Ouch. cemc - sounds like shoulder is giving problems - tendonitis. Could also be an osteophyte in the shoulder. Need an MRI or even a decent X-Ray of that shoulder, check out impingement. Might need a decompression (mine was most successful). ONLY with a good shoulder surgeon though. Arthroscopy. SAD/ACJ - see :-
http://www.shoulderdoc.co.uk/article.asp?article=1137§ion=3Also check out
http://www.shoulderdoc.co.uk - home page.
Whatever you do, do NOT have a cortisone injection intyo shoiulders. The cortisone burns out the tendons and ligaments of the shoulder - and that is what yr shoulder relies on! The shoulder has the most movement of any joint in the body and is the most fragile as it only has ligaments and tendons to support and protect.
http://www.shoulderdoc.co.uk/article.asp?article=1581§ion=56(snip...) "...there are problems with corticosteroids. They have been shown to be proteolytic and inhibit collagen formation in both cartilage and tendon. There is a high incidence of post-injection pain for approximately twenty four hours in many cases and the efficacy has been shown to be only of short term benefit. Corticosteroids are associated with tendon weakening and rupture, transient hypoglycaemia, lipoatrophy and fat necrosis.
Our biggest concern in injecting around the rotator cuff is the risk of additional tendon rupture and tendon damage.
(more...) (NOTE: see Funk's proviso - only inject under guided needle!)(snip...) "Essentially with any treatment our adage in medicine is to first do no harm. Therefore
there are other substances that we could inject that would be safer to the rotator cuff tendons. One of the substances that has shown to have a kinder effect on the rotator cuff is Hyaluronans. Hyaluronans are a normal substance within synovial fluid making up the meshwork of the synovial fluid with viscoelastic properties. Hyaluronans act as a joint lubricant. However this is not the effect that is required for these injections. They have been shown to have an anti-inflammatory effect - both mechanical as well as biochemical in inhibiting phagocytosis, reducing levels of prostaglandins, interleukin 1, free radicals and cyclic AMP. They also tend to have a barrier affect coating the pain receptors on the synovial surfaces forming a protective barrier. They have also been shown to stimulate endogenous Hyaluronan production and therefore having a
longer period of activity than corticosteroids. Shibata et al. (JBJSA, 1999) performed a randomised control trial of steroids versus Hyaluronan in patients with rotator cuff tears prior to surgicalintervention. Cuff biopsies were then taken.
They found the patients were treated with Hyaluronan, had denser collagen fibres compared to the corticosteroid group. They stated there was a link between the number of steroid injections and the outcome of surgery with a higher failure rate in rotator cuff repairs in those patients treated with a higher number of corticosteroid injections."
(more...) Strongly suggest exploring the site - it is considered the best bar none on shoulder conditions, treatment, surgical approach, rehab and physio. Prof Funk is a world leader in all things 'shoulder' (and yes, he is in England).
Continue to
'guard' that shoulder. Do not use arm above shoulder, and please
be v. careful lifting.
Hope this helps - any questions, pm me. Take care cemc -
