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Posted: 1/31/2006 12:52:38 PM EDT
[Last Edit: 1/31/2006 1:31:37 PM EDT by thebomber]
I'm 45, in shape and active. I have been having acute shoulder pain (8-9) for over a month. I discussed it with a good friend who is a Chiro. He ordered an MRI which shows I have a Focal Rim rent type tear to the anterior of the supraspinatous tendon. There is also moderate distention of the subacromial/sub deltoid bursa.

My intial thoughts (pre MRI) based upon the level of pain was an impingement which affected the bursa. I've been taking Naprosyn regularly despite my aversion to taking any kind of drugs. I'm not keen on burning a hole in my stomach, but I would be incapacitated without in. In addition, despite the naprosyn, my sleep has been profoundly affected.

I have an appointment with the Ortho but it's not to the 9th. Anything I should be doing or not doing? Will this require debridment? Any other thoughts or advise or links so that I can educate myself would be greatly appreciated.

Thanks in advance,

Bomber
Link Posted: 1/31/2006 1:10:23 PM EDT
Go to a Fellowship Trained physician. Check to see that s/he has done a fellowship in either shoulder and elbow surgery or sports medicine. Make sure you ask him how many he does, and if he can do it arthroscopically.
You should know that MRI is not the best imaging modality, and can be wrong or mislead surgeons or radiologists. The gold standard is a shoulder arthroscopy.

Get it fixed by the best surgeon you can find.

Link Posted: 1/31/2006 1:10:25 PM EDT
Not my area, but lots of good rotator cuff stuff here

Link Posted: 1/31/2006 3:52:57 PM EDT
Thanks for the replies!

Bomber
Link Posted: 1/31/2006 4:04:37 PM EDT
focal rim rent type tear? Never heard of such nomenclature, but it could be anything from a small non-retracted rotator cuff tear to partial thickness tear at the insertion of the supraspinatus. This most likely will require shoulder arthroscopy, which will entail an inspection of the gleno-humeral joint itself, then decompression of the acromion hook and acromioclavicular spur, then possible arthroscopic rotator cuff repair. Should take a skilled ortho guy about 45 minutes to do. Make sure the surgeon is a shoulder or sports specialist.

Also, things that make recovery much quicker and less painful - platelet graft into the subacromial space, and a continuous passive motion device to reduce post operative stiffness and adhesions. Since I added the last two my patients recover in 1/4 to 1/2 the time as previous.

Prior to seeing the ortho, avoid lifting anything with your elbows away from your body. Keep the elbows tucked in tight - there is much less stress on the cuff that way.

PM me if you need a recommedation for a good guy in your area

Link Posted: 1/31/2006 4:19:18 PM EDT
Thanks and an IM willbe inbound momentarily. My understanding is it's a partial tear of the supraspinatous at it's insertion into the greater tuborosity.

Is it common for such a tear to be so painful. The pain waxes and wanes throughout the day and seems to peak at night/early morning. The naproxen has been helpful but I'm concerned to be taking it so regularly. I also hear/feel some snapping during movement and there are several areas that exibit pain during palpatation.

Thanks for your input.

Bomber
Link Posted: 1/31/2006 4:31:56 PM EDT

Originally Posted By thebomber:
Thanks and an IM willbe inbound momentarily. My understanding is it's a partial tear of the supraspinatous at it's insertion into the greater tuborosity.

Is it common for such a tear to be so painful. The pain waxes and wanes throughout the day and seems to peak at night/early morning. The naproxen has been helpful but I'm concerned to be taking it so regularly. I also hear/feel some snapping during movement and there are several areas that exibit pain during palpatation.

Thanks for your input.

Bomber


Pain is universally bad no matter if it is a complete tear or just bursitis. Most people I see look like they have not slept in weeks - it is impossible to sleep comfortably. Naproxen is a bad medicine to take without a proton pump (acid) inhibitor for any extended period of time. Most people will develop stomach discomfort and even possibly an ulcer. Take some prevacid or pepcid AC with it.
Link Posted: 1/31/2006 4:43:40 PM EDT
What about Nexium or Prilosec OTC?

Bomber
Link Posted: 1/31/2006 4:46:26 PM EDT
Those are just as good!
Link Posted: 1/31/2006 4:55:03 PM EDT
Hey Beer_Slayer, How come I get a "go seek medical advise" reply and my thread is trashed but this request for medical assistance is allowed. Seems like you pick & choose who you like (or dislike) and that decides who stays or goes. Why don't you try being fair instead of being judgmental??

lawdog
Link Posted: 2/1/2006 1:37:52 AM EDT

Originally Posted By lawdog:
Hey Beer_Slayer, How come I get a "go seek medical advise" reply and my thread is trashed but this request for medical assistance is allowed. Seems like you pick & choose who you like (or dislike) and that decides who stays or goes. Why don't you try being fair instead of being judgmental??

lawdog


Because nobody knows how to treat a toxic reaction to alien semen.

For the person with the shoulder cartilage injury, yes, it's painful as all hell for at least a month. Sympathies. the popping noises/sensations might reduce in time as it heals, or you might have a permanent "click" as you move the joint around. Mine healed fine the first time, the second time it's been permanently weakened and has varying popping noises depending on the amount of stress I'm placing on the joint during movement. The doc didn't recommend surgery for me since there isn't much impairment, it's just noticeable.
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