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Q & A / View or ask Dr Joe de Beer a question

Select a question below to view the answer.

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

Question

I'm a 29yr old woman with constant pain in my right shoulder blade. I've seen various practitioners which include physios, biokineticists, body stress release, osteopath, yoga, pilates and X-rays. My most recent X-rays were done at constantiaberg hospital under the name Sarah Jane Mills about a year ago. The results have included: weak core muscles, hyper flexibility, bad posture, slight muscular scholiosis which adds pressure to the painful area. My history includes a cracked tailbone aged 12 which went untreated and resulted in lower spinal degradation. All treatments help either my shoulder or my lower back pain. My mother is about to go for surgery for a frozen shoulder which she has suffered from as far back as I can remember. 

My question is to assess the specific state of my shoulder and spinal situation to determine a long term treatment solution to avoid surgery until no other option is available. 

I am a seamstress, right handed, so I need full functionality. Please advise.

Answer

The most likely cause would be a neurological problem like Thoracic Outlet Syndrome. 

Regards,

Dr Joe de Beer

Question

Hi Dr de Beer,

 

I am 41 year male and have been have been suffering from a pinched nerve in my neck that is causing pins & needles feeling in my left arm and shoulder. I have tried treating it with cataflam with not much sucess. Are neck injuries like this something you look at?

Thanks

Michael

 

 

Answer

Sorry, I am a shoulder specialist so you need to go to a neurosurgeon for your pinched nerve in the neck

Regards,

dr Joe de Beer

Question

How much does it cost for a coristone injection? For a frozen shoulder (rotator cuff) ? And do I need a referral from my doctor?

Answer

No referral needed but you can chat to my staff about costs. (021 9111017)

If you are on medical aid we will do it at medical aid tariffs

Regards,

 

Dr Joe de Beer

Question

Dokter is daar niks wat ek kan doen om dit te verbeter nie. Dit is regtig baie seer. Ek bly in Pongola dit is redelik baie ver vanaf dokter af? Enge raad sal ek waardeur asb.

Groete 

Lewiesa

Answer

Beste Lewiesa,

Ek sal voorstel dat jy ons dr wat die Torakale Uitgangsindrome vir ons behandel se sekretaresse skakel en 'n naam kry van iemand in jou omgewing: ons man is dr Dave Harris : 021 9006411

Question

Dokter ek het verskriklik seer by my linker blad die pyn raak net erger dit is vanaf my blad na my linker kant van my nek en my linker arm. My linker arm raak lam. My vingers swel party keer. Ek wil nie net dokter toe gaan en dan se sy dit is 'n spier wat vas druk nie. Ek het al spier verslappings pille gedrink en voltaren maar niks verminder die pyn nie. Asb as dokter miskien vir my raad asb het ek sal dit baie waardeur? 

Answer

Dit klink beslis of jy aan Torakale Uitgangssindroom ly - kyk na my website en sien "Thoracic Outlet Syndrome"

As jy wil he ons moet jou sien kan jy skakel by 021 9111017 of info@shoulerinstitute

Groete,

Dr Joe de Beer

Question

Good day dr. I am 21 years old. I had a posterior dislocation in my left shoulder, because of rugby. I have recieved 3 operations to repair it. I believe they were bankarts. Not one of them was a success. Is a bone block the next step? And what is the success rate of a bone block operation?

Answer

Dear Tian,

Yes indeed, a posterior bone block is your only option and we have had very good success with that procedure in many cases. If you want to contact us about helping you the numbers are: 021 9111017 or directly on my mail at jodebeer@icloud.com

Regards,

Dr Joe de Beer

Question

Dokter ek het 'n stywe-seer gevoel in my kakebeen. Wat kan dit wees. Ek is 54 jaar oud.

Answer

Graag wil ek jou net inlig dat ek 'n skouer spesialis is - jy moet 'n tandarts sien

Question

Dr. Ek is 76 jaar oud het 'n dubbel rotatorkraag opersaie gehad. het vanf 1 week na operasie weeklikse fiso begin. Die operasie was op 14 Sep. 2015 gedoen (dus +/- 3 maande gelede). Nie meer pyn in skouer, net in bo-arm. Doen reeks oefeninge 2 x per dag, meestal strek oefeninginge met rek weerstand. Ek gaan nog steeds met die oefeninge voort het nou die fiso besoeke gestaak. Wil graag weer begin gholfspeel is daar 'n risiko aan verbonde, kan die penne waarmee die hegting gedoen was loskom agv. die gholf. My arm is nog nie strek soos dit voor die operasie was nie. ek sal u kommentaar en raad waardeer.

