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    MIddle trap pain - vicodin/skellaxin not enough, what next?
    bralwel posted:
    I have a pain in my right side of my tarpezius in addition to rotator cuff. While I have some exercises to address the rotator cuff, the trap pain is what is really bothering me now. It doesn't seem to matter what I do when sitting, the pain won't go away and occaisionally it increases for short periods of time, whether I move or not. Currently taking Vicodin and skellaxin to manage these, but quite frankly they aren't enough. My genl practicioner has said they have done what they can regarding pain medication. What would be next to deal with this?
    Anon_1421 responded:
    There are a lot of general practitioners who are not comfortable providing long term pain management. I would suggest asking your doctor to refer you to a pain management doctor, or physiatrist, which is a different type of pain management doctor. Hope you feel better.
    David Maine, MD responded:
    I would initially recommend seeing your orthopedist. A rotator cuff tear or other shoulder pathology can refer to the trapezious. Addressing the shoulder (there are a variety of treatment options depending on the problem) may help alleviate the pain. The cervical spine may also play a role. Good luck. Please let me know if you have any other questions.
    bralwel replied to David Maine, MD's response:
    I saw a pain specialist last Friday. I now have a combination of Celebrex, Tramadol and Baclofen. I also have Lidoderm patches to put directly on the spot where the pain is located. The first and second day this worked great and have included massage and exercise. I have to time when I drive to work as the medication mix causes me to be drowsy about an hour after taking. The drowsy period last about 1/2 hour. Pain has now gone to right side of trap and I will keep working with the exercises for another week to see if this helps. Next step is direct injection into the trouble spot. The knot is still there, but the lidoderm helps.
    David Maine, MD replied to bralwel's response:
    Thank you for the update. Hang in there!
    bralwel replied to David Maine, MD's response:
    I just had an MRI yesterday and am returnignto my pain specialist on Monday. Hopefully the diagnosis from Monday will get thsi resolved.

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