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Chronic Shouler Pain - Multiple Sources of Trauma


I have been coping with chronic pain in my left shoulder. All through my childhood, I played sports. That includes baseball. My shoulder had already been pretty worn out and then when I was 22, I was shot in the back of my shoulder. I have read that extensive athletic activity will cause tendonitis. That may make some sense. However, the pain I have is dull pain for the most part. Sometimes I get a very sharp pain. Especialy if I try to lift/move anything. Also, there may be nerve damage. I get a burning sensation down my left flank from time to time.

I want to know if Tramadol and Prednisone is a good way to control the pain, along whith physical therapy. Either way, I'd love to receive a professional opinion about what I should do.

I am afraid to talk to my doctor about it, because around here "Chronic Pain" is misused and abused. I want to know what my options are before I bring it to the attn of my doc. THANKS!
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replied November 8th, 2012
Especially eHealthy

Participation in athletics may cause tendonitis. But, this is usually a disorder which is evident during the period of participation, rather than years down the road. Tendonitis is a active inflammation of the tendon/muscles. However, repeated injuries to the soft tissues around a joint can lead to problems in the future, from tearing of the tissues and the formation of scar tissue, or residual instability of a joint.

Many throwing athletes do develop problems with their rotator cuff. However, rotator cuff arthropathy becomes more and more prevelant as we age (even without previous athletic participation).

You need to have a thorough evaluation of your shoulder by an orthopedic surgeon. Then, depending upon what the problems is, develop a treatment plan to manage the problems found.

Tramadol and prednisone would not be a good long term solution. Corticosteroids should not be used for extended periods of time. They may be used for active inflammatory problems, which do not respond to NSAIDs. But, should only be used for very short courses.

Tramadol has opioid-like proterties. And, it has, in some cases, been shown to cause dependency/tolerance and addiction. It is usually considered to be less of a problem than the opioids, but it is not totally without problems. It was marketed as a nonaddicting medication, which was proven to not be true. Most patient who take Tramadol for an extended period of time will show withdrawal symptoms if it is discontinued abruptly. It is a fine pain medication, but it must be respected.

So, again, you need to have your shoulder evaluated thoroughly, to find out what the problem is. Then, treat that problem.

Good luck.
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