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Question

Hi

 

I am 66 yrs old male - residing in Sea Point

I am a keen and regular gym fanatic! 

For over a year I have had some shoulder problem - some days better

Lifting and turning in my car is painful and sometimes OK

At night top of shoulder aches and later pain is intermittent

I had an Xray and it said Rotator Cuff Synd and mild arthritis

My biok said I must only use light weights and monitor discomfort

He didn't  think I need surgery 

I am using Voltaren 2 X day

What is your advice?

Regards 

Arthur Joffe

0848800130

Answer

Dear Arthur,

One cannot make  a clinical diagnosis from an X-ray only. "Rotator cuff syndrome" is a most vague diagnosis.

You need to be examined, X-rays viewed by a specialist and probably an ultrasound of the rotator cuff tendons. After that a definitive diagnosis can be made, and appropriate treatment (even if conservative) can be suggested

You may contact my office if you choose to do so at 021 9111017 and we can see you at Cape Town Medi Clinic 

Regards,

Joe de Beer

 

 

Question

Dr, my huis dokter het gesê dat ek verkalking in my skouer het en dat ek 'n ortopeudiese chirurg moet gaan sien vir 'n operasie. Ek het ongelooflike pyn in my linker skouer, boarm en voorarm. Ek kan nie iets optel met gemak nie. Ek het al gegaan vir 'n kortisoon inspuiting twee maande terug, maar die pyn is terug. Is 'n operasie die antwoord? Wanneer ek my arm roteer hoor en voel ek 'n gekrap in my skouer wat pynlik is.

Answer

Die verkalking kan verwyder word met 'n klein (artroskopiese) operasie of selfs met "needling". Kyk gerus na ons website oor die onderwerp (http://www.shoulderinstitute.co.za/calcific_tendinitis.php )

Jy is welkom om ons te kontak by tel nr 021 9111017

Dr Joe de Beer

 

 

Question

Hi Dr de Beer,

I have had an issue with my left shoulder that has now persisted for about 4 weeks. 

The pain is pointed on the front of my shoulder (inside) and along the back of my arm. 

I am quite fit, I noticed a huge change when I could not do a pull-up nor chin-up anymore as the left shoulder would buckle. Also pick up a free weight of the floor with my left arm hurts pretty significantly.

The left shoulder is very "snap crack & pop" and painful when sleeping / worse in the morning. 

The shoulder feels a bit stronger than before but strength has not returned to hold my weight nor do a single pull-up. Range of motion as I go higher to the bar increase the pain to a pain where I can't pull higher. 

I have been involved with alot of physical activities that likely have slowly hurt the shoulder (Rugby, Jiu Jitsu etc.) and I wondering if I am at a point where I may have a tear that will continue to deteriorate if I ignore it. 

I can, with pretty sigficant strength, pull weight in a seated row position - push / pull in a vertical motion is very painful - is this something that I should probably come in for a consult? 

Thank you so much for you time and this form submission! Very much appreciated!

Answer

There are many causes for pain as you describe- a rotator cuff problem ( even a tear) could do that. You need to be examined, X-rays taken as well as an ultrasound to confirm the diagnosis and work out the appropriate treatment

Question

Hi Dr. de Beer. I am a 36 year old female. Almost a year ago I was seeing a physio for neck spasm and she began working over my left collar bone area. It was very tender - always has been due to an old injury - but she focused on it and the level of pain as she worked was unreal. The old injury (14+ years ago) was an accident where I landed on the point of the left shoulder with my full weight - no dislocation, just 'over stretched' ligaments. I have had problems with the shoulder/ collar bone ever since that physio. Xrays were done, they said the joint looked almost normal so I was told it was most likely soft tissue damage, given painkillers and a sling to wear for a few days. Didn't really help. Sleeping on the shoulder is painful. The collarbone/ front of my chest & shoulder are sore to varying degrees daily. I don't have a reduced range of movement but I do have discomfort performing movements like rolling my shoulders, crossing my arm over my chest etc. Would soft tissue damage not have healed by now? I would not rate the pain as severe, but it is a daily thing, annoying and frustating and it impacts my quality of sleep. Should I continue to give it more time or is this something that needs to be looked at?