Groete Dina 

Answer

Beste Dina,

Het ons jou operasie gedoen? Die terukeer na sport soos golf sal bepaal word deur die sjirurg wat jou opereer het en die gensesing van die rotatorkraag objektief ge evalueer het

Groete,

Joe de Beer

Question

Dr Joe . What can be done about Marginal osteophytes that causes muscles to become inflamed around joint.Can the Osteophytes be surgically removed.Thx Chris

Answer

Osteophytes seen on an XR of the shoulder joint usually indicate that there is osteoarthritis of the joint. The osteophytes are a result of the pathology and not a cause of the problem. Best would be to see a shoulder specialist to discuss the best way forward

Regards,

Dr Joe de Beer

Question

Good Day,

 

I have been experiencing surfers shoulder for about 5 weeks now. I havebeen going to physio as well as bio and have not done any surfing in the 5 weeks since pain onset.  Do you think cortisone injections could help reduce the inflamation as I do not really want to have surgery if it is not nessesery.

 

Thank you so much

Answer

The best is to see a shoulder specialistto examine you, take XRays and ultrasound to make a diagnosis and then the proper treatment can be suggested - hopefully only an injection 

Regards,

Dr Joe de Beer

Question

Dear Sr

I live in Mauritius.

I have been given a quote for the following operation (copied from quote)

 

Surgery/Diagnosis : ARTHRO ACROMIOPLASTY+ REGULARISATION 1/4 EXTERNE Class of Surgery  6 + 4/2 Doctor's Name : CLAVICULE + BURSECTOMIE/// BY DR PH.SOUBRANE Surgery Time 2 hours

Apparently I have bone spur which has caused a small tear on the interior of a tendon/ muscle. I have had an MRI scan.

I would like to know what sort of fees you would charge for the procedure as the hospital cost here in Mauritius appears extortionate. I reaize that only a rough idea may be given.

Many thanks

Caryl Rey

Answer

Dear Caryl,

I believe my staff have been arraniging the procedure for you ? If any problems let me know

Joe de Beer

Question

I am interested in the Interpositional Graft for "shoulder Osteoarthritis". Is the only location to have the surgery done in South Africa? Or is it possible to have it done in the U.S. I first looked into the procedure in 2010. Have any Advances or developments been made?

Thanks you, Chris McGarvie

Answer

Dear Chris,

Yes indded good progress has been made and you may consult with dr Steve Burkhart who has a very good experience with the procedure. The two of us have done work togethere on it. He is in San Antonio, Texas and the man to go to

Joe de Beer

Question

I had 5 weeks ago a shoulder operation, everything was fine. Went to the fisio as instructed, untill last week when i injured my shoulder in a almost car accident. My fisiotheripist said my bisepmusscle teared from where it was re-attached. Is another operation neccessary or can one leave it be?

Answer

The biceps tendon can be left as it will not lead to much problems. You did not perhaps have the surgery with us, because if so we will of course look at it with pleasure

Dr Joe de Beer

Question

DEAR DR DE BEER,

I HAVE A TEAR IN MY SUPRSPINATUS MUSCLE OF MY LEFT SHOULDER. I READ THAT THE RECOVERY FROM REPAIRING THE TEAR IS VERY LONG AND PAINFUL. IS THIS TRUE?

Answer

It is not always that long a recovery but in some instances, depending on the size of the tear and the repair metnod it may take longer. What is important is that if it is definitely a tear it will not heal without surgery and the long term outcome is then not good

Regards, 

Joe de Beer

Question

Please asisst if possible my son is now 21 years old .since he was about 6 years of age he had a knob at the bottom of his foot in the hollow area. and it got painfull when he walked . now he has on his back just under his sholder blade . He has the worst pain after he wakes up because he might have turned and slept on it . I have an idea that it might me a musse that rolled up but I have no idea . 

Answer

There is a condition called osteochondroma of the bones which could also cause a growth deep to the shoulder blade. He should have an X-ray and CT scan to show it up and then one could consider how to manage it . If you  are in our area we will be happy to look at it : 021 9111017

Question

my left blade feels as if wants to tear off, my shoulder, elbow and arm pains and my fingers feel numb

 

Answer

Without examining you it sounds like a Thoracic Outlet Syndrome that you are suffering from but the exact diagnosis will be confirmed by clinical examination