Question:

Hi Dr. De Beer, I am a 47 year old female diagnosed with frozen shoulder (on right side - dominant side). I have had this condition before on my left side about 15 years ago due to injury/bursitis. It cleared up after 3 years. This time the frozen shoulder came on for no reason. Unlike last time, I had nerve pain running down my right arm, through my elbow and into my right hand to the point that I could not type/work. NSAIDS helped for about 1 month until they started giving me stomach problems so I have had to discontinue. I rec'd a corisone injection about a month ago which helped with joint pain. However, the muscle pain is still substaintial, waking me up every night at least twice. I have discontinued physio therapy due to not being able to tolerate the pain, and with no improvement in range of motion since this whole thing began 7 months ago. Over the last 2 months, I have noticed a worstening grinding/crunching noise in my scapular region. The trap muscles in this are are sore regularly and my shoulder blade feels like it is out of alignment (winged out) but I can't tell because I can't see back there to compare with my good shoulder. I would not be suprised if my trap muscles and rhomboids have atrophied. Now I am wondering if I have developed snapping scapula syndrome in addition to my frozen shoulder. Due to my inability to tolerate agressive therapy, and now with this other alignment problem, I am wondering if I should just allow the condition to run its course or if there is something I should do to address the scapular pain - exercises? I am seeing my Orthopaedist tomorrow. So far, all recommended treatments have failed. What can I do next? Please help.

Answer:

You are clealy suffering from a very severe frozen shoulder. To develop nerve pain happens often as the stiff shoudler causes the scapula to “wing” and that exerts traction on the brachial plexus with  nerve pain down the arm. Also, due to the movement now taking place a the scapuia and  not the shoulder joint, the scapula can develop symptoms like you are describing.  The pain you experienced with physiotherapy is often found and the inflamed shoulder should not be stretched with force as that increases the inflammatory response.

i would suggest that you have more cortisone injections as that will not harm you and could give you symptomatic relieg awaiting spontaneous recovery

Frozen Shoulder

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