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Shoulder injury, severe pain, unable to lift left arm, pain in elbows. Steroid injections for pain relief?

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Orthopaedic Surgeon
Practicing since : 1994
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Help! My boyfriend has an old shoulder injury (fell off a roof 5 yrs ago onto his right shoulder and never went to doctor...he's smarter now I hope). He waits tables and this involves trays, lifting, overhead stuff, and lots of external rotation at the shoulder. I'm a PA student only 2nd semester, but I know enough that he's definitely positive for empty can, apprehension test, can't lift his arm without help to his shoulder without a lot of pain. He complained of pain inside his elbow where the biceps inserts a few days ago, and today he is in a great deal of pain and is holding his arm close. He has worked 3 double shifts in a row, and needs to work two more. We leave the country on Saturday for 2 weeks. Is there anything that can relieve the pain and inflammation for now? (I don't think he really wants to be on narcotics on a trip to Europe with family) If he went to an urgent care would they give him a joint injection of steroids or something or be afraid to touch it? What would be a temporary fix that would help him make it through Christmas without agony and still remember it?
Posted Sat, 14 Apr 2012 in Bones, Muscles and Joints
Answered by Dr. Praveen Tayal 1 hour later
Thanks for posting your query.

From the symptoms that you have described, it seems to be Rotator cuff tendonitis or injury which is causing irritation and inflammation of the rotator cuff and the bursa when doing overhead activity and hence pain.

Usually, there is enough room between the Acromion and the rotator cuff, so that the tendons slide easily underneath the acromion as the arm is raised. But each time the arm is raised, there is a bit of rubbing or pinching on the tendons and the bursa. With overuse, this can cause irritation and swelling of the bursa.

It causes local swelling and tenderness in the front of the shoulder and initially it presents as minor pain but gradually it causes severe pain and loss of motion.

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 he can follow:

1) Provide complete rest and avoid overhead activities.
2) Apply cold compresses and take some anti inflammatory pain killer after consulting your doctor. This might fix his pain temporarily.

If the symptoms are severe then, after confirming the diagnosis by MRI, you may consider steroid injections or surgical arthroscopic technique (kept as last resort).

I hope this answers your query effectively. Please accept my answer in case you do not have further queries.

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