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June asked...

Persistent shoulder pain

I have a persistent pain in the back of my left shoulder and can persist down my arm to my fingers. Sometimes the pain is under both of my armpits. I thought initially it was a yoga strain, but as this has continued to get worse even though I have not done yoga for a long time, I am now worried it is a pain linked to breast cancer. I can not get an appointment with my GP to discuss this and I am 52 and not had a breast scan for 4 years.

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The answer

From what you describe we would say that your discomfort is likely to be of a muscular-skeletal origin. We suspect that you have possibly sustained an injury in your neck or thoracic area and that the muscles from compensating have now tightened up.

We feel that the symptoms you discuss are very unlikely to be a sign of breast cancer. Presenting symptoms for breast cancer usually consist of sudden inversion of the nipple, discharge /bleeding from the nipple, palpable lump or puckering of the skin surface of the breast.

However other possible causes for this discomfort could be related to other medical conditions such as trapped nerves or gallbladder or cardiac concerns where pain can be of a referred nature.

We would suggest that it would be advisable to see a medical clinician as soon as possible for review in order to establish the causative factor.

If it is not possible to obtain an urgent appointment with your GP then we would suggest asking for a telephone appointment so that they can obtain an idea as to the cause for your pain and then decide on appropriate management.

If you are still unable to see a GP then the other route we would suggest is contacting NHS 111 or attending the local minor injuries unit to see a GP through those means instead as a starting point for on going care and treatment.

If the discomfort you have is as a result of a muscular-skeletal injury then physiotherapy or osteopathy may be appropriate.

Answered by the Health at Hand nurses

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