Answer

The cause could be a Thoracic Outlet Syndrome and you should have it checked to confirm the diagnosis and so that the  most appropriate treatment can be done

check my website for more info:  http://www.shoulderinstitute.co.za/thoracic_outlet_syndrome.php

 

Question

My skouers voel of hulle dood gaan as ek slaap.  Dit voel of my skouers die heeltyd in spasma is, en dit is baie seer. Elke oggend as ek opstaan voel dit of my skouers in spasma is.  Dit voel of niks medikasie daarvoor help nie.  Het al vir my vere kussings gekry en slaap op n ortopediese matras. Kan iemand asb vir my raad gee of help. Het nog nie ekstrale laat neem nie.

 

Answer

Jy moet X-strale laat neem en ondersoek word om die oorsaak vas te stel

Laat maar weet as ons verder kan help. Dr de Beer

 

 

 

 

 

 

Question

Im 70 and have been experiencing a severe pain in my left upper are & shoulder The pain subsides in the day but becomes heavy at night keeping me out of sleep I've tried Ibruprofen & Voltaren But with limited sucess What has releived the pain is me taking a PH Alkaline powder daily Can you suggest something Been active all mey life A.B

Answer

You need to be examined and at least have X-rays: osteoarthritis of the shoudler is the first thing to exclude

Let me know if we can help you -- Dr de Beer

 

 

Question

Hi

Ek het pyn in linker bo arm...dit is n verlammende pyn. Dit is baie pynlik. Het dieselfde pyn voorheen in bo been aan agterkant gehad. Die spiere spring dan ook in arm. Pyn veral baie erg gedurende die nag. 

 

Answer

Die oorsaak kan een van vele wees -  rotatorkraag probleem of senuweeletsel. Jy moet ondersoelk word, X-strale geneem word en dan kan 'n diagnose en behandeling gedoen word

dr de Beer

Question

Hello Dr de Beer

I have an 18 month history of on and off shoulder pain, when raising my arm. And instances of pinching and weekness also when my arm is raised. 37 year old female.

2 weeks ago while washing my hair :) it happened again, but this time the pain was severe and accompanied by an audible and excrutiating popping with every movement, even shallow breathing. This lasted a few hours.

Since then the popping has mostly subsided but I have constant pain, aching burning and stabbing. Worse through the night and after arm use, but also when still and breathing. 

The pain is internal behind my shoulder blade and also below my collar bone, some pain on the upper inside of my arm. 

Xray and sonar seem fine, except for 3.8 mm subacromial bursa measurement and type 2 acromial proces noted.

Is it possible that bursitis can cause all this pain?

Regards

Tamara 

Answer

Calcific tendinitis, rotator cuff tear and other shoulder problems can present like that - you would have to be examined to determine the cause

dr Joe de Beer

Question

U het 2jr gelede n totale skouervervanging op my gedoen. Met my opvolg afsprake het alles goed gelyk. Ongeveer 4mnde gelede het ek weereens dieselfde pyn begin ervaar as voor die operasie en die beweging van my arm is baie beperk. Is dit normaal en moet ek weer 'n fisio besoekof sal dit self weggaan? 

Answer

Jammer vir die laat respons maar die regte volgende stap is om 'n X-straal te laat neem aangesien die prostese dalk los gegaan het

dr Joe de Beer

Question

I have been diagnosed via ct scan with a large irregular anvil shaped exostosis arising from the costal surface of the upper scapula at the level of origins of subscapularis. Surface of exosititis is flattened with features of enurnation and chronic contact between exostosis and the outer surface of the right second rib. I am in constant pain. Apparently this is a rare condition. Please advise best course of action. I have a cd disk of ct scan.

Answer

sorry for this very late response - was your problem ever sorted out or do you still need help?--dr Joe de Beer

Question

My partner has a reverse shoulder replacement done at a Government Hospital and since this she has had absolutely no use of her arm or hand.  We have had tests done and the report states : "Findings are compatible with a proximal brachial plexipathy with possible involvement of segments C5 to C8T1".  How could this have happened and considering no medical aid, how can we fix this.  Complete loss of use of right arm is a huge problem.

Answer

Sorry for this very later response but was the problem ever resolved or do you still need help?

Dr Joe de Beer

Question

Met verwysing na vraag 4 (soos hieronder).  Ek is 'n tipe 1 diabeet en het huidiglik 'n "frozen shoulder" vir die 3de keer in dieselfde skouer (regs) maar die keer is die ergste van al die vorige kere en het ek al die simptome soos beskryf en erge pyn veral in die nag.  Om watter rede sal ek dit vir die 3de keer ervaar as dit veronderstel is om slegs eenkeer per leeftyd te gebeur?

Q.4. After recovery, could the Frozen Shoulder come back again?
A. It usually never recurs in the same shoulder and rarely in the other shoulder.

