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alisande_gw

What would you do? (regarding physical therapy)

15 years ago

As I've posted here before, my shoulder started hurting in the spring from pulling the lawnmower cord and, I realized later, from overuse of the computer mouse. I consulted a shoulder specialist, and he ordered an MRI and physical therapy. The MRI showed swelling in the joint and inflamed tendons. It did not rule out a torn muscle.

I've had 8 weeks of twice-a-week PT, with a few appointments canceled. Increasingly, I've been feeling as though the PT is making my shoulder worse. The only thing that has made it better so far is changing the mouse to my left hand. I always leave PT with my shoulder feeling worse, and often it lasts for days. One of the problems I've experienced all along is the feeling that my shoulder (or something inside it) slips out of place, causing acute pain until it audibly snaps back to where it's supposed to be. That hasn't changed.

I'm reluctant to see the doctor again because he's a surgeon and we know what surgeons like to do--especially if I tell him the PT isn't working. Not only am I extremely reluctant to undergo surgery again (after having three procedures, albeit minor ones, this year), but I understand rotator-cuff recovery is rather long and difficult for someone living alone.

I'm thinking of putting a stop to the PT. If I do that, the insurance company won't let me start it up again. I want to discuss this with the PT people. They're very nice, and conscientious, too. But they are committed to the course of treatment they devised, and I don't see them changing it.

My inclination is to stop aggravating the shoulder, give it a rest, and see what happens.

What would you do?

Comments (31)

  • 15 years ago

    I have to ask myself this sometimes... why go to the Dr. if you aren't going to follow through with his recommended treatment?

    squelch that! LOL You probably should talk to the PT people. It wouldn't be good to lose your insurance coverage of PT.

    If you do need surgery, a long recovery period would be better than suffering with pain the rest of your life. Take a good long look at your daily activities. Are there things you weren't aware of that could be causing further aggravation?

  • 15 years ago

    Are there things you weren't aware of that could be causing further aggravation?

    Definitely. I really haven't favored the shoulder much, mostly because no one advised me to. I figured since PT aggravated it, there was probably no harm in aggravating it to a lesser degree at home.

    why go to the Dr. if you aren't going to follow through with his recommended treatment?

    Sometimes we go for reassurance, I think. Sometimes (as in this case) we hadn't met the doctor before the first visit, and when we did, we were unimpressed. :-)

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  • 15 years ago

    Have you told the PT your shoulder is feeling worse for days when you leave? i would start with them. Have you had the opportunity to try a different PT... Maybe your schedule could change and you would have to come now at night instead of days or something to see if you could try a new PT. A new PT may have a totally different plan of attack if you can start over with them and explain your pain and lack of progression.

    I also would maybe be a little under the weather for a while and cancel some appts. to see if a little rest may help.

    It's sad that you feel your Dr. will just operate instead of try something else...but you're probably right... still, there is a chance he won't demand operating and may suggest a new therapy plan. You can always say no the surgery. It's worth a try.

    You know years back I had a problem that sounds similar to yours. I tried a lot of therapy, etc... I found just through coincidence that when I cut out coke/phosphoric acid...my back/shoulder pain went away within a couple weeks and will come back when I drink lots of soda again. The correlation was kind of scary. If you do drink a lot of cola, try cutting it out for a while and see if you shoulder feels better.

  • 15 years ago

    I have a left shoulder problem.

    This I have learned from water aerobics.

    Stand up straight.

    Roll your shoulder with your arm by side, and roll roll roll, to the front and to the back.

    Then take your arm and stretch across your front, hold it with your other arm.

    Then lift your arm over your shoulder, with your other arm, stretch it, so you can touch your back.

    I might not be clear, but it sure as heck works for me.

    It's lubricating the joint in your bad shoulder.

    Also I swing my arms back and forth.

    My doctor told me, I'm too old to think about surgery, and recommended I do what I suggested.

    Works for me.

  • 15 years ago

    Carla, three PT people rotate so I get a different one each time. I've noticed differences in their touch, etc., but the exercises remain the same. I love the idea of doing something as simple as giving up (or adding) a food. Often this makes a big difference in how I feel in various ways. But unfortunately I haven't had a cola (or any other kind of soda) in about 40 years. ;-)

    Glenda, thank you.....I can understand (and will try to follow) the standing up straight and shoulder rolls, but I can't figure out the rest. I'll Google shoulder exercises and see what I get.

  • 15 years ago

    If you practice the shoulder rolls, it darn sure works for me.

  • 15 years ago

    Because I have been doing these exercise outside of water aerobics, I am free of pain.

    I do not take anti inflammatory pills or ibprophren now.

    If my shoulder gets tight, I work harder on rotating the shoulder. rotating from front to back and so on and so forth

    Water instructor says the rotating lubricates the shoulder.

    Know the "pros" will have more advice, but this works for me.

  • 15 years ago

    I'd consider getting a second opinion from a different doctor, keeping surgery as a last resort. I was reading about these 'miracle balls' that help with back and shoulder pain.. seems cheap enough. Lots of good reviews. Might be worth a try?

