• question-icon

    Suggest remedies for radiating pain in posterior right shoulder, biceps and arms

Posted on Tue, 31 May 2016 in Bones, Muscles and Joints
Question: Fell of the stairs of a bus more that 4 months ago. My right shoulder got injured and have been hurting since. I was only treated with ibuprofen and naproxen and have been doing physical therapy twice a week for 2 months now without significant improvement. My mobility has actually improved but I constantly have a pain in the posterior right shoulder. Pain radiates anteriorly along bicepts tendon and towards the arm. Physical Therapy and movement increase the pain. Pain is in the form of a burning sensation inside the shoulder. Since 2 months I have noticed increased episodes to numbness, stiffness and light tingling in the right hand.These symptoms have become slowly more and more frequent since. Right hand gets very cold normally when the other is warm to the touch. Discoloration was noticed too. Constant sensation of weight over the shoulder. Mobility not too bad. Dicreased strenght and grip. Did an open MRI to the shoulder in January. At the time it was noticed a mild supraspinatus tendinosis. No linear rotator cuff tear, retraction or atrophy seen. Tiny possible paralabral cysts adjacent to the anterior-superior labrum. Tiny amount of fluid seen adjacent to to the anterior superior joint space. What would you recommend next. what do you think it might be going on? I feel that Phisical therapy might be targeting the symptoms and not the cause. Thank you
Answered by Dr. Matt Wachsman 4 hours later
Brief Answer:
some thoughts.

Detailed Answer:
an exam would be rather helpful. I've had rather a lot of patients with Thoracic outlet syndrome of late so that sticks in my mind, but I rather doubt that is the case. But... if it were... Holding the hand in the air in the manner of a zealous student answering a question for 3 minutes would produce dramatic, if not alarming effects (pain, paleness, and decreased function up to near-paralysis!).

Type of pain, location, and elicitation are clues to the source of the pain.
Various tissues can be the source of pain. "burning", "tingling", or shooting or electrical feelings would, of course, imply the nerves as the source of the pain. Since pain of nerve origin XXXXXXX outward from the source, one can deduce the source as at the most central part of the pain. Furthermore, the size of the region affected implies the size of the nerve involved. Small. And at the site of the injury. Nerves pained by an injury do not invariably get better with even long intervals after their injury. There could be something still whacking on the nerve. in which case, movement would trigger a Sudden! jolt of pain like hitting the funny bone or hitting the nerve in a damaged tooth. This is why an exam would be helpful, and would not only show if there were such a particular trigger, but identify WHERE and WHAT the trigger is. (if scar tissue, deformity, or the cysts were "hitting a nerve" then particular movements would give a definite trigger of pain and localize where the problem precisely is).
If there's a particular trigger, it might...emphasis 'might'...be surgically correctable.

I doubt it, because people mention what the exact trigger is, and describe it as quite eventful.

Then, irritation/injury/perturbation of a small nerve by a previous injury isn't going to be as amenable to treatment and the best treatments are medications that damp down nerves generally. These include any anti-epileptic and the lidocaine like effects of amitryptiline/nortryptiline.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Answered by
Dr. Matt Wachsman

Addiction Medicine Specialist

Practicing since :1985

Answered : 3703 Questions


The User accepted the expert's answer

Share on

Recent questions on  Ibuprofen

doctor1 MD

My 3 yr old s scrotum is bright purple on the top part and darker than normal on the bottom half. He is acting normal, no fever, no swelling. We...

doctor1 MD

hi there i have a really bad migraine the lights hurt my eyes and i struggled to get out of bed to come research this on the computer..i was...

doctor1 MD

My five year old son has been complaining about a headache off and on now for 3 days & has had a fever on and off as well. I wasn t sure if it were...

doctor1 MD

MY daughter, 22 years old, had a soft marble size place come up on her arm below her elbow causing pain from fingers to shoulder. scan done and was...

doctor1 MD

I am 14 weeks pregnant with twins. For the past 3 days am having severe shooting pain in my arms and shoulders. It started with left hand now moved...

doctor1 MD

I'm 27 year old female from past few days I have got joint pains . especially while climbing up and down the stairs along with the cracking sound....

doctor1 MD

My left testicle has been giving me slight pain and discomfort for around a week now. Especially when I lay on my side to go to sleep, it floats...

Get personalised answers from verified doctor in minutes across 80+ specialties

185 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
Questions Answered By Dr. Matt Wachsman
  • Q - Is there any interaction between Morphine and Gabapentin?

  • Q - Can the presence of Oxycontin be detected in urine?

  • Q - Can Oxycodone be taken for wrist and back pain?

  • Q - What causes spitting of black mucus?

  • Q - How can Meth be flushed out of the system?

  • Q - Would Adderall show up in a urine test?

  • Q - What is the differece between Oxycontin and Oxycodone?

  • Q - What causes pain after knee replacement surgery?

  • Q - How long can i take Xanax for anxiety?

  • Q - Are Omega 3 supplements effective in helping muscle recovery after a...