<s>[INST] for the last 3 weeks i have felt like i had a knot in my back, close to my left shoulder blade, ive iced it used heat and had it massaged. it is getti ng worse. when i stretch my arm to right it feels like something is tearing. for last 2 night o cant even sleep because the pain is so bad. It definately hurts worse when i lay down or as the day is winding down. It hurts to take a deep breath, hic up now too. Pain is wrapping around to under my breast bone. Dont know why it is getting worse. [/INST] Respected user , HiThanks for using Healthcaremagic.comI have evaluated your query thoroughly .* This seems in relation with tear , sprain or strain involving muscle or    ligament  with  underlying irritation of nerve fibers also .*  Strongly recommended  to  get  an  MRI  of  the  part  to  get  the  final    diagnosis  and  management  .Hope this clears your query .Welcome for further guidance .Regards . </s>