Progressive? or Just Bad Luck?

[buggysmom]

HI. May 3, 2007, I lifted a 40# box at my former job, and my right shoulder began to hurt shortly after. I went to my Dr who gave me a shot (can't remember what) the 1st day (no help), sent me for MRI a week later, and then gave me a cortizone shot the following week, sent me to PT and said that it was tendonitis. I was off work for 36 days, and of course, Brickstreet denied my comp claim. My question is, that every since then, it like I constantly have muscle spams, headaches (daily upon waking and through out the day), severe fatigue, pain in various places, and I am now on neurontin for nerve pain in my hands (which has helped my shoulder, but i still have to "roll" my shoulder to reach above my head). My question is, could my original shoulder injury be causing these other problems, or is it just a coinesidence? Could this have started a Fibromyalgia type illness to begin? I worked as a resturant manager on my feet for 10 hrs a day 50 hrs a week, with contant overhead reaching. I have since quit my job to be home with my children, and am not looking to "go back on my former employer", just trying to get some answers that my DR dosent seem to have. I have been tested for pretty much everything, and the only thing that they have came up with is Thombocytopenia, which they believe is autoimmune.

Thank you

[Philip D Parks, MD, MPH, MOccH, FACOEM]

I would encourage you to continue to perform the exercises that they showed you in physical therapy for your shoulder. That will likely help stabilize and strengthen your shoulder given that the MRI did not show any tears or anatomical disruptions.

And, keep charging head with making healthy lifestyle choices -- continue to taper down to zero on your use of tobacco, try to stay as active as you can, and keep a positive attitude.

You might consider asking your physician about information regarding healthy food choices, controlling your portion sizes for meals, and how to safely increase your activity level to begin a cardiovascular exercise program.

Some helpful links:
1. http://www.americanheart.org/presenter.jhtml?identifier=537
2. http://www.hsph.harvard.edu/nutritionsource/


~•~ Dr. Parks

This answer is not intended as and does not substitute for medical advice. The information presented in this posting is for patients’ education only. As always, I encourage you to see your personal physician for further evaluation of your individual case.

[buggysmom]

Hi.
Thanks for responding.

The MRI showed slight tendonitis, no rotator cuff injury, tears ect. The original Dr said that he was considering a exploritory scope to see if there is damage that was "hidden" during the MRI. As far as pain now, I would put it at a 4, as long as I have not been using it alot, and not reaching above shoulder height. It is tolerable, so I don't really want to do the sugery unless it gets worse. I did go to Physical Therepy for 3 weeks, right after the cortizone shot, so I am not really sure which helped me more. I can say that I went back to work Mid-June, and by August 1st, I was back to were I started.

I do try to walk everyday, and have lost back to my pre-pregnancy weight (which is still too much, but I am still working on it 180#, 5'8".) I do smoke, but am slowly cutting back, now down to less than half pack per day.

Thanks

[Philip D Parks, MD, MPH, MOccH, FACOEM]

Hello.

In response to your question: "Could my original shoulder injury be causing these other problems, or is it just a coincidence?"

It is possible to have upper back, neck, and shoulder discomfort after a shoulder injury. This can occur because after an injury to the shoulder girdle muscles, tendons, or ligaments, the body may have to compensate for the injury by using other muscles. As a result, these "other muscles" in the neck and upper back can become strained and sore. It is possible that strained muscles in the upper neck and back can be related to headaches as well.

I cannot answer your question about fibromyalgia with any certainty--this diagnosis is a clinical diagnosis and is dependent upon your provider's impression of your symptoms and physical examination.

I would strongly encourage you to remain as active physically as you can. If you are not exercising 3-5 times weekly, I recommend that you discuss beginning such a program with your medical provider. If you are a smoker, I would strongly encourage you to consider stopping smoking. If you are obese or overweight, I would strongly encourage you to discuss "healthy" weight loss strategies with your medical provider.

Lastly, how is your shoulder now? Did you have physical therapy? What were the findings on your MRI?

I hope this is a helpful start to addressing your questions and concerns.

~•~ Dr. Parks

This answer is not intended as and does not substitute for medical advice. The information presented in this posting is for patients’ education only. As always, I encourage you to see your personal physician for further evaluation of your individual case.