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Suggest treatment for persistent shoulder pain when diagnosed with supraspinatus tendonitis

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Posted on Thu, 28 Jul 2016
Question: 48 M, Civil Pilot complains of Right Shoulder Pain for the past 1 year and he was diagnosed with Supraspinatous Tendonitis. No History of Trauma. Conservatively managed. Untill 3 months back pain aggrevated.

After repeated visits to an Othropedic Surgeon - was managed on physiotherapy and oral medications. But did not get any relief.

MRI - Suggesitive of Adhesive Capsulitits
ROM Right Shoulder -
Flexion - 130
Extension - 40
Abduction - 90
Adduction - 55
No muscular atrophy noted.

After repeated visits and conservative management with an orthopedic surgeon and Avaition Medics - was declared UNFIT for Flying permanantly.

Kindly comment if the patient is Permanantly Medically Unfit or Tempoarary Medically Unfit.
doctor
Answered by Dr. Prof. Kunal Saha (2 hours later)
Brief Answer:
Intense physiotherapy and treatment would be necessary.

Detailed Answer:
Thanks for asking on HealthcareMagic.

I have gone carefully through the query and understand your concerns. I find the nature of being declared unfit to be of temporary nature. However, the problem needs to be dealt with. Intense physiotherapy is needed for the same. Intramuscular botox injection (sometimes given to patients with cerebral palsy) may need to be administered. Topical steroids might also need to be administered. Stretch exercises and intense physiotherapy is needed to prevent development of permanent disability. It is only after proper resolution of the problem that he can be declared fit to fly again.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Prof. Kunal Saha (18 hours later)
Dear Sir,
Thank you for your revert.
We would like to inform you that Patient was under continuous Physiotherapy for 1 year and the last MRI report suggestive of - Mild Acromio-clavicular Arthropathy seen with Minimal Fluid Along subcromial Subdeltoid Bursa and Mild thickening of inferior glenohumeral Ligament - Concern for Adhesive Capsulitis.

Kindly suggest can this be considered as per Permanent disability.
doctor
Answered by Dr. Prof. Kunal Saha (4 hours later)
Brief Answer:
A step by step increasing effort has to be taken to limit the disability.

Detailed Answer:
Thanks for writing back. I understand your apprehension but I have already stated the answer. If the battle is won, the failure is just temporary. It is not easy to win the battle and would require significant effort. If the efforts are enough to fight off the odds, failure would not be permanent and can be overcome. If not, and if you he is unable to fight it out, disability would have to be considered permanent. There is no single answer to this. I hope that I have been able to explain you.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Prof. Kunal Saha

General & Family Physician

Practicing since :1954

Answered : 4472 Questions

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Suggest treatment for persistent shoulder pain when diagnosed with supraspinatus tendonitis

Brief Answer: Intense physiotherapy and treatment would be necessary. Detailed Answer: Thanks for asking on HealthcareMagic. I have gone carefully through the query and understand your concerns. I find the nature of being declared unfit to be of temporary nature. However, the problem needs to be dealt with. Intense physiotherapy is needed for the same. Intramuscular botox injection (sometimes given to patients with cerebral palsy) may need to be administered. Topical steroids might also need to be administered. Stretch exercises and intense physiotherapy is needed to prevent development of permanent disability. It is only after proper resolution of the problem that he can be declared fit to fly again. Regards