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Extreme Arm, Neck And Shoulder Ache. Had X-ray Which Is Normal. Taking Anti-inflammatory Drug. Is It Frozen Shoulder?

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Posted on Thu, 16 May 2013
Question: I had a motorbike accident and pain came to my shoulder 4 days after the accident, since then I have had severe pain in the morning which lasts about 2-3 hours, then the rest of the day my shoulder and upper bicep just aches slightly, also my back and neck can sometimes ache sporadically. This injury was 4 weeks ago, and since the I have had severe motion loss of arm unless using I use it low to the ground , now the pain also radiates to my neck and shoulder blade sometimes, My bicep area has become numb also, I think it maybe an extreme case of frozen shoulder. “frozen shoulder”, but im worried if my tendon is torn and worry about losing motion with this arm for the rest of my life, My arm now 3 hours after waking up and taking a anti-inflammatory drug, a muscle relax and a heavy pain killer "Lyrica" The ache continues right now i have no motion whatsoever with my shoulder outward from by body in all directions. Forgot to mention i have dislocated this arm "right arm" when I was young approx 6 years old, and I am 26 years , but i have had an xray and it and it showed no dislocation. What would be your thoughts/diagnosis and what treatment do I need ?

Kind Regards XXXXXX
doctor
Answered by Dr. Ketan Vagholkar (1 hour later)
Hi,
Thanks for writing in.
A shoulder injury following a motorbike accident needs to be attended to seriously. There is a high chance of what is called a neurological examination by a specialist.This should be supplemented by imaging studies namely a MRI of that region along with nerve conduction studies if required.X XXXXXXX has ruled out bony injury which is a good thing. This will give a clear picture as to whether there is any worrisome problem necessitating further intervention or whether conservative treatment will suffice.
I hope this answers your querry.
regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ketan Vagholkar (6 hours later)
Hi, in response to your answer, I live in Thailand and for me to get any decent medical care is difficult ie. MRI But I do have full movement and control from my elbow joint down to the fingers and abit of movement from my shoulder too. I have started doing exercisers for a frozen shoulder, which my local GP diagnosed me with. I also have a business here which I cant really leave back to Australia to get the proper MRI and diagnosis.
I looked on wiki and it stated that a complete sever of the nerve would leave my arm fingers etc. paralyzed, in my case i do not have. I am now considering that it could be a stretched nerve or frozen shoulder, In the case of a stretched nerve what should I be doing to treat it? ie. exercisers or maybe a sling?

Also the motorbike accident was at low speed in which I had full enclosed helmet and have had skull scans which showed no evidence of damage to the brain.
doctor
Answered by Dr. Ketan Vagholkar (1 hour later)
Hi,
Thanks for the feedback.
If all the movements of the injured limb are normal then good physiotherapy can be of great help. Graded exercises along with periods of rest and mild analgesics will help in early recovery. In case of a stretched nerve the treatment is the same as aforementioned. It is good that brain scans are normal.
The frozen shoulder must be a contusion of the shoulder joint which requires analgesics and good physiotherapy. Therefore I would advise you to seek the services of a good physiotherapist.
I hope this answers your query.
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ketan Vagholkar (2 days later)
Hi,
Do you think that due to the pain in my shoulder and loss of movement in my shoulder happened 4 or so days after the accident that "if it was a nerve had not been severed, if it was severed when I had the accident wouldn't I have had severe pain and loss of motion instantly, along with loss of movement of elbow joint, bicep muscle, hand grasp and further numbness down my forearm? Now I have full control of every part of my arm, joints and muscles except for the loss of motion of my shoulder. Now the only trouble pain wise is after i wake up about 5-10 minutes severe pain starts and after taking medication or just standing up and moving around seems to make the pain go away although it still aches a little bit during the day and hurts to try and move the joint by it own. im just confused why the the severe pain is after a wake up within 5-10 minutes lasts for 15 minutes or so. With the information I have given you, do you suggest if it is a Brachial plexus injury it would be of the less severe and that I could wait some months for it to repair itself. and if so should I put it in a sling to prevent movement so It could heal quicker? Or if a nerve was severed would the pain and immobility of my shoulder start straight away rather than 4 days after the accident. sorry for the long msg but im far from and decent hospitals that would be able to diagnose this problem. Kind Regards Len.
doctor
Answered by Dr. Ketan Vagholkar (5 hours later)
Hi,
Thanks for writing in.
Brachial plexus injury does not always present in its severest form. It may at times present only in a mild form without much neurological deficit. In your case a good neurological examination is a must. If that happens to be normal that is the movements and power of all the muscles as well as the cutaneous nerve supply is normal then the cause of shoulder pain most likely is contusion. This can be picked up by a MRI scan and confirmed by nerve conduction studies.
Since at this moment of time you do not have access to good centers I would suggest
1. Intermittent periods of rest by way of a sling
2. Physiotherapy on a regular basis to regain movement and to reduce stiffness.
3. Mild pain killers.
4. Hot fomentations.
I hope this answers your doubt.
Regards
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Ketan Vagholkar

Gastroenterologist, Surgical

Practicing since :1989

Answered : 883 Questions

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Extreme Arm, Neck And Shoulder Ache. Had X-ray Which Is Normal. Taking Anti-inflammatory Drug. Is It Frozen Shoulder?

Hi,
Thanks for writing in.
A shoulder injury following a motorbike accident needs to be attended to seriously. There is a high chance of what is called a neurological examination by a specialist.This should be supplemented by imaging studies namely a MRI of that region along with nerve conduction studies if required.X XXXXXXX has ruled out bony injury which is a good thing. This will give a clear picture as to whether there is any worrisome problem necessitating further intervention or whether conservative treatment will suffice.
I hope this answers your querry.
regards