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Medical Forum / General / General / October 2004

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Shoulder pain delayed onset

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Charles Packer - 23 Oct 2004 13:11 GMT
The Web resources on muscle strain (the ones I can read before
my screen is covered in popup ads) seem to be concerned
with the first days after an injury. What do you do when you
don't realize you've injured yourself until _weeks_ later? This
has happened to me.

Apparently I strained my right shoulder during our vacation,
carelessly hefting heavy luggage in and out of our vehicle.
A few days into the trip, I got pain that I took to be the transient
bursitis that's afflicted me in recent years (I'm 58). It wasn't
for another week or so that the pain maxed out and I realized what
had caused it. There was no other symptom -- no swelling, etc.,
just pain deep inside the shoulder upon certain specific motions
of arm and shoulder.

It's now a month later, and there's been a noticeable improvement
in the last couple of weeks. Still, it seems like a long time.
I use a heating pad on the shoulder in the morning for an hour
or so. Should I be flexing the affected muscles as well?

Or, if you're going to tell me to go to a doctor, should I start
with the generalist I saw for my biannual physical last year
(I hope he remembers me) or proceed directly to look up a
right-shoulder specialist?...
Hammer - 23 Oct 2004 19:02 GMT
> The Web resources on muscle strain (the ones I can read before
> my screen is covered in popup ads) seem to be concerned
[quoted text clipped - 15 lines]
> I use a heating pad on the shoulder in the morning for an hour
> or so. Should I be flexing the affected muscles as well?

I don't believe using a heating pad for an hour is a good idea. 20 minutes
at a time is what's been prescribed to me in the past. As for flexing, since
it can affect muscles like light exercise, I'd recommend you rotate and
stretch the delt/shoulder area slowly & thoroughly beforehand.

> Or, if you're going to tell me to go to a doctor, should I start
> with the generalist I saw for my biannual physical last year
> (I hope he remembers me) or proceed directly to look up a
> right-shoulder specialist?...

Since you've noticed improvement, I'd say you're healing. It may not be as
quickly as you'd like, but if you keep taking care of it, hopefully you can
avoid going to the doctor. Obviously, healing takes longer as we get older,
so unless you believe it's becoming chronic, I'd say hang in there and rest
it as much as possible when not actively recuperating it. Good luck.
Howard McCollister - 23 Oct 2004 20:01 GMT
> The Web resources on muscle strain (the ones I can read before
> my screen is covered in popup ads) seem to be concerned
[quoted text clipped - 20 lines]
> (I hope he remembers me) or proceed directly to look up a
> right-shoulder specialist?...

Your description suggests chronic rotator cuff irritation progressing to a
possible frank tear of the rotator cuff. Shoulder spurring is common in
people your age. This can lead to chronic and/or recurring irritation and
fibrosis of the rotator cuff with eventual tear. It's easy to envision this
scenario from your description. The diagnosis is ultimately defined by MRI
scanning.

If you go directly to an orthopedist, he/she will undoubtedly obtain plain
shoulder xrays and depending on those and physicial exam order an MRI.
Possible outcome might be the demonstration of spurring and inflammation
only, resulting in physcial therapy or possibly arthroscopic subacromial
decompression. If a tear is found, the orthopedist might recommend an
arthroscopic repair of the rotator cuff.

Your primary care doctor may very well be capable of the diagnosis and
non-operative initial treatment, although that can vary widely from practice
to practice. If you elect to see an orthopedist, I would strongly recommend
one that specializes in Sports Medicine.

HMc
fresh~horses@despammed.com - 24 Oct 2004 07:28 GMT
Dr. McCollister

How long have we had MRIs?

How long have we had rotator cuff injuries?

How were they diagnosed before MRIs?
How does MRI use add to health care costs?

Zee
Howard McCollister - 24 Oct 2004 14:54 GMT
> Dr. McCollister
>
[quoted text clipped - 6 lines]
>
> Zee

You can answer those questions for yourself with just a little searching on
the internet.

Look at http://www.googleguide.com/

HMc
 
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