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Forum Name: Neurology Topics

Question: Burning pain on left shoulder


 Fiamma - Fri Jan 09, 2009 6:10 pm

Hello,

I have been experiencing constant burning prickly pain on the left upper back/shoulder region. The size of the painful region is about the size of my palm. There is constant pain but also increased sensitivity to touch. The pain seems to come from underneath the skin or close to the surface of the skin and it has been constant for over a week. Nothing is visible on the surface of the skin: there is no redness, the skin is not hot, there are no lesions of any kind. It does not feel like muscle pain or a bruise.

About four years ago, I suffered from extreme blistering sunburn to the back of my neck and shoulders. Since that time, I occasionally experience similar pain in this area to what I am experiencing now but previous times the pain was much shorter in duration (1 to 2 days).

I also experienced the same quality of pain before on my face and scalp before. In the past 2 years, occasionally I have burning pain and sensitivity to touch on one side of my face (either the left or right side but not generally both at the same time). This lasts 1 to 2 days. This happened perhaps five or six times in the past couple of years.

Thank you very much in advance for any information or advice.
 John Kenyon, CNA - Wed Feb 11, 2009 11:33 pm

User avatar Hi there -

What you've described sounds very much like nerve pain of the sort caused by either an irritated cranial nerve or, in the case of your shoulder, more likely due to a virus (usually herpes simplex). This can happen to anyone who's ever had chickenpox, and can show up at any time later in life. It doesn't always show up as shingles with the typical blisters, either, but sometimes just hurts (the burning, stinging, just-under-the-skin sensation you describe). It's also sensitive to the touch.

When it occurs in your face or scalp it is quite possibly trigeminal neuralgia, irritation of the 5th cranial nerve. This may or may not be post-herpetic in origin, but it hurts a good deal nonetheless, and can recur at random intervals.

If the pain doesn't respond to over-the-counter pain meds (such as ibuprofin or naproxyn) and the pain becomes really bothersome, there are medications which can function as pain blockers and often can reduce or eliminate the pain -- but they also can have some annoying side effects, so the pain must last long enough and be severe enough to risk putting up with that. In most cases these episodes are transient and don't last too long. However, if you've had this particular episode go on for more than a week, you may want to do something about it. Again, it will often respond to common NSAIDs. If not, and since it's on your shoulder instead of your scalp or face, there is another option for pain management, which is lidocaine patches which are applied to the area and last all day. Side effects are usually absent or minimal, and this can be a great alternative to taking noxious medications.

If you do develop blisters on the skin you can be fairly certain you're having an outbreak of shingles. If not, it's still most often related to that.

I hope this is helpful to you. Good luck, and please follow up with us as needed.

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