Dear doctor;

I have a lump that keeps growing on the back around the shoulder blade. It hurts real bad when I take long without a massage. I usually think it is due to using a computer mouse but recently someone suggested it could be due to ulcers. What are the signs and symptoms of ulcers? Eric, 27.

Dear Eric,

How long has the lump been present, how does it look and feel like, does it pain on touching or is painful all the time, does massage reduce the pain only or also the lump? These questions, if answered, can help to answer your query better. 

Bacterial infections of the skin or underlying soft tissues can cause painful swellings, which are cured completely by antibiotics and anti-inflammatory drugs. Surgical incision and drainage of these swelling also helps in healing. Cysts (fluid filled swellings) can occur anywhere in body, including on the back due to infection, blocking of oil glands ducts. A cyst can get infected causing redness and pain on touching. Cysts are completely cured by surgical removal involving a prick. 

Tuberculosis can cause a slow growing painless swelling. There would be associated symptoms of a chronic infection like low grade fever, night sweats, anorexia and loss of weight. Similarly, if the swelling would be a tumor, there would be overshadowing symptoms of a slowly growing malignancy.

Soft tissue injuries of the muscles, cartilage, among others, supporting a joint can also lead to swelling over that part. If the pain is relieved by massage, that is one possible reason for the swelling. Using a computer mouse for long hours can cause pain around shoulder joints but not a swelling. Ulcer around the shoulder blades would be a visible ulcer, that is, denuded skin over some area.

Diagnosis of the swelling can be made by doing a CT scan of affected part and  taking a biopsy. Treatment of the cause will cure the swelling completely.