Sort of OT: Frozen shoulder, anyone?

Dragonfly1... We feel your pain!!! I am 6 months post surgery. I still am doing my strengthening exercises for both shoulders. I was a little lax for a few weeks and BAM, I had pain during the night. That was my wake up call that I will have to do my exercises for a very long time. I agree that in order to do PT you might need more than just a cortisone shot. Nothing short of surgery helped me. In retrospect I wish I could have tolerated pain meds so I could do the PT and avoided surgery. Good luck!!

Interesting. I am considering BMX. I hope to heck that doesn't create even more problems. They told me implants would cause a more pain bcause of the AX, which is why I am considering tissue transfer. What do you all think?

This article appears in today's NY Times regarding sports injuries and MRIs.  I know it's a little off topic, but it reminded me of when I had my first shoulder MRI 5 years ago for my other shoulder.  Interestingly, the MRI MISSED some of the damage and some bone spurs in my shoulder.  At the time, the doctor told me that the MRI was only 60 - 70% accurate.  With my current shoulder problem in the other shoulder, the same doctor told me, based on the X-Ray, that I didn't even need an MRI, but he was going to do it anyway to confirm that I needed surgery.  Once again, the MRI UNDER diagnosed the extent of the problem. The article below deals more with OVER diagnosing problems. Leaves me wondering for orthopedics exactly how important an MRI is.  I think like the article states, the history, symptoms and X-Ray are of greater importance in determining whether or not a person needs a procedure.

BC-EXP-MRI-OVERUSE-NYT

Sat, 10/29/2011 - 01:33No descr                            The Associated Press       

(This article is part of TIMES EXPRESS. It is a condensed version of a story that will appear in tomorrow's New York Times.)

c.2011 New York Times News Service<

Dr. James Andrews, a widely known sports medicine orthopedist in Gulf Breeze, Fla., wanted to test his suspicion that MRIs, the scans that almost every injured athlete or casual exerciser gets, might be a bit misleading. So he scanned the shoulders of 31 perfectly healthy professional baseball pitchers.

The pitchers were not injured and had no pain. But the MRIs found abnormal shoulder cartilage in 90 percent of them and abnormal rotator cuff tendons in 87 percent.

"If you want an excuse to operate on a pitcher's throwing shoulder, just get an MRI," Andrews says.

He and other eminent sports medicine specialists are taking a stand against what they see as the vast overuse of magnetic resonance imaging in their specialty.

MRIs can be invaluable in certain situations - finding serious problems like tumors or helping distinguish between competing diagnoses that fit a patient's history and symptoms. They also can make money for doctors who own their own machines. And they can please sports medicine patients, who often expect a scan.

But scans are easily misinterpreted and can result in misdiagnoses leading to unnecessary or even harmful treatments.

For example, said Dr. Bruce Sangeorzan, professor and vice chairman of the department of orthopedics and sports medicine at the University of Washington, if a healthy, uninjured person goes out for a run, a scan afterward will show fluid in the knee bone. It is inconsequential. But, in an injured person, fluid can be a sign of a bone that is stressed or even has a crack and is trying to heal.

And scans almost always find something abnormal, although most abnormalities are of no consequence.

In sports medicine, where injuries are typically torn muscles or tendons or narrow cracks in bones, specialists like Andrews say MRIs often are not needed - they usually can figure out what is wrong with just a careful medical history, a physical exam and, sometimes, a simple X-ray.

MRIs are not the only scans that are overused in medicine but, in sports medicine, where many injuries involve soft tissues like muscles and tendons, they rise to the fore.

The price, which medical facilities are reluctant to reveal, depends on where the scan is done and what is being scanned. One academic medical center charges $1,721 for an MRI of the knee to look for a torn ligament. The doctor who interprets the scan gets $244. Doctors who own their own MRI machines - and many do - can pocket both fees. Insurers pay less than the charges - an average of $150 to the doctor and $960 to the facility.

Ok, so I was feeling sooooo much better and was only having shoulder pain at night after 4 weeks of PT. Then, yesterday I ended up right back where I started:( I have excruciating pain radiating down my arm, shoulder is painful to touch, can't lift my arm without pain, can't turn a doorknob, can't drive the stick shift in my car (because I can't push the gears forward), was awake from 2 am on last night because there was no position that didn't hurt terribly and I ended up sitting upright on the sofa just to tolerate it. What I can't understand is how it's become so inflamed again when I didn't do anything different and I was progressing so well? The only other variable I can think of is that I had a Herceptin infusion this week as well and I wonder if it triggered inflammation? I'm so annoyed. I don't have another appt with the Ortho doc until the week after Thansgiving. Meanwhile, I'm taking the prescription anti-inflammatories again and I'm going to take a Vicodin with my dinner....ARGGHHHH Have other people had this kind of flare-up and what causes it to happen?

Do you have numbness in your fingers?

Oy! Dragonfly...

 I know how frustrated you feel.  Don't look for a reason why it might have happened.  You could have sneezed hours before and inflammed the area and THEN felt the pain hours later when you were turning the knob on your front door.  I also can appreciate your frustration in driving.  Even today, after years of shoulders, arm and hand surgery, I MUST drive a car that I'm comfortable in.  For years when I would rent cars with front-wheel drive, I would be in AGONY after an hour of driving.  Did I tell you I even get sciatica from time to time?  My driver's seat also has to be "just so" or I am in agony!

Are you applying ice and/or heat?  Ice was the only thing that helped me.  My doctor told me to ice my shoulder for a half hour before going to sleep.  It worked for half the night.  When I woke up from the pain, I would then stretch my arm and then do another 15 minutes of ice and then I would get through the rest of the night.

I couldn't take narcotics because I get sick from them.  I would highly recommend that you take anti-inflammatories around the clock, if your stomach can tolerate them.  My doctor said that I had to take the anti-inflammatories around the clock for the duration of the pain and then to continue taking a lower dose of the anti-inflammatories for another week AFTER the pain subsided. 

Hope you get relief soon!  And...I hope you get a good night's rest!

Ok, so I went to the Ortho doc for followup today. He wants me to stop the anti-inflammatories unless the pain flares up again and wants me to continue the PT. He still didn't want to give me a cortisone shot because he's worried about overlapping with the Herceptin infusions and confusing the situation. I also mentioned that I'm beginning to get pain in my other shoulder now as well and in my right hip although it's not severe at all. He moved my hip and said I have tendonitis in the hip-it hurt pretty badly when he moved it in certain directions and put pressure on specific places-ouch! What is going on? I find it rather coincidental that I'm having shoulder problems and now hip tendinitis after all of this treatment. Ortho doc called my MO who said she doesn't think the Herceptin could aggravate any of this but wonders if Tamoxifen is contributing. Well that sucks since I need to be on the Tamox for 5 years. I may completely fall apart in that time:(

Dragonfly!!! One year out and you want to feel normal??!!! What's normal? I don't think there will ever be a normal again! I am almost two years out from diagnosis and I am still trying everyday to keep my shoulders from hurting. No doubt since my second shoulder surgery, I feel better. But when I look back on these last two years, I can't believe how many treatments and therapy I have had! And did I mention that my husband is disabled and chronically sick? In September he had a six hour heart procedure. Between the two of us, I can't remember a single week in the last two years that neither of us didn't have some kind of medical appointment. And while I am on a roll, shall I tell you about my gums??? I feel your pain! I am sick of being sick! And despite it all...I try hard every day to feel well! I keep walking everyday because I swear that "normal" is right around the corner and I will find it! I wish you well and "normal" and a good night's sleep! And if you find "normal" before I do... Would you mind sending it my way???