Jock Doc

Severe shoulder, neck pain can sometimes be treated with Botox

Q: I have had a severe pain on the right side of my neck and shoulder blade for about one month. I work out regularly but I don’t remember injuring it. Tylenol has only helped mildly and even with not working out, the pain is there. I also have neck stiffness and occasional electric shocks in my shoulder blade. Who should I see and what is my next step?

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Dr. Harlan Selesnick

A: The trapezius is a large trapezoidal-shaped muscle that goes from the base of the skull, down the neck, and across the shoulder blades. This muscle can be injured when working out, playing sports or even just sleeping.

Symptoms of a muscle strain are pain, tenderness, stiffness, and spasm. Initial treatment can be initiated by your primary care doctor or spine specialist. The first line of treatment is usually anti-inflammatory medication and physical therapy to decrease the pain and spasm and restore normal motion.

Some patients will also have an area of the muscle known as a trigger point that when touched or irritated can produce electric shock or burning pains emanating from that spot. Dr. Alan Herskowitz, a Miami neurologist, is a pioneer in the successful use of Botox for trigger point injections that have not improved with traditional medications and rehab.

Dr. Harlan Selesnick is team physician of the Miami Heat and director of Miami Sports Medicine Fellowship, Doctors Hospital. Send your questions to