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Long-Term Effects of Injuries
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Long-Term Effects of Injuries

Good morning.  I will try to set this up the best I can understanding that there may be some questions which are unanswerable without an actual examination.

I was involved in a rather serious accident six months ago.  I had dislocated my shoulder and the mobility of my left leg was limited by a pinched nerve.  I think it was the L5 if memory serves.  I also had 2 cracked ribs, although I did not know about that at the time.

While all of these injuries have improved, the biggest problem I seem to be having lately is coming from what, at the time, was the least cause of concern which was my left shoulder.  Two weeks ago I started experiencing a tremendous pain at the very top of the shoulder, which was so severe I felt it radiating to my collarbone, up my neck, down my arm to the elbow, and in my rib cage below my armpit.  When it happened it was very difficult to turn my head or lift my arm anywhere near to above my head.  Whenever I did move the shoulder, I could hear all kinds of noise like knuckles cracking.  I used ice and aspirin and in a few days it subsided.  I should mention that this shoulder has almost always made some kind of noise when I move it, the result of a childhood injury.

Since it subsided so much, I thought it was healing but a few days ago I awoke and the pain was back in a big way.  This time I actually still had full mobility of the arm, but it hurt like hell.  I had an appointment for my annual physical so I mentioned it to my doctor at that time.  I guess because I was complaining of arm pain he did an EKG and the chest x-ray to be safe and that's how I found out about the cracked ribs.  He said that I possibly had radiculitis (I think) and that I could be aggravating it by sleeping the wrong way.  He did some x-rays on the shoulder and gave me an immobilizing collar to wear when I sleep.  

My question is, what are the long term effects of these injuries and am I starting to experience them with the shoulder?  At the time of the accident, I was told that I would almost surely develop arthritis in my shoulder and in the knee which I had also injured in childhood and re-injured in the accident.  I thought that would be years from now.  Could that be the case here?  What tests should I be asking for?  Is surgery something that could potentially be necessary?

Sorry to be so long winded.  Thank you.
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Dear Ken:

Sorry to hear about your problems.  It is difficult to say, because as you have already indicating that you know, without examinating you the answers are vague.  The radiating pain may be a couple of things.  The first is that you might just have irritated a already sensitive nerve in your cervical cord by the way you slept. This would explain the radiating pain.  You might also have done damage to your cervical spine in your accident and the way you slept that night just irritated the spine problem.  I think I would see a neurologist.  This way you can get a good neurological exam and also maybe get a neuroimage of the cervical spine, MRI. I think that one can better prognosticate after these things are done.

Sincerely,

CCF Neuro MD
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