Donald Corenman, MD, DC
Moderator
Post count: 8436

Pain radiation into the shoulder blades is a common pain referral location for nerves C3-T1. It is not uncommon for the C3-4 level to radiate into the scapula. I would make sure that the fusion at C4-7 is really solid. An MRI can reveal that but also can give misdirection. Flexion-extension X-rays would be a better tool for evidence of fusion.

If solid fusion is noted, and you have “moderate to severe right foraminal stenosis, and moderate left foraminal stenosis”, a selective nerve root block at C3-4 with good temporary relief would give evidence of the pain generating capacity of C3-4 where you could do something about this surgically (or the injection calms down the area and can be used for treatment).

See:
https://neckandback.com/treatments/epidural-injections-and-selective-nerve-root-blocks-diagnostic-and-therapeutic-neck/ and
https://neckandback.com/treatments/pain-diary-instructions-for-spinal-injections-neck/

Dr. Corenman