Answer

Dit gebeur gewoonlik net een maal in 'n spesifieke skouer maar die uitsondering soos in jou geval kan gebeur maar is baie selde wat mens dit teekom. Mens moet net seker maak dat dit wel 'n bevrore skouer is en nie iets anders soos 'n kalsifiserende tendinitis, rotatorkraag skeur, ens nie

Question

Dr de Beer

9 Months ago I fell off my mountain bike, landing on my right shoulder and rolling forward, head-over-heels. All symptoms indicate AC joint dislocation. There has been no improvement at all in the last 9 months, road riding is possible, but any off-road mountain biking causes great pain at the end of the ride. Any advice would be appreciated. I live in Mauritius.

 

Answer

If it is an AC joint dislocation and it causes pain for so long it should be fixed

Question

Dear Dr Joe de Beer

my name is Gideon Avissar i had my thorn tendent operation on my right hand shoulder done 6 month and two weeks at cape town medi clinic. on my last communica two month ago i ask is that posible to get back to yoga clases your answerd was yes, i have taken only two clases and it is paintfull especially when i strech my hand, does the shoulder need more time to heal, or i need to come for a check up, yours faitfully, Gideon  

Answer

yes I think best is that you come in for me to check your shoulder

Regards,

Joe de Beer

Question

Hi Doctor

I am based in Jhb, have total ac joint separation. Unfortunately I am in Jhb any Doctors that you can recommend to do the operation please.

 

Regards

 

Hannes Coetzer

Answer

Dr Dinos Kastanos in Johannesburg

Question

Goeie Middag Dr

My ma se hele regterkant van haar liggaam raak lam en seer gereeld sy was by die dr hulle se dat haar senuwees in haar nek vasklem is dit so is baie bekommerd raak erger elke dag

 

Answer

Dan moet sy 'n neuroloog sien dat die korrekte behandeling uitgewerk kan word

Question

Hi there,

 

I have had a dull pain in my shoulder for well over a year now. It comes and goes but I can always feel it there. I feel as if it runs down my arm, and into my inde finger making it feel as if it is almost slightly numb - Can this be caused by a rotator cuff injury?

 

The pain in my shoulder feels as if it is in the centre of the ball of my shoulder. I really dont want to have to go to surgery, whats the chances of needing to go for surgery rather than some physiotheropy and exercises?

 

I look forward to your response.

Answer

It is more likely a nerve in the neck being compressed but one needs to examine you, take X-rays and make a diagnosis 

Question

Good day Dr Joe de Beer

Ive suffered with TOS for almost five years now and Im struggling to find a doctor in the Pretoria or Johhanesburg area. Is there any one that you can recommend in this area as I'm living in the Brits area?

Answer

I do not know the doctors in your area but I would suggest that you contact the dr who we refer to - dr Dave Harris who would be able to recommend someone in that area. His nr is 021 9006411

Question

My 16 jarige seun; speel tans flank; het 8mnde terug skouer beseer. Intussen Fisiotx ontvang maar sukkel nogsteeds met gedeeltelike ontwrigting? Waarna sy arm lam voel; meeste vd tyd speel hy aan. Hy het soms ongemak met Abd en ER maar hy voldoende spierkrag? Ons strap sy skouer voor elke wedstryd. Moet hy gaan vir sonar of MRI scan wil graag dit uitsorteer hy voel hy kan nie voluit speel altyd nie?

 

 

Answer

Dit wil voorkom asof sy skouer beslis onstabiel is- die beste is dat ons hom sien, ondersoek en tenminste na "n X-straal kyk. Julle kan 'n afspraak maak (tel 021 9111017) en my ontvangsdame sal reel vir 'n X-straal, ek doen self die sonar. Ek sal dan besluit of 'n MRI nodig is aangesien dit nie altyd geindikeerd is nie. Ons kan dan die beste pad voentoe uitwerk

Groete, dr Joe de Beer

Question

Had a Shoulder reconstruction in 2008, and got 2 screws put in. What are the odds of screw causing pain and can it get loose inside of shoulder ? If yes do I get surgery to remove the screws ? If so, how long before I can play Rugby again ? 

 

 

Answer

Did we do the operation? To determine the cause of the pain you would need to be examined and have an X-ray. If the screws appear to be causing the pain they can be removed arthroscopically (with key hole surgery)

If you want you may make an appointment to see me (021 9111017 is the nr for appointments) and they can send you an XR request form so that you can go for the XR first

Regards, Joe de Beer

Question

Good Morning Dr joe de beer

My name is Gideon Avissar i had my operation on my right shoulder done with you at cape town medi clinic 3 and half month ago and i wonder can i get back slowly  to my physical activity such as swimming and yoga. please let me know your opinion have a great weekend.

