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Have Monophobia, Agoraphobia And Claustrophobia. Having Shoulder And Arm Pain. Suggested Shoulder Injecting. What To Do?

Posted on Thu, 25 Jul 2013

Question: I have monophobia, agoraphobia, claustrophobia, been abused mentally, physically and sexually from the age of 8 years, got abused by a man in the homeless hostel I stay, but cos of my anxiety/panic attacks etc have trouble remembering much stuff. I am also prone to falls and walk with crutches as have a hump on my lower back caused years ago by constant kicks with steel toe capped boots. I fell sunday and landed hard on my right side, since then the pain in my right upper arm and shoulder and muscle really hurts and is sore to touch, in accident and emergency last night the doctor said I had a condition call XXXXXXX something, but cannot remember he said it was there for a while now but escalated through my fall and said something about arthritis and said I will need my shoulder injecting, do you know what this is?

Answered by Dr. S. Jegadeesan (3 hours later)

Hello,

I am sorry about your past events. On Sunday, you fell on your right side, causing pain in the right upper arm and shoulder. I assume that an X-Ray has been taken and your movement of shoulder joint is painful. Shoulder joint is a meeting place of 3 bones 1) Upper arm bone called - Humerus 2) Clavicle 3) Scapula

Injury to shoulder joint can cause
1) Hematoma
2) Fracture to any extend - a minor crack to major fracture in any one of the bones
3) Ligament tear or Injury
Preexisting osteoarthritis is not common in that joint bone.
The escalated pain is due to the involvement of this particular joint. Usually shoulder joint injury is much painful and healing will be much delayed.
Treatment is as per the type of injury. I assume that there is no fracture, otherwise the Dr might have told you.
If the fracture is ruled out only ligament injury is the possible cause for the pain.
Whatever may be the reason, what you need is a CUFF and COLLAR to immobilize your shoulder + Antibiotic + Anti-inflammatory + Rest thus allowing the injury to be healed.
Some time if the injury is due to ligament damage and the pain is intolerable we can plan for a Hydrocortisone injection to alleviate the inflammation and pain.
The duration of that injection is as per the Dr's choice. Since it happened only in the last Sunday, it is better to wait for the injury and yourself to settle. Even if it is ligament injury there will be some amount of blood collections. If at all a needle is introduced it should be only for aspiration of blood collected inside the joint and not for injecting any medicine.
Even if there is preexisting osteoarthritis - Injection is contraindicated at this stage.

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. S. Jegadeesan (1 hour later)

I was not x rayed at the hospital amd my right shoulder is higher up than the left, making me look lop sided, the doctor just said I have arthritis and it was exacerbated by the fall and need to get my gp to refer me to the hospital to have my shoulder injected, it's making it difficult to walk with my crutch and so I just tried walking without it and fell again in the garden, I cannot lift my arm very high as it makes the pain worse and there is also a lot of pain in my musle and in my upper arm

Answered by Dr. S. Jegadeesan (58 minutes later)

Hello,
Thanks for your follow up question,
Few doubts on my part
You say that your right shoulder is higher up than the left - since when? Before or after the fall.
You have stated as crutches - so I assume that you are using crutches in both your upper arms. If so was there any difference in holding the crutches.
How Arthritis was confirmed without X-Ray?
You say that after the fall you are not able to walk with the crutch under your armpit, and you are not able to lift your right upper arm very high - indicating some form of injury in the shoulder joint - which necessitates for X-Ray right shoulder.

Kindly clarify me. I am ready to answer.
With warm regards
dr. S. Jegadeesan.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. S. Jegadeesan (7 days later)

My crutches are the one's that you put your arm in and hold the handle, my shoulder was not higher than the left one before the fall, I also then fell in the bathroom and because of the injury to my right shoulder and upper arm I couldn't get myself up, so have now injured my left knee and it's all bruised at the back of itI had my shoulder x XXXXXXX at the hospital yesterday as my doctor sent me for them. I'm also waiting to see an oncologist as my stomach looks as though I'm 7 months pregnant all I've been told is that my whole liver is course when it should be smooth, I have so many health problems but never seem to get any where and the doctor I have just seems to take forever to get any thing done, she did repeat bloods and it shows for liver that I would be a heavy drinking when in fact I don't drink any alcohol I'm still folate anemic even though I been taking folic acid daily for 6 months now and my red blood cells are enlarged

Answered by Dr. S. Jegadeesan (7 hours later)

Hello,
I went through your follow up details
X-ray was taken only yesterday. But you have not mentioned about the X-Ray report. It may reveal the cause of your elevated shoulder like a dislocation.. Your liver is coarse and your abdomen is enlarged – Non alcoholic also may get similar condition – may be cirrhosis liver with portal hypertension.
You have an appointment with the Oncologist. That means that your treating Dr wants to rule out other problems in the liver and abdomen. Anemia is expected in such conditions. Wait for results and after the consultation with the oncologist we can arrive at a diagnosis and plan for future treatment. Meanwhile continue the treatment you are getting.
Best wishes

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Shanthi.E