#MedicalCase

Chronic shoulder pain (Orthopedics and Traumatology)

Dr. Shakti Mishra., B.P.T, M.P.T

 

Medical Case Details:

A 63-year-old female having dull aching pain in the shoulder area, around the back of the neck and hand region. She has diabetes, thyroid, and high blood pressure. She was diagnosed with frozen shoulder six months back and took Nurokind LC and Myotop). She had physiotherapy sessions for a month. The pain reduced a bit, but now instead of sharp shooting pain, she is having dull aching pain while working and unable to sleep during night time. Any suggestions on what to do next and the preferred medications will be appreciated.

 


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    Discussions


    Dr. Shakti Mishra
    Nutritionist

    Any suggestions , plz advice urgent

    30.May, 06:40pm

    Dr. Anuj Gupta
    Orthopaedician And Traumatologist

    Is he able to do overhead activities comfortably? how about his external rotation of shoulder?

    30.May, 07:44pm

    Dr. Shakti Mishra
    Nutritionist

    Overhead activity is fyn..rom is good in all direction except extension and backward movement of hand

    30.May, 09:18pm

    Dr. Anuj Gupta
    Orthopaedician And Traumatologist

    Ok. then the pain is coming from cervical spine. you should examine her reflexes especially Hoffman reflex and plantars. check Romberg. if she can afford get a MRI done. best is to refer her to orthopedic spine surgeon as you won't be able to diagnose her.

    30.May, 09:45pm

    Dr. Shakti Mishra
    Nutritionist

    Thank u sir

    30.May, 10:25pm

    Dr. Santosh-kumar Bashyal

    I would suggest to go for MRI of shoulder and also check status of C spine !

    01.Jun, 08:38pm

    Dr. Shakti Mishra
    Nutritionist

    Thank u sir

    01.Jun, 08:41pm

    Dr. Amit Dhamankar
    General Practitioner

    Does the patient have any neurological symptoms? tingling numbness, altered sensation? if not then MRI won't add much input and it will also be expensive. Instead try dry needling, musculoskeletal release massage, TENs therapy, This therapy gives alot of relief in nonspecific pain. Also chiropractic manipulation may benefit. Please consult if you need more help!!

    02.Jun, 07:13pm

    Dr. Peter Grutas

    Does she have trigger points? Myofascial pain syndrome can cause referred pain to the shoulder area especially if the upper trapezius and the paracervical muscles are affected. In this case, I recommend HMP, TENS, US, cervical and bilateral shoulder range of motion exercises followed by gentle passive stretching (GPS), scapular clock exercises, ischemic compression therapy followed by GPS, myofascial release, PNF and calliet exercises. You may also consider trigger point injection using steroid or prolotherapy. I hope these helps.

    03.Jun, 08:26pm

    Dr. Deepti Jakhmola

    Hello Dr Shakti
    The type of pain that you have explained here may also be a result of unbalanced occlusion. please check out patient's oral health. Long term unbalanced occlusion results in pain of head and neck region that is commonly missed out.
    thank you


    04.Jun, 12:36am

    Dr. Bhavya Sri Ambica

    I think She has to go vth MRI of c spine and she has to maintain proper posture during her activities and advise her not to take heavy loads over shoulder.

    09.Jun, 09:53pm



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