Joe A Shaw PA-C - 6/2/2010

Question
a few months back, i landed on my left side with my left arm next to my body elbow tucked into the rib area and I heard a crack (sort of like the crack i heard when i broke my rib last year.) The crack sounded like it came from between the shoulder and the neck on the left arm (my good arm for the past few years.) initailly it just burnt. Didnt really hurt until a few hours later, but then the pain didnt really last all that long. Then the other day i was on my left side and pressure was applied downwards and that area "crunched." Since then a lot of pain. Lifting shoulder causes pain. Taking off / putting on bra enough pain to almost cause eyes to leak water. Cant really put much weight on the shoulder... as in like leaning on the arm. Sometimes it will shift and i can use it easier, then if it shift again i can barely lift it. Turning steering wheel smarts too. Movement that allows the elbow to come away from the body is uncomfortable (to the front) and downright paiful (when taken to the side. Like the right... i will do what i have to do and block out what i can so that i can work, etc. I need to train and i can barely do that right now. Burns all the way to the neck. Behind the boney protrusion of where the collar bone ends near the shoulder joint on the top of the shoulder there is a "pressure point" that if given the slightest pressure is like instant pain spike. Thankfully if i dont touch it the area just aches =), only spikes when i am trying to figure out why and where the source of the ache is. Do you have an idea at what is going on?

Answer
Vicki,
You need xrays at the least to rule out any fracture and really an MRI to see if you have a rotator cuff tear of muscle or tendon. There is really no need to speculate beyond that until these tests are done. If you have a tear you will probably need surgical repair. If not, steroid injections, NSAIDs, Physical therapy will be tried