QuestionOn 2/20/08 I was shoved into a shelf at work and hurt my arm and shoulder. At first it appeared that I may have dislocated it my shoulder, but x-rays showed that I did not. I had physical therapy 12 visits and to no avail, no help. I continue to have swelling in my shoulder and my ROM is at 30- 70 and all the MRI's and CT scans have shown nothing wrong with me. The last doctor I saw said I have atrophy in my muscles in the back of my shoulder and that I probably stretched a nerves or torn them. I also was diagnosed with C5 compression and nerve block did not help and neither did steroid shots. My main doctor said my shoulder has frozen up. I feel physical therapy will not help and my NCM says I need surgery to free up my shoulder. I have great pain in the neck area from the drooped shoulder. I have to keep my left arm propped up to elevate the pain and I am on percocet for pain all the time and sleep is disrupted all night due to the pain. What are your suggestions for what might need to happen? My doctor is on vacation till next week and I am on WC till they figure out what to do with me. I want to work and get my life back to normal. Please help me.
Laurie Fisher
Answerdrooping shoulder, shoulder injury, workers compensation injury, MRI, CT scan, muscle atrophy, frozen shoulder, neck pain, dislocated shoulder, herniated disc, pinched nerve
Hello Laurie,
Sorry to hear of your injury.
Dislocated shoulder?, did you feel your shoulder (your upper arm bone) 'pop' out and then 'pop' back in again? Have you ever had a dislocated shoulder before??
The first time we dislocate a joint, often it re-locates on it's own. There may be a 'pop' sound or feel, in and out. When we dislocate a shoulder, it is actually the humerus (upper arm bone) that sits in the shoulder blade(scapula) sliding out of position. Sometimes this can happen without any damage to the shoulder joint (gleno-humeral joint). The 'head' of the humerus sits in the glenoid fossa of the scapula. Sometimes when we dislocate the shoulder we can damage muscles, tendons, nerves, bone or the larum cartilage of the joint.
That is why Xray, MRI, CT examinations are important. You say your tests are normal.
Last doctor you saw said 'atrophy' in the muscles. A common cause of atrophy in the muscles is nerve involvement. Have you had EMG/ncv tests of the neck/ back/ arm ? This is a test I would recommend to evaluate nerve damage. Atrophy occurs after time. Was the injury weeks/ months ago? If so, you may have injured your shoulder AND neck and nerves feeding the muscles of the area. Nerve damage over time leads to atrophy of the muscles.
Frozen shoulder possible? yes. Frozen shoulder can be so severe it is impossible to move your shoulder/ arm at all. If you cannot reach into your back pocket, you have some degree of frozen shoulder.
C5 compression? please explain. I do not know what C5 compression means. C5 compression fracture? Broken bone?
The most interesting thing to me is the neck pain, muscle atrophy. Without seeing you, and from afar, reading your description of the incident and signs/ symptoms: i would recommend a Cervical MRI to evaluate for a herniated disc in your cervical spine (neck). In my Staten Island Chiropractic office I deal with workers compensation cases, and I know it it sometimes difficult to get the authorization for this test, but I think it is a necessary test given your description. I would recommend an EMG/ncv of the C-spine, upper extremity. A Herniated disc and resultant pinched nerve could be a cause of your condition.
Along with orthopedic, neurologic evaluation, I would recommend a trip to the local family Doctor of Chiropractic. If you have a C-spine problem, whether herniated disc or subluxation resulting in pinched nerve, a Doctor of Chiropractic could be very helpful to your condition. This Staten Island Chiropractor deals with herniated discs and pinched nerves every day.
A couple of informational handouts I utilize in my office:
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Disk Herniation
Herniated disk is actually a quite common condition. However, the course of the condition is highly variable. Some patients with a herniated disk literally cannot walk, yet other patients with similar MRI findings may be able to run marathons or lift heavy weights. Some people suffer for only a few days with pain and symptoms, some people suffer for months. Although the course is highly variable, there are certain steps that are always helpful to follow: Ice the area when painful- 10/ 15minutes on, 30/ 45 minutes off; avoid certain postures and movements; bend the knees when coughing or sneezing; bend the knees when lifting anything; do not extend legs straight out when sitting, laying down, lifting, or driving. Avoiding certain movements and postures will prevent aggravation of the condition. Practicing good postures and movement patterns will help the condition heal and be less painful.
Disk Herniation is often caused by, or often concurrent with the Vertebral Subluxation Complex.
Vertebral Subluxation Complex (a.k.a. 憇ubluxation?
The vertebral subluxation complex is the underlying cause of many healthcare problems.