    Here is a link that might be useful: 'Miracle Balls'

  • 15 years ago

    I think its worth checking in with the DR again-even if calling his office to say you are feeling worse with the PT and it lasts for days! He may have other ideas besides surgery. Also discuss it wit h the PT people if you haven't already. All of them are working to make you better. You need to let them know what you are experiencing.

  • 15 years ago

    If therapy isn't helping, talk to the head person at PT (in my case, he's the owner and also head therapist). Give them the straight story, maybe thay can treat you with massage, heat, electrical stimulation, things that don't hurt. If you scale back for a few weeks, maybe it will give you time to heal. And seeing the dcotor won't hurt. Tell him the truth and that you'd like to avoid surgery if possible. Good luck!

  • 15 years ago

    I would do what everyone else is suggesting. Talk with your Dr and the PT people and then you can make a decision before giving up the insurance without all the information at hand. DH had a rotator cuff problem. Dr said surgery wasn't always a cure all. Recommended PT. He didn't go to PT very long....they gave him some stretch bands and exercises to do at home which he did. Shoulder is better now. I hope you find your answer.

  • 15 years ago

    I have had trouble with both shoulders - bursitis in one and calcific tendonitis leading to frozen shoulder in the other (for which I had PT).

    I agree with Glenda - shoulder rolls and shrugging are very helpful.

    I also had cortizone shot in each because the pain was beyond bearable.

  • 15 years ago

    I forgot to say I had trouble with my mouse too. So that it would be lower and closer to my body, I moved it from the top of the desk to my lap. I place the mouse pad on a book and then rest the book on the opened drawer in the middle of the desk.

  • 15 years ago

    Susan, I will echo the others, speak the the therapists and the physician but I would tell him that at present you are really not considering surgery without exhausting all other options. Have you seen a chiropractor? Or an osteopath? I went to an osteopath for accupuncture, it helped some things but in the end my RA won the battle. If there is an audible pop then something is definitely moving our of alignment, to the therapists know this?

    I went to therapy for a frozen shoulder, it did grant me relief without surgery but I don't think I have ever suffered anything more painful than that shoulder. It was debilitating, I feel for you.

  • 15 years ago

    I don't know what kind of relationship, or trust you have in your GP, but if I were in your position, I'd sit down and have a discussion with my regular dr about the situation. He's a great dr, and often is better at diagnosing and treating issues than specialists, I've found. You may or may not have such a good primary care physician. But it does sound as if it's time to do something.

    If your Phys. therapy place is like the one I went to, the folks who work on you are just techs, and there's one (maybe more if it's a big place) actual physical therapist who is in charge and devises the individual programs, following the dr's prescription. Can you sit down with him/her? If he can't make any changes, then you do need to discuss with a dr--either the one you've been seeing or another who can give a 2nd opinion. You don't want to keep on as you are--besides not getting relief, you may be doing further damage.

    Good luck and hope you find the right treatment soon so you can feel better.

  • 15 years ago

    That happened to me with my neck. I'd be in angony for days after and it never really got better. I'm not a real big fan for taking medications, but that's what I ended up doing and it helped much more than the physio.

    Follow your gut. I finished my recommended sessions but I think they were making money off of me, or the insurance company. But I never went back and ended up going to another specialist who found the real problem was with a disc.

  • 15 years ago

    I had a frozen shoulder once, and often thought after I finished physical therapy, that that is just a matter of common sense. You exercise and work on mobility one day and the next you increase it all. It seemed like something I could have done myself.

    Don't quit using it, b/c that's when a frozens shoulder will develop. I heard something "pop" in my shoulder one day and think it was those ligaments that were causing the problems. I am pain free now, but it was AWFUL, so I know what you're going through.

  • 15 years ago

    Susan, my doctor gave me a choice- the chiropractor or PT. I asked which was cheaper (I have a high deductible) and she said Chiro. So I went, X-rays in hand. Dr Jan looked, spotted my first rib was out of place, too high, and started working on that and then gradually we figured out a lot of my shoulder problems stem from my neck. My right shoulder was also pulling in to the front, I could feel it doing it and she could feel it and see it, and got that problem solved, too. I'm SO much better now after about a dozen trips to see her, and I go back about once a month for some massage and minor adjustments. Oh, I also got a steroid shot in the butt to get the inflammation down so Dr. Jan could work on me without me hurting too much. :) I NEVER thought I would ever go to a chiropractor, but after the huge improvements I've had since going, I know she's helping me a lot.

    And putting the mouse in my lap helps a lot, too. I do some stretching and the pain in my tendons is much better now, too. I still don't have 100% range of motion, but I have a lot more than I did. I rarely have to take anything anymore for the pain, it's so much better.

    Good luck! I hope you get some relief soon.

  • 15 years ago

    I've been digesting all your good advice.

    I'll try the mouse in the lap when I edit photos. Using my left hand works for most things, but photo adjustments often require more fine-motor control than I have with the left hand.

    I had a frozen shoulder once, years ago (but I'll never forget it). This pain, fortunately, isn't nearly as bad--unless I do certain movements, or unless that "something" slips out of place.

