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Suggest treatment for severe arm and shoulder pain after an injury

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Posted on Wed, 16 Jul 2014
Question: My friend had a bad injury to her right shoulder, over the past 20 years she has had several surgeries to repair it. She now has severe pain when she trie to lift her arm above the shoulder. she just saw a doctor and he feels it is the nerve being pinched when she does try to lift it. My question is is there a doctor or hospital that specializes in this kind of repairs? here is a lot of scaring inside of the shouder.
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Answered by Dr. Prasad (11 hours later)
Brief Answer:
Physiotherapy is the first option...

Detailed Answer:
Hi,

All surgeries leave behind some scarring and adhesion which limits the mobility of joint. Those adhesion keep adding with number of surgeries performed. I would not let my patients to be operated further to treat scars accumulated over 20 years through numerous surgeries. It's just going to add some more scars instead of correcting it, more over I don't think all the scars can be taken care of.

Rather I would refer such patients to a physiotherapist. Physical therapy to some extent might help.

In addition, she can also visit a neurologist who after detailed evaluation might be able to figure out the nerve that is trapped. Neurosurgeon or your orthopedic surgeon can release this nerve if possible. If not, it can be managed with pain threshold lowering drugs and pain killers.

To summarize, in my opinion her first step is to visit a physiatrist who specializes in physical therapy. If the physiatrist has no treatment options, then she can follow up with a neurologist and surgeons. If you are convinced with this plan of action, specify this patient's location. I shall try looking for a doctor/therapist nearby.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Prasad (4 hours later)
Thank you for answer She did go through physical therapy a few years ago. and it didn't help her. The doctor did sugeest seeing a neurologist, she lives in the north central part of Minnesota. Can you recommend a hospital o doctor for her to see, see is about 2 hrs from XXXXXXX ND?
doctor
Answered by Dr. Prasad (17 hours later)
Brief Answer:
Sanford Medical Centre, XXXXXXX ..

Detailed Answer:
Hi,

The closest institute that I could find which might be able to help her is Sanford Medical Centre. I was able to narrow down my search on Dr. XXXXXXX L Scarberry. She specializes in neuromuscular conditions and has enough experience to be able to assess her. You can try reaching her there. It is located at 700 1st Ave S, XXXXXXX ND 58103. This doctor can only assist her figure out if the nerve is involved. She will need a surgeon who can release it (if its feasible). You may find the surgeons at the same place.

Having said that, if the nerve is involved, we may or may not be able to release it as it has been trapped with plenty of scars over many years. I shall keep my fingers crossed.

If surgery is not feasible, the next option is to discuss about using pain threshold lowering drugs to kill the pain and give her a better quality of life.

I wish her good luck!!

Please write back for clarifications.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Prasad

General & Family Physician

Practicing since :2005

Answered : 3612 Questions

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Suggest treatment for severe arm and shoulder pain after an injury

Brief Answer: Physiotherapy is the first option... Detailed Answer: Hi, All surgeries leave behind some scarring and adhesion which limits the mobility of joint. Those adhesion keep adding with number of surgeries performed. I would not let my patients to be operated further to treat scars accumulated over 20 years through numerous surgeries. It's just going to add some more scars instead of correcting it, more over I don't think all the scars can be taken care of. Rather I would refer such patients to a physiotherapist. Physical therapy to some extent might help. In addition, she can also visit a neurologist who after detailed evaluation might be able to figure out the nerve that is trapped. Neurosurgeon or your orthopedic surgeon can release this nerve if possible. If not, it can be managed with pain threshold lowering drugs and pain killers. To summarize, in my opinion her first step is to visit a physiatrist who specializes in physical therapy. If the physiatrist has no treatment options, then she can follow up with a neurologist and surgeons. If you are convinced with this plan of action, specify this patient's location. I shall try looking for a doctor/therapist nearby. Regards