### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hi. I have been having pain in the left side of my back - below shoulder blade and radiating into the rib area below the shoulder blade. It only hurts when I have been laying down with pressure on my back but I have been getting sharp stabbing pains, mostly early morning hours before I get up. The pain has started to wake me up. I can move a bit and it subsides but eventually comes back in a few minutes. It does not seem like it is in the ribs but the area between the ribs and muscle. Taking a deep breath brings on sharp pains but again, only while laying on my back. I am a back sleeper because I have some tendon pain with my shoulders if I sleep on either side. There is no pain if I lean against a wall or chair and there is no swelling or pain with movement. I have full range of movement of my arms, can stretch and easily lift up to 50 pounds. I had this pain a few years ago but it was temporary and not as severe. This time it started about a week ago. Can not associate it with any known over exertion and I have not had a cold or any coughing. I did talk to a doctor about it several years ago and routine exam showed nothing wrong. I am female, 51 years old general good health with normal activity level.

### output:

-Hello, I have studied your case. It can be rotator cuff injury which may need MRI for confirmation. Medication like methylcobalamine with muscle relaxant and analgesic will reduce pain, you can take them consulting your treating doctor. You may consult physiotherapist for further guidance. He may start TENS, or ultrasound which is helpful in your case. Another possibility of nerve compression in cervical spine which can lead to radiating pain. Also check your it B12 and it D3 in your blood. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take disregards Chat Doctor. 