    I told both the doctor and the PTs about that slippage. The PTs have heard it snap back into place many times.

    Flamey, your chiropractor sounds like a gem--and so does your doctor, for recommending one. My chiropractor tells me Medicare is cracking down on chiro visits, BTW. Isn't that ducky?

    I suspect an anti-inflammatory would help the situation, and speed up healing. But I've had problems with ibuprofen, and aspirin makes my tinnitus worse. Also, I react badly to cortisone. Who knew I was such a delicate flower? LOL

    Azzlea, the setup at my PT is the same as yours. I have a call in to the PT in charge. She knows I've felt that the sessions have been making my shoulder worse, but now I'll explore my options. My PCP is an internist, so he might not have much experience with joint injuries. But I like your idea of talking to him, and might end up doing that.

    I've been doing shoulder rolls ever since I read Glenda's post, and I could swear they're helping already. Maybe it's just the placebo effect, but whatever it is, I'll take it!

    Thanks, everyone! I appreciate all your input.

  • 15 years ago

    I spoke with the head PT, and she told me my script for the treatment is up this week. She suggested I take a break, see how it goes, and if necessary, make another appointment with the doctor. So for now, that's the plan.

    Thanks again, everyone.

  • 15 years ago

    I had a painful shoulder impingement - saw an orthopod who referred me for PT. I went and then continued the exercises religiously for six months. At that time my shoulder pain was as bad or worse than it was previously so I stopped the exercises. That was in the fall and in the spring my shoulder was much, much better. I then proceeded to injure the other shoulder. I skipped the PT and exercises entirely, rested it over the winter and it was fine in the spring.

    I figured out I was causing the problem by inproper kayaking technique. Deduced that because it happened every summer and got better every winter.

    So long story short, I found PT made matters worse in my case.

  • 15 years ago

    Do you have any Physiatrists in your area? They're physicians who specialize in physical medicine and rehabilitation.

  • 15 years ago

    Gibby, thanks for sharing your experience. It's good to know others were in the same boat. (Or kayak.) ;-)

    Maire, I never heard of a Physiatrist--but that doesn't mean they're not here. I'll look into it, thanks.

  • 15 years ago

    Gibby, thanks for sharing your experience. It's good to know others have been in the same boat. (Or kayak.) ;-)

    Maire, I never heard of a Physiatrist, but that doesn't mean they're not here. I'll look into it, thanks.

  • 15 years ago

    I have had frozen shoulders - the first one in '04 after the 3 hurricanes that came through our area and I cleaned the soffit of our house by hand. Overuse of the right shoulder. I didn't go to the doctor until I could no longer stand the pain and could not even wash my hair. had a manipulation done to break the adhesions and intense PT for 8 days afterwards. But I did have PT for 3 months before the manipulation and you are right Alisande, it did make it worse. It was explained to me that as they work around the area different trigger points are worked. They are literally chasing down the areas that are "knotted" and until they get all the areas worked out, you will have more pain and soreness. Unfortunately, the areas can knot back up between sessions and in my case the adhesions just kept pulling everything back up into knots.

    Two years later, the other should froze on me. I didn't wait that time and went directly to having the manipulation. I now have full motion but every once in a while my right one flares up and the massage therapist said it was probably due to over use of the computer.

    Alisande - if you check out excerises called Active Isolated Stretching by Aaron L. Mattes, these are wonderful for stretching all parts of a muscle. The difference between these and what the PT does is that you don't hold these for as long and you work each part of the muscle seperately. I got more relief from them than I did any of the PT ones.

    Before doing the excerises warm your shoulder by putting a wet towel in the microwave for a couple minutes. Wrap that towel in another and lay over the shoulder. Be careful not to burn yourself. After excerising, ice it for about 15 minutes. If you can find Biofreeze, its like BenGay but much better. It really helped at night so that I could sleep. I avoided cortisone shots because they actually damage the tissue. However, when the doctor had me under for the manipulations, he gave me one each time.

    Hope you get some relief - I feel your pain!

  • 15 years ago

    Gibby, thanks for sharing your experience. It's good to know others have been in the same boat. (Or kayak.) ;-)

    Maire, I never heard of a Physiatrist, but that doesn't mean they're not here. I'll look into it, thanks.

  • 15 years ago

    Gibby, thanks for sharing your experience. It's good to know others have been in the same boat. (Or kayak.) ;-)

    Maire, I never heard of a Physiatrist, but that doesn't mean they're not here. I'll look into it, thanks.

  • 15 years ago

    Alisande, taking a break and seeing your doctor again to address the issue sounds like a good plan !

  • 15 years ago

    My DH went to a physiatrist after his car accident. When the lady hit the front side of his car it spun around several times and the air bags deployed. He didn't break anything but he was so stiff and sore that he could barely move and he had pain from his back and shoulder. The Physiatrist did heat treatments and electrical stimulation and gave him exercises to do.

  • 15 years ago

    There was a long thread on this topic on the Home Decorating - comversations forum recently. I wonder if there's any information that that might help you.

    Here is a link that might be useful: home decorating - off topic

  • 15 years ago

    Thanks, Maire.......I'm still reading it -- interesting!