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Conditions and Diseases > Orthopedics Forum > Physical therapy working for shoulder / neck pain? Inflamma
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Q: Physical therapy working for shoulder / neck pain? Inflamma
asked by: DoctorQuestion on April 26th, 2007
What is wrong with my shoulder, and what can I do to make myself better?


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Dr. Nikola Gjuzelov , MD
replied on May 9th, 2007
Orthopedics: Hip, Knee, & Shoulder Injuries Answer A2683
You stated in your medical history:

"n November I was being treated by a physical therapist (massage & ultrasound) for a repetitive stress injury in my shoulder/neck. During my last week of physical therapy, I was at home in bed, & I reached for something with my right arm across my body toward the left and down towards the floor, & felt a snap or popping sensation, followed by a different sort of pain than I had been feeling. I commented to my husband that I thought that I might have torn a muscle, because it hurt so bad. The next day it wasn’t as painful, and I went to physical therapy, where the therapist did her usual massage and ultrasound routine with no problems. But when I went back to work afterwards, my shoulder really started hurting, and the pain continued to escalate all afternoon and into the night to the point that I couldn’t take my shirt off or on by myself, or move my body once I was in a laying position. This lead me to have to sleep sitting up for ! about 2 months. The pain starts to the right of where my shoulder meets my neck (in my trapezius, I think), and sometimes goes up in to my neck, down into the back of my shoulder blade, down the outside of my arm, and into my chest (my collarbone). I went back to the doctor and she sent me for an MRI of my neck, which came back fine. I then went to see a Physiatrist, who thought that I tore my rotator cuff. I had MRI of my shoulder, which showed inflammation, swelling, fluid and an inflamed bursa, but no tear in my rotator cuff. He prescribed hydrocodone twice a day, a TENS unit and physical therapy twice a week. I am unable to lift my arm from the side even to 90 degrees, let alone above that. I am unable to shrug my shoulder at all. Any kind of upward movement of my shoulder causes muscle spasms. They tried exercises, ultrasound, phono, laser treatments, manual stretching, etc. but none of these things were able to get my trapezius to relax for any length of time. This whole time, they have never been able to tell me exactly what is wrong with my shoulder. I am wondering how they can effectively treat something when they don’t know exactly what they are treating. A few weeks ago, the physical therapist noticed that I was complaining about one side of my back hurting down low, and, after measuring me, realized that my pelvis on the left is tilted/twisted. He thinks that this is why my shoulder is not getting better, as it puts pressure on the shoulder. Is this possible? In the meantime, I don’t have any physical therapy sessions left that insurance will pay for, and I can’t afford to pay for them myself. My ultimate goal in all of this was to get off my pain medications, but now they are the only reason that I am able to function. I am really starting to get frustrated with this whole thing."
Current medical treatment: hydrocodone/APAP 5/325 twice a day go to physiatrist once a month for recheck/new prescriptions.

Question: What is wrong with my shoulder, and what can I do to make myself better?

Hydrocodone is an opiate analgesic drug. Prolonged usage of more than 2 months of hydrocodone can cause dependency. Therefore, hydrocodone might not be the best solution for you. I’m not sure what the real problem with your shoulder is. For example, the problem may originate in the shoulder joint, or cervical spine (neck). You can consult an orthopedist immediately for an expert opinion.




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