Shoulder Pain

The shoulder has greater mobility than any other joint in the body. Pain in the shoulder may indicate a problem in the shoulder itself or elsewhere in the body. The shallow depth of the shoulder joint contributes both to its mobility and its susceptibility to instability and injury.

Shoulder pain that is poorly localized may be pain that is referred from elsewhere in the body. The classic symptom is left shoulder pain that indicates a heart attack. Nerve impingement or entrapment in the neck or upper back can cause shoulder pain. Irritation of the diaphragm from an abdominal catastrophe (ruptured ectopic pregnancy, perforation of the bowel or rupture of the spleen) can cause shoulder pain on the same side.

One of the easier diagnoses is shoulder pain following trauma. The evaluation will consist of taking a history, examination and sometimes imaging. The history and examination will determine the type of imaging (X-ray, ultrasound or MRI). Pain that arises months after the injury may be due to adhesive capsulitis from immobility.

Excessive use of the shoulder can lead to inflammation of the fluid filled cushioning sacs around the shoulder (bursitis). Tendonitis is can be due to a sudden injury, advancing age or overuse. Osteoarthritis resulting from wear and tear can also cause chronic shoulder pain.

Surgery may be required to resolve some shoulder problems; however, 90 percent of patients with shoulder pain will respond to simple treatment methods such as altering activities, rest, exercise, and medication.

Some exercises, after checking with your physician. 

It Can Happen to Anyone

Winter weather brings snow, sleet and ice – along with slips and falls. Any one of us could be temporarily disabled, making it difficult to get around our own homes. I recommend that anyone who remodels consider this, particularly when designing a bathroom.

If this is new construction, consider having enough room around the toilet to pivot a wheelchair. Clear floor space for one wheelchair must be 30” x 48” (760 mm x 1219 mm) or more to accommodate the chair with ease. The equipment to be used must be approachable from the front or the side. Some of this clear floor space may be located underneath fixtures, lavatories, or accessories as long as the necessary knee and toe clearance is available. Even if not using a wheelchair, having enough clearance will allow another person to assist.

Grab bars provide stability and support for people getting on and off the toilet. There are many attractive surface materials available. Grab bars should also be in the shower, along with a seat. The grab bars are permanently installed; the seat can be put in as needed. Adding a seat improves safety and allows for more independence in personal care. The seat should be against the wall so that one can lean for additional support. Don’t forget to put the shower controls within reach.

If possible, the entrance to the bathroom and the shower should be roll in. Even a low saddle can be hard to navigate on crutches or with an unsteady gait.

Even a minor remodel will make a bathroom friendlier. Consult with an architect or certified planner for grab bar placement. Consider a hand-held shower. A fold-up shower seat would be appreciated by anyone.

Anti-Resolutions

It’s three days in - how many New Year’s resolutions have you already broken? Chances are at least one, and by this time next week several more. Here’s a contrarian notion: anti-resolutions.

Think about the past year – what didn’t work? Not successful in losing ten pounds? Then how about resolving not to gain ten pounds.  Never got around to sorting through the closets? Then how about resolving not to increase the mess. Didn’t retire the credit card debt? Then how about not increasing the amount owed.

Once you figure out what didn’t work – don’t do it. I’ll bet that at the end of 2015 you will be in a better place than you were in December 2014.