dueling diagnoses, advice needed

Posted , 4 users are following.

doc #1 said shoulder impingement and recommended surgery

doc #2 said frozen shoulder &  phys therapy

both are orthopedic specialists.  both looked at the same MRI.

not surprisingly i am a little lost.  i am in malaysian borneo, which is not exactly awash in medical expertise, and it can be difficult to communicate in malaysian english (I'm an american).

i am leaning toward believing frozen shoulder, since my mobility is so restricted, but i have a question about symptoms.

i rarely have pain if still and i sleep fine, so long as i restrict the movement of my problem shoulder.

however, if i move just the wrong way, even with very slight motions, i get intense shooting pain, that takes like 10-15 seconds to subside, and may result in soreness after.  it is not really related to distance the arm is moved necessarily--it is very often the slightest move i don't even realize i am making.  sometimes i can feel the pain coming and back out of the motion quickly, saving me from the worst of it.  it can be difficult to predict what motions will cause the pain, but they can be extremely subtle.  i don't know what a shoulder dislocation feels like, but when i first started experiencing this, that what i thought it was.  or perhaps that i was pinching a nerve.  it is not a pleasant way to go about life, worrying about the slightest movements all the time.

so my question for you FS veterans: does this sound consistent with your experiences of frozen shoulder?  

thank you for listening!

steve

 

0 likes, 8 replies

8 Replies

  • Posted

    Hi Steve,

    That sudden serious pain upon slight movements in the early months of FS is very familiar to me. That was happening to me before I really understood what FS was or even had a proper diagnosis. I had never heard of FS and was baffled by my symptoms for many weeks. I had X-rays and ultrasounds, and the docs and physiotherapists (I saw many) concluded FS when they could see no other pathology on the scans that would indicate my lack of range of movement, AND my active and passive range of shoulder movement kept reducing over many weeks. Active range is when you can move it. Passive range is when you relax your arm completely and someone else tries to move it. When both of these are reduced and there are no obvious reasons on X-ray and ultrasound (and MRI if you have one) they can assume it is FS. FS is rather insidious, and creeps up on you over time. It may be many weeks before you have a conclusive diagnosis. The reduction in passive range of movement is a key to watch out for though. If FS is indeed what you have you will find a lot of good tips on this site. Good luck and whatever you do have, I hope you recover soon. 

    • Posted

      thank you hilary for your response.  my symptoms weren't really matching with a lot of what i was reading, but it seems the condition goes through phases.  i am not looking forward to the phase where i can't even sleep at night, if i do indeed have FS.  

      i have my first phys therapy appointment in a week based on the FS diagnosis and i honestly can't even imagine doing any of the FS exercises i see online without severe pain.  

      question for all....is it normal for phys therapy to be an extremely painful experience?

    • Posted

      Hi again Steve, in my experience it definitely went through the stages. First stage was lthe most painful. Exercise and stretching the shoulder capsule in that stage is completely a matter of choice and whether it feels right to you. I have not found any scientific evidence to say it helps. It's personal choice. In fact for some people it just creates agony and then lingering worse pain. Find practitioners you trust and try different things until you find what works for you and your pain management and your recovery in time. Very gentle movements, particularly the pendulum exercise, and lots of rest helped me. You might need to talk to your trusted doctor about pain relief options too. There are many many ideas on this blog from people who have been through it all and have good suggestions.

    • Posted

      My PT lady had me do only stuff with no pain to slowly loosen and stretch.
  • Posted

    Hi Steve, Your symptoms sound exactly the same as how mine first started. My consultant wasn't sure if it was an impingement or frozen shoulder, An ultrasound scan showed up an impingement so he set a date for me to have surgery. By the time my date came round, the pain had gotten a lot worse and I could barely move my arm at all without pain. When he operated he discovered I had an impingement AND a very badly frozen shoulder so I also had manipulation while I was under the anesthetic. Seven months later my shoulder is still frozen and still painful but no where near as painful as before the surgery. I'm still having physio for my frozen shoulder and I've been told it could take up to 2 years before it starts the thawing stage.

    • Posted

      thank you paula.  that's very helpful.  perhaps i have both issues as well.  i wonder if an impingement can lead to a frozen shoulder?  though it is odd that one doctor would see impingement on my MRI while the other did not.  an MRI should be even more conclusive than an ultrasound, from my understanding.  i think i will have to see a third doctor. 

      good luck with your situation.  

  • Posted

    I had frozen shoulder in my right shoulder last winter. My shoulder was getting very restricted around January. I happen to fall on that same shoulder in my bathroom a few weeks later which resulted in complete loss of movement. I saw a ortho DR who said it was frozen shoulder. I had some pain but it was as bad as some people. I did have that same slight movement issue that I had a hard time to explain.

    I had a cortisone shot in my shoulder which loosened up my shoulder up a bit to do physical therapy for 6 months. I did get my shoulder back after 7 months.

    Unfortunately, I got the same thing in my left shoulder. The only difference was, I had not fallen on this shoulder so it hasn'the locked up like the other. I have restricted movement reaching back and lifting arm up. I have some pain but again not to bad. I also have the same quick movement that usually makes me pull my arm in with buying sharp pain. Sleeping on the shoulder is not good.

    I have read it's common to get it in the other arm but I didn't expect it to be the next year. I also read something that was interesting. Do you have any discomfort in your bicep? I read about bicep tendon slips that sounded a bit formulary. I to thought maybe my shoulder was unstable and possible was dislocation. I wonder if that's what the bicep tendon slips feels like? I have not done any cortisone shot for this one or PT and so far recovery is almost same.

    Hoping for a speedy recovery for you.

    Melissa

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