When shoulder pain isn't bursitis. The myofascial pain syndrome

Pain in the shoulder girdle and the arm is often referred pain from a remote trigger point, ie, the myofascial pain syndrome. Once initiated, this definite disease entity perpetuates itself through various feedback loops. Treatment consists of interrupting the pain cycle. Local block of the trigger point with 1% lidocaine (Xylocaine), to which a short- or long-acting steroid may or may not be added, has proved to be most effective.