Shoulder Injury (MRI Attached)

[bijnori]

I just want to know is there any other way to heal up this injury with out operation. Patitient feels serious pain in moving left arm.
MRI REPORT
M.R. Left Shoulder (Plain)

Multiplanner, Multiecho MR images were performed using T1, T2, T2 STIR and 3D PROSET sequences:
-Reduced Joint space between acromial arch and humeral head.
-Abnormal focal hyper intense signal in supra spinatous tendon suggestive of focal tendinopathy.
-Small joint effusion around humeral head.
No abnormal signal is seen in the surrounding muscles.

IMPRESSION:
Tendinopathy left Suprraspinatous with minimal joint effusion.
On comparison with previous MR time related reduction in the effusion seen.

[bijnori]

Hi,
pain is almost gone after 4 months. no pain killer for last one month.
range of motion of rt arm   is gradually improving
the arm cannot be raised. if raised with support it drops automatically.
should we continue with phsyiotherapy or go for orthoscopy/ opertion to repair the suspecteded tear.
please advise

[litllena]

i have had severe discomfort with my left shoulder and bicep for almost a year.i have had pyshio 3x a week for 4 months ,and a cortisone injection and still have the paining discomfort.i have a hard time lifting anything,pushing or pulling{doors ect.},my arm will only raise maybe 1/4 ways up and feels like it is about to snap in half at the top of my bicep.i don't feel there has been much recovery and if so ..it has come to a platue.i ceratinly feel for anybody experiencing these issues .they have altered my life so much in so many ways ....if there is anybody who has honestly gotten good advice or treatment and showed some healing please let me know your secret.thanks...

[JainMD]

Hi,
How are you feeling?
It's nice that your treatment is going on well. I think you should be continuing on physiotherapy for long. Not only does physiotherapy help in improving the range of option around the joint, but also help in getting over the associated pain.
I think during sleep the pain could be due pressure symptoms. Your feeling of bruised pain and heavy weight on shoulder would resolve soon.
Keep me informed if you have any queries.
Bye.

[bijnori]

-today is 5th day of application of physiotherapy/shortwave diathermy.
-movement of arm on wheel improving.
-loose arm hanging in circle impoving.
-pain intensity reduced albeit during sleep pain is severe on movement.
-a feeling of bruised pain with heavy weight on shoulder/ cervicle persists.
-many thanks for your interest /valueable advice.looking forward to your advice.
bye.

[JainMD]

Hi,
I am happy that you are recovering and feel nice I was of some help to you.
I think gradually on physiotherapy you would be able to recover your range of motion. I can assure you with the help of physiotherapy, analgesics and consistent tolerable exercise will help.
Keep me informed if you have any queries.
Bye.

[bijnori]

pain reduced by short wave diathermy and physical exercise.lifting of arm laterally not yet possible.

[JainMD]

Hi,
I understood from your earlier post that you were asking regarding one of your patients and not for yourself.
Your symptoms of pain in overhead movement suggest that either it could be biceps tendonitis, rotator cuff tendonitis, or rotator cuff calcific tendonitis.
I think you can ask for an arthroscopic evaluation for therapeutic and diagnosis. Arthroscopic repair could be planned.
Arthroscopic repair allows for complete evaluation of the shoulder but is technically challenging.
Medications are the initial choice for managing the pain and inflammation associated with rotator cuff injuries. NSAIDs are beneficial during pain exacerbations.
Have you been recently examined for your pain?
Any recent imaging studies done apart from above mentioned MRI?
Keep me informed if you have any queries.
Bye.

[bijnori]

-CORTISON INJECTION GIVEN A MONTH BACK.NO RELIEF.
-NOW SHORT WAVE AND PHYSIOTHERAPY HAS BEEN RECOMMENDED.
-IF THE SHOULDER GETS A SUDDEN JERK OR HITS SEVER PAIN ENSUES.
-DURING SLEEP SLIGHTEST MOMENT MAKE ME CRY DUE TO PAIN
-IF THE ARM IS RAISED IT PAINS
- NATURE OF PAIN IS TEARING
-PL ADVISE

[JainMD]

Hi,
How are you feeling?
I think what your patient has got is Shoulder Impingement syndrome. Supraspinatus tendonitis is often associated with shoulder impingement syndrome. The common belief is that impingement of the supraspinatus tendon leads to supraspinatus tendonitis (inflammation of the supraspinatus/rotator cuff tendon and/or the contiguous peri-tendinous soft tissues), which is a known stage of shoulder impingement syndrome (stage II).
Where is his pain?
What movements, if any, exacerbate his pain?
Does his shoulder ever give way?
Did his shoulder previously have pain, but is now only stiff?
How long has he had shoulder pain and has he tried anything to help it?
Stage II injury suggests that he has now progression of rotator cuffs abnormalities to fibrosis and tendinitis.
You should start physical therapy for him which Improves ROM, particularly internal rotation.
Commonly the Rotator cuff program includes Strengthening of muscles, Work in pain-free ROM, Scapular stabilizers, Rotator cuff muscles and it will help keep humeral head within glenoid.
I think you should plan for Ice application to the joint, ultrasound application with electrical stimulation to the joint space.
Keep me informed if you have any queries.
Bye.