Scapulocostal syndrome.

The scapulocostal syndrome, myofascitis of the shoulder muscles, is caused by altered posture, prolonged immobilization of the shoulder region or fixed scapular/spinal deformities. The author studied 440 patients ranging from 18 to 60 years of age whose altered posture caused deep pain in the shoulder region originating from the medial aspect of the scapular spine. Treatment consisted of infiltrating a trigger point in the subscapularis region of the medial aspect of the scapular spine (root of the scapular spine) with a mixture of 2cc plain 1% lidocaine hydrochloride (Xylocaine [Astra]) plus 1cc beta-methasone sodium phosphate and acetate suspension (Celestone Soluspan [Schering]) followed by physical therapy exercises. 190 patients (43.19%) received one block, 175 (39.77%) received two blocks, and 75 (17.04%) received three blocks. Upon completion of treatment, 97.7% of the patients were relieved of their discomfort and returned to their original occupation.