<s>[INST] I have been going to PT once a week for light traction due to pain in left shoulder to left neck area. Pain worsens with any leaning forward or turning my head to the left. Suddenly I have two dented areas, size of two fingertips, between left shoulder blade and neck. This first appeared three days ago and has not improved. The area is NOT swollen. What could be going on? [/INST] Hi, thank-you for providing the brief history of you. A thorough clinical neuromuscular assessment is advised As you have a neck pain and shoulder too, by your history I understand that you have a degenerative disc disease of the cervical spine. In this condition the pain travels the course of the nerve and leads to weakness of the muscles it supplies. Taking and MRI will help assist to understand the level of disc degenerative disease and also the nerve impingement. Also, undergoing physical therapy like - Therapeutic ultrasound therapy and TENS therapy should help reduce the Pain. Avoid taking traction as it may lead to increase in the intramuscular tension and lead to headache or such abnormal muscular symptoms. With Therapeutic ultrasound therapy and TENS therapy the pain and inflammation can be controlled. Also, some static neck muscle strengthening exercises and some shoulder girdle Strengthening exercises will work better as per the evidence of research. In my clinical practice such cases respond well to physical therapy post accurate clinical assessment and therapy. We avoid traction due to certain factors involved. RegardsJay In Chat Doctor.  </s>