Shoulder injury

I am a millwright by trade.  I injured my left shoulder at work 12 months ago.  I underwent therapy for awhile to alleviate what was said to be inflamed bursa and tendons in such shoulder.  After 3 months of limited use, it seemed to feel less painful and I was released for work as this was a workman's comp claim.  The doctor said it should strengthen and regain all strength and movement without pain as it was prior to the injury.  This has not been the case.  My profession requires rigorous lifting,pulling,reaching, and overhead work.  The more I use the shoulder the worse it gets.  I can't sleep now without waking up 3-4 times a night in pain.  It is at the point now that the pain is constant throughout the day even with no activity.  While researching such injuries on the internet, it seems to me that I could have impingement syndrome.  Researching this has shown all kinds of attempts to alleviate the pain but in the end,, with my age and activities, it seems pertinent to have surgery on the shoulder.  I want to know if that is a reasonable request as I don't want a temporary fix such as cortisone injections that I read are risky anyways.  Workman's comp treats me as if to just let it be, but my statute of limitations runs out in a year and I want fixed right!  What advice could you give me about said injury and symptoms?

[Bridget A. Hewitt, RN]

HI and thanks for using the forum.

A shoulder impingement is pain in the shoulder caused by pressure on the rotator cuff from part of the shoulder blade when the arm is lifted.  It is usually diagnosed by a review of symptoms, x-ray, and shoulder examination.  Treatments include surgical and non-surgical options.  Non-surgical options include rest, anti- inflammatory medications, physical therapy, and cortisone injections.  Surgical treatment involves removing the impingement and thus alleviating the pressure on the rotator cuff.  

Have you gone back to the orthopedist who originally treated you?  I think you should definitely do this, especially because you want it documented that you continue to have problems with this shoulder.  Usually, you want to use surgery as the last option.  Cortisone shots can be effective in alleviating pain in the area, while you are working on strengthening the shoulder.  Also, continued physical therapy can be effective as it localizes that area and focuses on helping you regain strength and movement.  

Surgery can be effective, but again, after other options have been tried and proven unsuccessful.  With surgery there is the chance of infection, there is a recovery period, and the risk of complications.  I think you need to discuss these options with the orthopedist and figure out what is the best next step for you.  Good luck- I hope you get a quick resolution for this.

Bridget