I went to the ER because I had a back spasm. The muscle under my shoulder blade felt like it tied itself in a knot. I have DM1 so I've had this happen before. I called 911 because I couldn't even walk, that's the worse it's ever been. When the ambulance came they took me away, they couldn't give me any pain meds cause my heart was 33 BPM. I was in excruciating pain for hours, finally the muscle relaxer. The next day they said I needed a pacemaker, I'm only 34 yrs old. I think maybe they were too hasty with the pacemaker idea!