A subluxation interferes with the proper functioning of the nervous system (the master system which controls and coordinates all function within the body) and may cause various other conditions, symptoms and problems.
Subluxation is a serious condition identified by its five parts:
Spinal Kinesiopathology:
This is fancy way of saying the bones of the spine have lost their normal motion and position. It restricts your ability to turn and bend. It sets in motion the other four components.
Neuropathophysiology:
Improper spinal function can choke, stretch, or irritate delicate nerve tissue. The resulting nerve system dysfunction can cause symptoms elsewhere in the body.
Myopathology:
Muscles supporting the spine can weaken, atrophy, or become tight and go into spasm. The resulting scar tissue changes muscle tone, requiring repeated spinal adjustments.
Histopathology:
A rise in temperature from an increase in blood and lymph supplies result in swelling and inflammation. Discs can bulge, herniate, tear, or degenerate. Other soft tissues may suffer permanent damage.
Pathophysiology:
The VSC contributes to OsteoArthritic degeneration. Bone spurs and other abnormal bony growths attempt to fuse malfunctioning spinal joints. This spinal decay, scar tissue, and long-term nerve dysfunction can cause other systems of the body to malfunction.
The Vertebral Subluxation Complex describes what happens when spinal bones lose their normal movement patterns and position. When subluxated, joints are in a stressed, vulnerable, compromised condition. Subluxation may cause Arthritis, Disk Herniation, or aggravate such conditions.
Vertebral Subluxation cannot be corrected through chemicals (medicine), stretching, yoga, vitamins or physical therapy alone. Subluxation- a neuro/skeletal/muscular- mechanical- problem requires a mechanical correction- - - a manipulation, best performed with the chiropractic adjustment.
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揚inched Nerve? ( Also Known As- neuritis, neuralgia, brachial-neuritis )
Sometimes we can wake up with a 憄inched nerve? or a muscle spasm.... sometimes a slip, trip, fall, heavy lift, or even a motor vehicle accident can cause a 憄inched nerve? Ultimately- a c a u s e of the pinched nerve, pain in the neck and/ or shoulder and/ or arm and/ or hand; could be a misalignment, a 慿ink?in the neck- more properly termed a Vertebral Subluxation.
A long term 'pinched nerve' could result in muscular wasting- muscular atrophy.
Vertebral Subluxation Complex (a.k.a. 憇ubluxation?
The vertebral subluxation complex is the underlying cause of many healthcare problems.
A subluxation interferes with the proper functioning of the nervous system (the master system which controls and coordinates all function within the body) and may cause various other conditions, symptoms and problems.
This is a serious condition identified by its five parts:
Spinal Kinesiopathology:
This is fancy way of saying the bones of the spine have lost their normal motion and position. It restricts your ability to turn and bend. It sets in motion the other four components.
Neuropathophysiology:
Improper spinal function can choke, stretch, or irritate delicate nerve tissue. The resulting nerve system dysfunction can cause symptoms elsewhere in the body.
Myopathology:
Muscles supporting the spine can weaken, atrophy, or become tight and go into spasm. The resulting scar tissue changes muscle tone, requiring repeated spinal adjustments.
Histopathology:
A rise in temperature from an increase in blood and lymph supplies result in swelling and inflammation. Discs can bulge, herniate, tear, or degenerate. Other soft tissues may suffer permanent damage.
Pathophysiology:
The VSC contributes to OsteoArthritic degeneration. Bone spurs and other abnormal bony growths attempt to fuse malfunctioning spinal joints. This spinal decay, scar tissue, and long-term nerve dysfunction can cause other systems of the body to malfunction.
The Vertebral Subluxation Complex describes what happens when spinal bones lose their normal movement patterns and position.
Automobile accidents, improper lifting, improper posture, alcohol, emotional stress, chemical imbalances, and long periods of sitting can cause the Vertebral Subluxation Complex.
Vertebral Subluxation cannot be corrected through chemicals (medicine), stretching, yoga, vitamins or physical therapy alone. Subluxation- a neuro/skeletal/muscular- mechanical- problem requires a mechanical correction- - - a manipulation, best performed with the chiropractic adjustment. For good health- Treat the Cause, not just the Symptoms.
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I hope these help.
I would enlist a Doctor of Chiropractic onto the healthcare team. I would get an MRI, EMG of the neck.
I wish you good luck and good health naturally,
Dr. Victor Dolan, DC
http://drvictordolan.chiroweb.com (email newsletter)
http://www.GoodHealthNaturally.info
http://www.DocDolan.net
