Suggest treatment for frozen shoulder
About 3 1/2 months ago, I tripped and fell down the stairs in the middle of the night and injured my shoulder. Because it didn't heal after a few weeks, I went to my primary care physician. He said I had shoulder impingement and I did physical therapy for about 2 months. My symptoms at the time were slightly decreased range of motion, sharp pain if I accidentally moved my arm the wrong way, and biceps soreness upon physical activity. Physical therapy didn't help although I don't think it made it worse either. I was getting sore from the physical therapy, though, and I (incorrectly) thought that meant I needed rest. (Because of the soreness, I didn't do the exercises at home either, and I may have just not given it a fair shot.) So I didn't do physical therapy or use the arm much for about 3 or 4 weeks. During that period, I lost a significant amount of range of motion in all directions. I went to a sports medicine doctor this week who thinks I have frozen shoulder. We've already done x-rays and today I have an MRI. Here are my questions.
1 - Does this sound like impingement or frozen shoulder? Or could I have both? Can you have biceps soreness with frozen shoulder or does biceps soreness mean it's impingement?
2 - Will the MRI definitely indicate which of these diagnoses it is?
3 - How effective and how much risk is associated with having a manipulation under anesthesia done? He mentioned that but it sounded scary.
More likely a frozen shoulder.
Thanks for posting your query.
1. From the history provided it seems that you had a mild tendon injury that gradually due to disuse of the shoulder has progressed to frozen shoulder. The biceps soreness can exist with a frozen shoulder or it could be due to a minor sprain due to the fall.
2. MRI scan will indicate any rotator cuff tear or any tendonitis in the area. Frozen shoulder or impingement are more of a clinical diagnosis which are confirmed by MRI scan which indicates an inflammation. It will help us in deciding whether surgery is needed or not.
3. Manipulation under anaesthesia helps only in frozen shoulder but after that regular physiotherapy is needed to increase the range of movement of the shoulder.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Dr. Praveen Tayal.
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From what I'm reading about frozen shoulder, it seems to normally fully resolve in a year or so. Once that happens, will the biceps get better? I'm worried about the biceps issue lingering. Thanks again.
MRI scan can detect tendonitis- inflammation.
Thanks for writing again.
If the pain appeared few weeks after the fall then it can be due to tendonosis. It cannot be diagnosed on MRI. An MRI scan can only detect the inflammatory changes- tendonitis.
If the frozen shoulder becomes better then the pain in biceps should also improve. You can take an oral muscle relaxant and do a hot compress and see if it helps.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
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