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Rotator cuff tear, took Lidocaine, painful arm, electric shock feeling, painful bicep. Brachial plexus injury?

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Orthopaedic Surgeon
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I had a heavy object fall from a 10 ft shelf onto my arm 10 months ago. I still have pain, decreased ROM in my shoulder. I sustained a small lidocaine injection in my shoulder. Immediately afterward had a little better ROM and a decrease in pain, but pain relief lasted only a few hrs. I have been doing stretching and light strengthening exercises, but nothing seems to be making it any better. Of note, my arm is very painful from my elbow to my shoulder. Overhead, behind my back, and lifting anything more than a pound or two is impossible due to pain. Ialso get alot of electric shock feeling and severe pain to my bicep. It is worse at nite so I am loosing sleep. I won't even take a nursing job because it involves alot of activities I am physically unable to do with my arm like this, God forbid someone code on me and I have to do chest compressions! I wonder about adhesive capsulitis or?.. Thanks
Posted Mon, 16 Apr 2012 in Bones, Muscles and Joints
Answered by Dr. Praveen Tayal 30 minutes later
Thanks for posting your query.
You suffered an injury to your shoulder 10 months ago where you suffered a inflammation of the area.
It seems to be Rotator cuff tendonitis or shoulder impingement syndrome which causes irritation and inflammation of the rotator cuff and the bursa when doing overhead activity and hence pain.
You need to get an MRI scan done which is a more sensitive test for soft tissue and muscular injuries. An Orthopedician is the best person to be consulted.
Here are some general treatment measures which you can follow:
1) Provide complete rest and avoid overhead activities.
2) Apply hot compresses and take some anti inflammatory pain killer after consulting your doctor. Applying local analgesic gels will be helpful.
If the symptoms are severe then after confirming the diagnosis by MRI, you may need repeat steroid injections or surgical arthroscopic technique.
It is not suggestive of brachial plexus injury.
I hope this answers your query effectively. In case you have additional questions or doubts, you can forward them to me.
Please accept my answer in case you do not have further queries.
Dr. Praveen Tayal.

Above answer was peer-reviewed by
Follow-up: Rotator cuff tear, took Lidocaine, painful arm, electric shock feeling, painful bicep. Brachial plexus injury? 33 minutes later
I was a little worried, given that the tear was only 1 cm, that when I guarded my arm and the pain got worse as did the ROM, that possibly the lack of use may have caused adhesive capsulitis. I am allergic to NSAIDS which limits what I can take. Also with my diabetes I do not like to take the steroids due to increased blood sugars. How long does something like this usually take to get better, and should I just use a simple arm sling? Are there other things that could be causing this?
Answered by Dr. Praveen Tayal 32 minutes later

Thanks for writing again.

The rotator cuff tears may remain unhealed in the absence of proper rest. Using an arm sling will be helpful if the tear has not healed yet. Pain can be treated with heat fomentation and topical pain balms. Since you are allergic to NSAIDS, the only anti inflammatory agent that will be helpful to you is low dose steroids or local steroid injections. You may consider it after controlling the blood glucose levels with appropriate treatment. Adding muscle relaxants like thiocolchicoside might also be helpful. You can get the appropriate drugs prescribed from your Orthopedician.

The time taken for recovery depends on the regular physiotherapy sessions.

Physiotherapy is helpful in restoring the range of movement after the tear has healed. This can be confirmed by doing an MRI.

Hope my answer is clear and helpful to you. Please accept my answer in case you do not have further queries.

Wish you a trouble free early recovery.

Above answer was peer-reviewed by
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