OpenHealth Q&A

Seeking Urgent Medical Assistance

I hope to convey my situation succinctly and would sincerely appreciate any guidance or insights. In May 2022, during a physical education tug of war activity, I suffered injuries due to being compelled by my instructor to participate. We used a worn, dirty nylon rope, which unfortunately led to third-degree burns on both my index fingers. I also developed a blood infection due to the contaminated rope, but that’s a separate issue. By September 2022, my burns partially healed, and I began occupational therapy to restore strength and flexibility in my fingers. During this time, I began to experience instability and nerve discomfort, particularly when trying to rest on my left shoulder, though I initially dismissed these symptoms. Fast forward to May 2023, as my therapy concluded, I found that I could no longer comfortably rest on my left shoulder due to increased pain and dislocation sensations radiating down my arm. My symptoms remained stable, only escalating in June 2024, when I noticed my left shoulder was increasingly unstable, often dislocating when my arms were in a downward position. In June 2024, I was struck by a vehicle, yet remarkably sustained no significant injuries. However, my sleep quality deteriorated as the pain and instability in my left shoulder intensified. I began to suffer involuntary dislocations, and I could feel my scapula grinding against my ribs, accompanied by a burning sensation in the upper back. Come August 2024, I underwent my first shoulder MRI (without contrast) which led to a diagnosis of os acromiale and acromion apophysiolysis. Though I was only 17, surgery or injections weren’t deemed necessary; physical therapy was recommended instead. By January 2025, both of my shoulders began to dislocate and grind against my ribcage, with the left side being significantly worse. My physiotherapist diagnosed me with seven different conditions, and the prescribed exercises changed weekly according to my evolving diagnoses. In April 2025, I transitioned to a different physiotherapist and began taking muscle relaxants to aid with sleep, as I had become limited to only sleeping on my right shoulder, which was growing increasingly difficult. From May 2025 to the present, I've had four appointments with my new physiotherapist, and I have been given eight additional diagnoses during this period. I consulted a shoulder surgeon and received a referral for an updated MRI of my left shoulder with contrast. Below are the findings for your review: - A small partial-thickness tear is noted at the base of the superior labrum. - A small anterior labrum alongside a thickened middle glenohumeral ligament suggests a Buford complex. - There is also evidence of partial thickness tearing at the base of the posterior labrum, which did not fill with contrast, indicating granulation tissue. - Type 1 acromion is noted, along with an unfused os acromiale and mild mechanical changes at the synchondrosis. Although I received an injection beneath my scapula, possibly targeting a bursa, it failed to alleviate the pain, leading to my discharge from physiotherapy and a recommendation to seek pain management care. CURRENT PAIN AND ISSUES: I am experiencing a burning lump at the top left of my back, over the scapula. When I maneuver my shoulder back, the lump vanishes, eliminating the burning discomfort. However, maintaining this position is impossible; once I release the hold, the shoulder shifts forward, and the lump reappears. Pressing below my shoulder socket causes it to dislocate or drop. Lying down results in similar dislocations, and on the rare occasion I do manage to sleep in that position, I wake up with numbness in my arms, which is incredibly frustrating. Rolling my shoulders back leads to sharp pain and a noticeable crackling sound. I have some pressing questions: 1. Is the burning lump on my upper left back near the scapula related to the subacromial bursa? Could that be causing the stickiness during shoulder movements? 2. Should I advocate for a follow-up appointment with the surgeon because my condition appears to be worsening? I am in dire need of help and would greatly appreciate any assistance. Thank you!

Answers (1)

6/25/2025, 9:40:50 PM

OpenHealth AI

Thank you for sharing your detailed medical history and concerns. It’s clear that you’ve been through quite a journey with your shoulder issues, and it's understandable to be seeking additional guidance during this challenging time.

Main Points:

1. The burning lump on your upper left back could be related to shoulder issues, including possible inflammation or structural problems like the subacromial bursa.
2. Based on your worsening symptoms, a follow-up appointment with your surgeon is advisable.

Explanation:

• Burning Lump and Shoulder Mechanics: The burning lump you describe may indeed relate to the subacromial bursa or other shoulder-related structures. The sensations of pain and instability you experience can arise from the complex anatomy of the shoulder, particularly involving the labrum, tendons, and bursa. Inflammation or irritation in these areas can lead to similar discomfort.

• Worsening Condition: Your symptoms, including increased dislocations, pain, and the impact on your sleep, indicate a need for further evaluation. It is essential to address the underlying causes effectively, especially since you've already undergone various interventions.

Next Steps:

1. Request a Follow-Up Appointment: Advocate for an appointment with your shoulder surgeon. Bring a succinct overview of your current symptoms, the changes you've noticed, and how they impact your daily life. This information will help the surgeon assess the need for further intervention.

2. Keep a Symptom Diary: Document specific instances of dislocation, pain levels, and triggers over the next few weeks. This could provide valuable insights for your healthcare provider during the follow-up appointment.

3. Pain Management Strategies: While awaiting your appointment, consider gentle range-of-motion exercises that are comfortable for you. Heat therapy may temporarily relieve discomfort, and over-the-counter pain relievers (like ibuprofen or acetaminophen) may be beneficial, but consult a healthcare professional before starting any new medication or treatment.

4. Consider Additional Support: In parallel with your physical therapy, discussing with your physiotherapist or a pain management specialist about integrating a structured pain management plan can be helpful.

5. Explore Alternatives: Based on your symptoms, exploring options such as acupuncture or consultation with a pain specialist may also provide relief while you await your surgeon's recommendations.

Your situation is understandably complex, and it's important to remain proactive about your health. Please remember that you are not alone in this journey, and seeking further clarification and assistance is a positive step forward. If you have additional questions or concerns as things progress, feel free to reach out.