Do I need surgery

[Jacki797]

This question is for Dr. Parks. I had a flue shot too high on my shoulder 7 months ago. I still have a lot of pain and have limited use of shoulder (I get pain if I move it certain ways, but I do not have a frozen shoulder). An MRI shows mild tendonitis and bursitis. I have had 2 cortisone shots and 10 weeks of physical therapy. Some doctors say this will heal, others say to consider surgery. Do you think this will heal without surgery? How long should I wait before considering surgery? Should I continue to do physical therapy even if my shoulder hurts more after I do it (not just immediately after I do it, it can feel worse for a couple of days, which makes me worry that I am doing further damage rather than helping)?
     Jacki

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

Yes, if there was inflammation related to the influenza vaccination, it is likely that overtime that the inflammation would decrease overtime.

It will be important for you to focus on functional goals at this point: range of motion, strength. These goals can be guided by a physical therapist and your medical provider.

I am not sure what a doctor of environmental medicine would add to your care plan at this point.

~•~ 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.

[jacki799]

What I really need to figure out is, Do you think any damage caused by the flu vaccine will repair itself on its own?  Do you think an injury to a nerve is the problem? I think the subtle labral tear is a separate issue.  And lastly, Do you think if I see a doctor of enviromental medicine, he would be able to help? Thank you so much for your help.

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

Hi Jacki,

It is very unlikely that the labral tear is causally related to the influenza vaccination.

The decision to have surgery or to not have surgery to repair the labral tear is a decision that you will need to discuss with your surgeon and primary care physician. That decision should be based on your symptoms, physical examination findings, functional status and anticipated outcome from surgery (i.e. less pain, increased range of motion, etc).

I hope that this is helpful.

~•~ 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.

[jacki799]

Hi
Here's the exact findings on the MRI

1. Rotator cuff intact with minimal supraspinatus and Infraspinatus tendinopathy.

2. Possible new posteroinferior Labral tear.  Further evaluation with MR arthrography recommended if surgery is contemplated.

The shot was given in my left shoulder and I am righ handed.  The PT said my shoulder is very weak and any kind of exercise seems to flare up my condition.

Thank you
Jacki

[jacki799]

Today I was told that the new MRI showed possible labrum tear. Two other people on the internet reported the same kind of tear after a flu shot. Do you think I need surgery with this condition if I have not improved after 7 months? Also, the MRI said I would need an MRI with contrast to confirm the diagnosis. I am not willing to do this test as I had difficulty with my second MRI. Also, do you think the vaccine itself has contributed to this problem and in what way? I will let you know the exact findings on the MRI tomorrow. The two people on the internet who had this problem did not do well after surgery, so I am worried. Thank you for your help. Jacki

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

Hello Jacki -

Are there any other findings on your MRI? (such as a rotator cuff tear?) Have you had improvement of your range of motion or the severity of your symptoms (for example, after the cortisone injections)?

Have you seen a surgeon yet? What are they recommending for you?

Based on the MRI findings that you describe, conservative management (physical therapy - range of motion + strengthening exercises) will likely be the best solution.


~•~ 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.