Ongoing shoulder pain for 5 months


Q: I have had ongoing constant shoulder pain (right shoulder) for the past 5 months or so. I do not recall a specific injury. The pain came on one day and got worse. I have been sent for an ultrasound, xray and ct scan and nothing shows up on these tests. I have also been to a pysio, chinese medical practioner, had massages, accupuncture and cupping to no relief. This pain is now transferred to my neck and upper back. The doctor has given up on me, he keeps telling me to take pain killers. This is obviously not going away, I need to find out the cause and fix it. It is very hard to sleep at night as it's so painful. Most of the time It's too painful to lift my arm above my head to take my shirts off. Please help me, this pain is agony sometimes. Kim


A:    There are several causes of arm-shoulder pain; one of the most common is the Rotator Cuff tendinitis and/or Impingement and this seems to correspond with the description that you have made of your pain. The rotator cuff is a group of tendons that support the shoulder. These tendons may be injured during weight lifting, when playing sports with a lot of throwing, after repetitive use over a long time even with everyday activities or suffer degenerative changes with the aging process. Typically, the pain worsens at night, is a dull ache in the upper outer arm and shoulder that may be radiated to the neck or not, it results from mechanical impingement of the rotator cuff tendon beneath the anteroinferior portion of the acromion (one of the bones of the shoulder joint), causing changes in the distal part of the rotator cuff tendon, which is at risk due to poor blood supply.Conservative treatment of the Rotator Cuff tendonitis involves: physical therapy to control pain and keep range of motion of the shoulder, combination of relative rest and icing (20 min, 3-4 times per day) or warm compresses depending on what of those works better for you, avoidance of painful movements and activities; anti-inflammatory drugs (i.e.: “Advil”, “Aleve”), sleep with a pillow between the trunk and arm to decrease tension on the supraspinatus tendon and to prevent blood flow compromise in its watershed region. You should continue the pain control techniques at home, work, or vacation as part of your exercise program. The home exercise program builds on itself through each phase of the rehabilitation process, and carry-over should be monitored. If there is poor or no improvement, then, local corticosteroid injection may be considered.

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