Reply To: Bilateral shoulder restriction/medical side effect

Exit forum Bilateral shoulder restriction/medical side effect Reply To: Bilateral shoulder restriction/medical side effect

#5455

Scott Glidden
Participant

Here we go:
73 year old male
Weakness and stiffness in both shoulders for last 3 months, but much worse over last 2 weeks.
7/10 sore/weak in morning
2-3/10 sore week by end of afternoon
P+ rest, plus gets better as the day progresses
P- any activity with shoulders, especially that which requires him to reach overhead.

Codman’s: Mild catch bilaterally, but can stop arm from dropping
Speed’s: Negative
Supraspinatus Press: Mild ache at top of shoulder

Shoulder Abduction: B 90 degrees (“just won’t go past that”)
Palpation: Mild adhesion at B infraspinatus, subscap, R teres minor

DDX:
1) Arthritic AC joints
2) Bilateral mild degenerative tear of supraspinatus
3) Adhesion listed above
4) possible drug interaction

Reasoning: Problem worse in morning but better throughout day points to arthritis. The codman’s and press tests, as well as age, point to degenerative tears. Adhesion was present, but not prominent in palpation. MD’s believe that drug interaction is a possible cause, and since it IS possible for soreness and aches to be a side effect I have no reason to doubt them (especially since its out of my scope).

My plan was to treat adhesion present to take tension off of supraspinatus and unload arthritic joints since I cannot directly treat #1 or #2. My plan then changed once ALL improvement was revealed to be reflexive at the next visit–I told him we should give it 2 more appointments to see if we could get any improvement and if there is none we could get imaging and come up with another plan. Patient cancelled remaining appointments and wants to meet up in a few weeks once the drug interaction possibility has settled down.

Thoughts?