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Elbow injury, pain in shoulder, cervical spine Ap lateral, osteophytes, spondylotic, zyloric, uric acid. Suggestion?

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Practicing since : 2001
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Dear Doctor,
I had a fall three months back.I fell forward took most of the impact on the right elbow where there was wound ,which heeled up very fast.At that point of time time I felt pain on the right shoulder extreme end and at elbow, a slight pain.It is about 3 months since that incident.When I compare the pain I find it far worse now than when it first happened.I took an Xray about 2 months back of the right shoulder Ap/axial which showed everything normal.I was prescribed about six session of heat treatment 20 minutes each and followed up the heat treatment at home too with a hot water bag.Thereafter I was given some exercises for the shoulder which I did for about 5 days.I found this was getting worse.The pain seems to be more.I therefore stopped the treatment and hoped time would cure.But the pain has not gone away.So I met with another doctor who asked me carry out another xray of the cervical spine Ap lateral.Here, the problem lies with "Reduction in c4-5 and c5-6 space with Osteophytes suggestive of Spondylotic". All other parts are fine.This pain is a bit uncomfortable preventing me form sleeping well and making a bit edgy at times.I am 53 years old,height 167cms and weight 82kgs.I work as a Captain in the merchant navy.I have been taking zyloric due uric acid is on border line 8.0.I have been suggested to carry out some other tests,which I am waiting for the results.I don't have diabetes and my Blood pressure is normal.I would be grateful for your advice and suggestions of how I can rid myself of these pain.
the heat treatment followed is called short wave diathermy.i had 6 sessions of 20 minutes each.this was around 20th XXXXXXX
the medication taken around 04th XXXXXXX was invilin tablets,flexilor 8 mg ,pansec 40 mg,carvic casules .
around 14th may i took lobak tab,pantodac dsr caps,voveran emul gel.
Thank you.
Posted Wed, 11 Apr 2012 in Bones, Muscles and Joints
Answered by Dr. Rakhi Tayal 48 minutes later

Thanks for writing to us.

The pain in your shoulder is probably due to cervical spondylotic changes in your spine.

The treatment given to you is appropriate consisting of pain killers and anti ulcer drugs. Continue them as recommended by your doctor. You may have to add a good muscle relaxant to it like thiocolchicoside and methylcobalamin supplementation of at least 1000mg at night after consulting with your doctor.

Avoid doing any exercise during acute pain phase. Short wave diathermy to the cervical region will be helpful again in relieving the pain.

Cervical isometric exercises are beneficial to maintain the strength of the neck muscles. Neck and upper back stretching exercises as well as light aerobic activities are also recommended under the guidance of a physical therapist.

Apart from this, use of cervical collar will also help in immobilisation. This will bring relief.

I hope my answer and recommendations are adequate and helpful. Waiting for your further follow up queries if any.


Above answer was peer-reviewed by
Follow-up: Elbow injury, pain in shoulder, cervical spine Ap lateral, osteophytes, spondylotic, zyloric, uric acid. Suggestion? 22 hours later
Thank you Doctor for the advice.
I am bit confused if the diagnosis is do with the neck.i dont seem to have any pain in the neck and the movements of my neck appear pain free.
I just have the report of my blood test.Following is the gist of the reports:

Haemoglobin 14.6 Range 13.5-18
PCV 41.8 40-54
RBC count 4.78 4.5-6.5
MCV 87.4 76-96
MCH 30.5 27-32
MCHC 34.9 32-36
RDW CV L 13.4 range 14-16

EOSINOPHILS 03 0.0-6.0
MONOCYCTES 01 0.0-8.0
BASOPHILS 00 0.0-1.0
PLATEELT COUNT 0000 0000-0000

Cholestrol H 230 < 225
triglyceride 122 <150
HDL Chlosetral 51 >35
LDL cholestral H 155 80-150
ldl/hdl Ratio 3.0 2.5-4.0
Blood sugar FPS 98 60-110
Blood Sugar PP 104 60-160
Uric acid 5.1 3.5-8.5
Creatine 1.1 0.5-1.4
SGOT 38 15-46
SGPT 45 10-66

Kindly advise if any of the above could be a obstacle in the healingprocess.Also since I work on the ship in a XXXXXXX rank there is not much physical work but at times it may be required.Can you advise what sort of jobs i should refrain from? eg lifting weights , climbing ladders etc.

The current doctor I am seeing has prescribed :
Tablet Sirdalud 2m once at night
Caps Lactobacille plus 3 times a day
Tab Sera Dase

Thanks and regards XXXXXXX
Answered by Dr. Rakhi Tayal 49 minutes later

Thanks for writing again.

All your investigation reports are almost normal. The symptoms in your arm and shoulder are due to the problem in the neck vertebrae only. It is usually due to compression of the nerves rather than a muscular problem.

You should avoid lifting weight and doing heavy work from that side, avoid using a pillow and working on computer for long hours.

The treatment you are getting does not include a good pain killer. You need to have a better muscle relaxant like thiocolchicoside instead of Sirdalud and add methylcobalamin supplements after consulting with your physician.

Hope my answer is helpful.

Wishing you a trouble free speedy recovery.

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