[TheForge] Re: shoulder pain OT

[Mike Spencer]

> My left shoulder hurts. I can't sleep on it and raising my
> arm is painful. 

Been there, done that, have the gel hotpack. :-)

> I think it might be a rotator cuff  injury.

I usually try to stay out of the these amateur medical advice threads
but after Terry posted a mixed bag of scary stuff along with the false
assertion that "frozen shoulders generally require surgery to get them
to move again", I thought I'd have take a shot.

The term "frozen shoulder" isn't well defined but, more often than
not, it's used to refer to a condition that:

    + limits mobility

    + is very painful if you try to exceed that limit or do so
      forcibly

    + may include pain even within the range of mobility or at rest and 

    + from which recovery is usually complete without permanent sequelae.

I always opt for the least intervention  and certainly the least
invasive intervention.  That isn't guaranteed to be the best strategy
but it usually is.

So if ordinary home treatment:

     + hot pack or heating pad for, say, an hour at a time, 2,  3, or
       4 times a day

     + firm but gentle attempts to increase mobility

     + 1 or 2 ASA (Aspirin) once or twice a day (both for pain and for
       the anti-inflammatory effect) [1]

fails to show improvement after a week or so, then you need a good
diagnosis.

Uncomplicated "frozen shoulder" will typically respond to hot packs
and (relatively) careful manipulation by a physiotherapist and
exercises [2] after a few weeks.

Some MDs will suggest the above home treatment and physio combo.  Some
will suggest a cortisone injection.  Some will offer you a choice.
Cortisone will work more quickly but there is the potential for error
or unwanted side effects.  There is the potential that cortisone will
mask a more serious condition, overlooked by your MD but which might
be recognized when the physio approach fails to produce results.

Part of the conventional therapy for this kind of thing used to be
"diathermy".  I think that's obsolete now.  It's been replaced with a
form of electrical stimulation done by a physiotherapist.  I don't
know much about the latter.  When I had a "frozen shoulder" (twice), I
declined that treatment because I have an epicardial pacemaker lead in
place (but no pacemaker) and no one could answer my questions about
the possibility of induced currents in the lead.

If anything in the shoulder complex is actually torn or displaced,
that's a whole 'nother ballgame. I have no advice on that except: See
above re. good diagnosis.

The odds are greatly in favor of your doing fine with non-invasive
treatment.  Get a good diagnosis. (Am I repeating myself? :-)


- Mike

[1] Don't sneer at Aspirin.  Unless you have a condition which ASA is
    known (or subsequently found) to aggravate, it's not only a
    pain-reliever, it's a really effective anti-inflammatory.  Enteric-
    coated ASA will avoid gastric side effects in most cases.  ASA
    doesn't make you crazy or muddled like some of the more trendy
    meds.  Other common OTC pain meds (e.g. Tylenol) don't have the
    anti-inflammatory effect.

[2] Terry wrote

    > finger walk a wall. using the fingers walk up a wall to a couple
    > times a day to keep the shoulder moving.
    > ...
    > get a pulley that you can hang from the ceiling or over a door
    > and some rope. use the good arm to lift the
    > bad/sore/hurt/injuried arm.

    Both of those are good.  I especially like the last one. Small
    pulley, light cord and a couple of sticks in the ends to make
    T-handles.  Do it sitting so that there's room for (eventual) full
    extension of your arm.

-- 
Michael Spencer                  Nova Scotia, Canada       .~. 
                                                           /V\ 
mspencer at tallships.ca                                     /( )\
http://home.tallships.ca/mspencer/                        ^^-^^

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