Gideon Avissar 0836030521

Answer

Good morning Gideon,

 

Yes you may certainly get back to activities now

Regards, Joe de Beer

Question

I am a 48 yo female from the usa coming to Capetown on Thursday and arriving, for a month on Feb 13.

Can I make an appointment to come in for a pain block in my left shoulder? I have the pain in shoulder, on front outside of shouldr, worse at night and radiates thru arm to fingers. It's too late to get to a doctor here and it needs immediate pain relief by injection.

I had one in right arm a year ago & no pain since.

I carry great insurance (Blue Cross Blue Shield & covers me worldwide & am able to see any doctor according to insurance

Please, please help? This pain breaks through all other meds I take & injection worked in past for other shoulder (an injury) but left arm no injury. It just started hurting bad.

Your office may reach me at Tarragona Lodge in Hauts Bay Monday, the 15th of February. 

Thanks, I'm in agony!

Patricia Davila

 

Answer

Dear Patricia,

What do you suffer from - in other words what is the cause of the pain in your shouler? I will of course be willing to administer a injection into your shoulder and I  presume that you are referring to a cortisone injection into the joint?

You may contact us at info@shoulderinstitute.co.za (tel nr : +27 21 9111017 )

Regards,

Joe de Beer

Question

I have a 2cm calcific deposit in the supraspinatus tendon of my right shoulder. I have had 2 cortesone injections which have reduced the sweeling. However i still have a few rough days and nights when the shoulder gets sore. Myspecialist has told me that I may need surgery to cut it out. I was not offered lavage. I think this is due to the face that the deposit is well corticated. I attach a copy of my x-ray. How do you think I should proceed?

Answer

The calcium is very large and can be needled but that is not always successful with that size. Nevertheless it is worth a try as one cannot lose anything with a needling procedure and if successful it would save you an operation

Regards, Joe de Beer

Question

Dear Dr de Beer

I am seeking advice for ongoing shoulder impingement and painful tendinosis please. I’m a South African now living and working in Singapore. I’m male, 46, active sportsman – regular gym, swimming and surfing. Long history of shoulder (Left) injuries - original rugby injury 1993 (Grade 2 Slap tear), repaired 1999 by Dr Sham Osman KZN (anterior and posterior anchors). While playing club water polo - ongoing pain. 2007 circumferential tear of labrum treated by tenotomy and bicep tenodesis by Dr Sham Osman. Left SA to work in the UK. Ongoing impingement - ACJ excision arthroplasty and Sub acromial Decompression by Prof Ofer Levy, Reading Shoulder Unit UK in 2010. I continue to have reoccurring problems with this shoulder. Great progress for some months then impingement, pain and rehab only to repeat several months later again. Am currently suffering from chronic tendinosis - supraspinatus and subscapularis but also long head of the biceps tendon where most pain presents, with regular clicking. Sports doctor recently did ultrasound - apparently showed some calcification of rotator cuff – especially subscapularis and infraspinatus which was treated conservatively with physio and anti-inflamotories. No tears. After little improvement following 4 weeks of physio though was referred to an Orthopaedic surgeon here who sent me for an MRI (please see MRI report attached) - shows no structural damage or tears and everything appears intact. Rest prescribed for 4-6 weeks. It’s been almost 6 weeks and although pain has subsided somewhat shoulder remains very tender and painful especially with uncontrolled movements, and particularly around bicep tendon and rotator cuff areas. I am still not able to return to any exercise. What course of treatment might you suggest from hereon in?

Sincerely, Neville

Answer

Dear Neville, it is quite difficult to make a suggestion after such a long complex history and not seeing you. I cannot see the MRI report - do you want to send it to our e-mail address : info@shoulderinstitute.co.za

Regards,

 

Joe de Beer

Question

had lots of artroscopies to clean shoulder, but it still pains, cant lift arm backwards and higher than shoulder and cannot hold weight as it goes lame, cant even sleep on shoulder. the extra problem with this is one head of the biceps is off for more than 15 years already and i have an idea it make the shoulder unstable. will u be able with shoulder surgery also re-attach the bicep head or can this head have sort of died in this passing years?

Answer

You need to be examined to find the cause of the problem. If the biceps long head has been torn for 15 years it may not be repairable any longer. If you want we can see you and make decisions: 021 911017 is the number to make an apppointmen

Joe de Beer