<s>[INST] My daughter is complaining that her back hurts badly. The pain is in the area of her right shoulder blade, and seems very tender to the touch. Slight touch to her skin and any amount of pressure is making her wince. It seems to be minorly swollen/lumpy but only on close inspection. It hurts her a little more when she hangs her arm straight down at her side. Nothing has reduced the pain - not ice, heat or advil . About 9 months ago, while doing gymnastics, was the first time she noticed any pain, but it quickly went away and I attributed it to gymnastics. She has since quit the sport but remains very active. She says that the pain has come back here and there, but the pain was only minor. The onset of this severe pain was 2 days ago - and while she is a very active child, I can t point to a specific reason that it would hurt. No fever, no loss of appetite , no bruising or bleeding. I am worried about a tumor or bone infection. Can you please offer advice? [/INST] Thanks for the query. Don't be panic. Most probably it seems to be muscle sprain. Was there any injury to shoulder? Need to ask her? Tumour or infection is relatively rare conditions to happen. I would suggest getting her examined by an orthopedic doctor, and he may suggest X-rays and if needed MRI of the region. Also blood counts and ESR gives fair information if anything wrong going on in the body. Thanks. </s>