. The ligaments that hold them together were likely sprained and/or torn. You may or may not have developed a bump over your AC which can be seen with your shirt off. An AC sprain is not something that is typically repaired surgically and is usually left to scar down and heals pretty well naturally over time.

The results of your MRI show some pretty good things going on. A probably labral tear, torn bursa, and internal impingement are definitely going to cause some pain. These injuries will cause a change in the mechanics of your shoulder significantly, which will cause you to use it much differently that you did when you were healthy.

This is likely what is causing the pain that you feel in the back of your shoulder. I see it often, following an injury such as this, that the trap muscle becomes very dominant in an effort to help stabilize the shoulder. The trap is not meant to do this, so it is going to become very inflamed and will develop trigger points. These trigger points can be very sensitive to the touch and will cause shooting pain up into your neck, ear, and jaw.

Given the nature of the scapula, there are only so many things that can be injured in that area, and it would likely have shown up on the x-ray. So, with that being normal, it almost has to be soft tissue related and muscular pain.

I would recommend that you request some good physical therapy at this point. This is a pretty complicated case, so you are going to need a good athletic trainer or physical therapist who works with a lot of shoulders and athletic people. They should be able to help normalize the mechanics in your shoulder to help give you some relief.

Keep in mind, though that your injuries will likely eventually need to be fixed surgically. No therapy will be able to fix a labrum or the shape of your acromion. This is a last resort, obviously, but something that will likely need to occur at some point. Make sure you find a good orthopedic surgeon that specializes in athletic shoulders.

To sum it up...request from your physician that you be referred for therapy. Give that 3-4 weeks. If it isn't better, request that you be referred to an orthopedic surgeon for an evaluation.

Good luck!

Click here to add your own comments

Join in and write your own page! It's easy to do. How?
Simply click here to return to Sports Injury Question

SBI!

MRI results vs pain symptoms

Comments for MRI results vs pain symptoms

Comments for
MRI results vs pain symptoms