Right Shoulder Pain

This is a 46-year-old female with a 5/9/2014 date of injury. On the date of injury, the claimant was performing cleaning activities as a custodian, and the claimant developed symptoms of pain in an affected shoulder.

*insert article *attachedBesides being able to see the inside of a shoulder, doctors use different physical tests to evaluate the shoulder in order to determine what type of injury and how severe an injury may be. One such test was recently developed by Dr. Carl J. Basamania at the Womack Army Medical center in Fort Bragg, N.C. The test was developed to evaluate shoulder instability in a patient. During the test the Dr. or examiner stands next to the patient who is to lay flat on his/her back. The hand of the examined should is held firmly by the examiner. The examiner then pushes against the clavicle to stabilize th scapula, while they also gently hold the pectoral muscle with their thumb in order to be able to assess relaxation. The examiner then rotates the arm form neutral to full external rotation. If the patient has AIGHL incompetence there is a lack of tightening as the arm reaches full external rotation. The test has appeared to be highly accurate and may be of value to Dr.'s and surgeons alike. After doctors have determined what type and what degree of injury a patient has sustained using various tests it is on to the next step, rehabilitation.

Assessments include bilateral shoulder pain, bilateral subacromial bursitis, bilateral shoulder tendinosis, left elbow pain, numbness and status post left shoulder surgery on 03/23/16.

This is a 51-year-old male with a 1/21/2014 date of injury. A specific mechanism of injury has not been described.

S: In 10/22/2014, TM was seen for bilateral shoulder pain. Today TM is here complains of left shoulder pain. According to TM he was aligning a Santfa, a process involving reaching. When he was bring his arm down, he felt the sharp, tearing pain in his anterior of his shoulder. TM is here with left shoulder pain. TM reports his pain at 6-7/10. The pain was sudden, sharp at The pain was localized, and didn’t radiated to anywhere else. The pain was so sudden and so severe, it scared him. TM denies any tingling or numbness, loss of movement.

The patient presents with chronic neck and low back pain status post MVA in 2008. He was ran off the rode while on his motorcycle fracturing his neck and lower back. Mr. Buchanan denies having radiating symptoms down either lower extremity. His pain is constant throughout the day making it very difficult to perform his daily activities. The patient has not had injection therapy or surgeries for his neck and back pain. The patient was told after his last MRI that he has arthritis in both his neck and lower back.

A physical therapy evaluation dated 08/07/2017 indicated that the claimant had a right shoulder pain after a fall onto her elbow and knee at work on 06/28/2017. She stated that she will have a surgical intervention on her right shoulder. She rated the pain at 6-8/10. She was unable to reach above her right with the right upper extremity. Objective findings showed reduced right arm swing. It was noted that the claimant was unable to place the right hand behind the head or the ear. There was a noted atrophy of the right forearm. Therapeutic exercises, moist heat, TENS, cryotherapy, and patient

Shoulder pain can range from mildly unpleasant to completely debilitating. It can be easy to put off treatment if you don't live within close proximity to a skilled shoulder doctor, but by doing so, you run the risk of having the condition worsen. Founded by Dr. Robert E. McLaughlin, North Shore Shoulder offers world-class orthopedic shoulder care. The facility is based in Beverly, MA, but if you need help with shoulder pain and aren't close enough to come in for an initial consultation, you can send your X-rays, CAT scans, or MRIs in to Dr. McLaughlin for a complimentary review. When doing so, keep the following guidelines in mind:

Typical symptoms consist of pain in the front of the shoulder, which often radiates to the side of the upper arm. There is increased pain with lifting, reaching, and overhead activities. Swelling and tenderness are usually present over the front of the shoulder. As the shoulder impingement progresses, the pain may start at night also, and loss of ROM may occur.

01/26/16 Progress Report noted that the patient presented with left shoulder pain. The pain was gradual in onset and is constant. The pain is characterized as burning, sharp, shooting, and throbbing. It radiates to the neck. She described her pain as moderate to severe. Her condition is associated with numbness in her left fingertips and weakness in her upper extremities. Any activity, movement and reaching aggravate the pain. Stretching and hot showers relieve the pain. The level of sleep has been decreased due to difficulty falling asleep. The quality of sleep is poor. She has difficulty performing her ADLs. Current medications: Meloxicam, Naproxen, and Spironolactone. Review of Systems was positive for weakness and nausea. The patient also has anxiety and depression. She has had psychiatric, psychological, or social work evaluations or treatments for problems. The physical exam of the cervical spine revealed that the ROM is restricted. There were spasms and tenderness of the paravertebral muscles bilaterally. There was also spinous process tenderness noted on C6 and C7. Tenderness is noted at the paracervical muscles and trapezius. Spurling’s maneuver produces no pain in the neck muscles or radicular symptoms in the arm. Adson’s test is negative. No signs of meningism. Cervical facet loading is negative on both sides. The exam of the right shoulder was

S: TM completed ESI X 5 visits. TM reports her shoulder is much better, reports her pain at 2/10 with movement. TM is very appreciative with Medical Clinic and ESI’s service. TM denies any other issues.

01/08/16 Progress Report noted that the patient sustained an initial injury in June 2014, due to a cumulative trauma. She sustained a new injury in January 2015 as well. She sustained an injury to her neck, right shoulder, right arm, and right knee. She had X-rays and MRI post injury. Her right knee swelled, but improved right after she received treatment for her right shoulder and right knee. She received PT and chiropractic treatment twice a week, medications and surgery to her right shoulder in May 2015. She has received no treatment for her neck or left shoulder. She has not received acupuncture. The patient presented today with complaints of occasional, mild to moderate, throbbing neck pain, stiffness and cramping. The physical exam of the cervical spine revealed positive tenderness to palpation of the cervical paravertebral muscles and bilateral trapezii. There is also a muscle spasm of the cervical paravertebral muscles. The cervical ROM is decreased and painful. Shoulder depression causes pain. The exam of the thoracic spine showed tenderness to palpation of the thoracic paravertebral muscles, right trapezius, T1-T2 spinous process, T2-T3 spinous process, right Rhomboid and right lateral

related injury to his right shoulder when a bathroom stall door struck him. As per OMNI entry, he is status post right shoulder repair on 09/23/2011 and repeat shoulder surgery on 03/23/2012. The patient was subsequently diagnosed with shoulder impingement syndrome, right. AME dated 1/12/16, future medical provisions states that the left knee will be treated conservatively including anti-inflammatories and perhaps periodic intra-articular cortisone injections. Viscoelestic supplementation is not recommended. It is also stated that it is reasonable to obtain a spinal consultation with someone such as Dr. Jones, Dr. Herron, or Dr. Hutchinson. The prior lumbar MRI scan (6/27/14) demonstrates instability and stenosis, so it is recommended for an

O: on inspection of the right shoulder, no redness or edema noted; on palpation warmth noted; on deep palpation TM reports increased pain; .Pain with abduction at 70 degrees.

Right shoulder examination reveals restricted abduction, internal rotation, and external rotation. Positive Hawkins’ and Neers’ tests were noted. Assessments are right shoulder pain and dysfunction of the right rotator cuff.