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Old 03-08-2010, 03:34 PM   #1
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Shoulder Issues

Hello,
I have been having shoulder pains and I have not yet seen a doctor. I have done some minor weight lifting and I would presume it is not helping it heal. I cannot pinpoint when the actual pain had started. the pain appears to be near the acromioclavicular joint or if the pain is within the rotator cuff it's near the top.
It maybe from the way I sleep or gradual wear and tear from lifting weights. I just recently got a PPO health insurance and I am confused on who to see for my shoulder problem. From the specialist that are in-network it seems they only have orthopedic surgeon, physical therapist, and pt/occupational therapy. I am confused on who to see. Also who would be cheaper to see cause I am on a very tight budget. My insurance covers 90% of my pt costs and I am unsure of the coverage for orthopedic costs.

Any suggestions would help. Thank you.

 
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Old 03-08-2010, 11:56 PM   #2
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Re: Shoulder Issues

I had shoulder pain begin without any obvious injury. Not sure exactly what course is best for you, but I can share my experience.

After a couple weeks, I went to see my PCP. She had me take anti-inflammatories and ice the area. That didn't help much. She then sent me for PT. The PT was able to diagnose my problem and I did shoulder exercises for several months. That helps the majority of people with minor problems. When it didn't help me, I self-referred to a highly recommended shoulder specialist. He did x-rays (which my PCP had also done) and an MRI. Those tests were not only diagnostic, but helped determine my course of action.

I understand the tight budget. If I were doing it again, I'd probably seek out the Orthopedic doctor sooner. He would have had me do the PT anyway first, but he would have been able to confirm if there were any rotator cuff tears with the MRI. If you have a tear and it is severe enough, you really do need to look at the surgical route first. As it was, I had months of PT I paid for before seeing the specialist and months of PT after surgery. In the long run, it would have been cheaper seeing the Ortho first.

In my case, I found out that I have a shoulder that subluxes. This means that it comes out of socket just a bit every time I move it. It had resulted in Shoulder Impingement Syndrome with Bursitis and Tendonitis. I just woke up with soreness one day and it got worse over time.

 
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Old 03-09-2010, 10:58 AM   #3
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Re: Shoulder Issues

i know MR had been posting about the same 'shoulder ick' that i have and does have a wealth of knowledge on this subject as i do ONLY from our own experiences, which just IS the best freaking teacher. the very first thing you seriously need here even before being referred to anyone for anything IS that very good, much more in depth 'look' inside that rotator cuff area itself, THEN let that be your guide to the very next step. the one tendon within that rotator that just IS the most commonly torn IS that very top tendon called the supraspinatus(it just gets the most overall use and wear and tear)? this is also the one that was only a partial tear in me(did NOT have a freaking clue it was that bad) that decicided to just snap in half on me one morning and i instantly lost the ROM i was using to simply lift up my purse from on top of my fridge(was forced to have to just drop that in mid lift cuz that ROM was instantly gone on me), and the freaking pain went WAYYY up too right then and there. just the area of your chief complaint even being within the more top area, really could be at least a partial in that very same tendon that WILL simply end up being total/complete without some surgical intervention here sooner vs later. its just what these tears do over time and over use, even just doing things that are not considered to be like 'heavy lifting' type situations? it just does what it does tiny bits at a time?

by the time my supra totally snapped on me that morning, becasue it was getting soo bad, it was also starting to impact the tendon right directly underneath that one just in compensating for the supra being less useful? so i also, among the other odds and ends(solid findings that DID also include problems with that acro joint too) had already started to partially tear that one too.

your very best bet at just finding out what IS going on within that cuff area just so you even know for certain what has been impacted and how severely, would simply be s good contrasted MRI being done on that shoulder. like i mentioned above, once you can just obtain THAT one really defining test being done to show you what IS the underlying issues there, THAT alone will dictate more in what needs to be done, and you will already have that MRI in hand when you DO have the consult and eval with any orthosurgeon. he or she too will just do their own read of your hardfilms along with just trying to move you thru all the most prominant ROMS that would just show certain areas of damage/losses that may not even actually show themselves upon any real scan, even MRI. most good orthosurgeons simply know how any given body part and joint is 'supposed to' actually move when everything is good, and what they cannot actually get any limb to really do at all or without pain is what 'they' use to gage loss and damage to.

you can obtain that simple MRI referral from any doc like your primary? just make certain it IS with a good contrasting agent for the best possible pics. but this one test will seriously just 'show' what any real damaged areas are and by how much. getting ANY tendon when it is in the "partial tear" level vs complete like mine was is just soo much less invasive and painful overall with less healing time. if you wait til it snaps on you, trust me, it IS just a much bigger deal in like every way to have to deal with. if i HAD actually known how bad that R rotator was, it would have been fixed much sooner vs later for me too. i do wish you luck with this. please keep us posted as to what you find out, K? but DO make getting that one MRI a major priority right now. FB
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3-22-01,herniated C-6-7
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9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.

 
Old 03-09-2010, 11:45 AM   #4
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Re: Shoulder Issues

Thanks guys... I appreciate it. Looking up nearby orthopedic surgeons right now... Hopefully the MRI will be covered my insurance to a degree

How much did it cost you guys? and what did you guys end up doing for your shoulder? and how's the progress?

Last edited by calreg11; 03-09-2010 at 11:49 AM.

 
Old 03-09-2010, 07:54 PM   #5
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Re: Shoulder Issues

When you are looking for a good orthopedic surgeon, make sure you ask if they specialize in shoulders.

I can't remember the exact cost of my MRI. A few hundred though I think. I know I hadn't met my deductible when I had it so I had to pay more out of pocket at the time.

I was luckier than feelbad. I lost my ROM and was in significant pain, but I hadn't developed a tear yet. I do feel if I hadn't sought out treatment that it would have eventually gotten to that point though. I ended up having arthroscopic shoulder decompression. Basically they cleaned up the debris in my shoulder and shaved down some of the bone on the bottom of the acromion. This created more room in the joint to accommodate the swelling that takes place when my shoulder subluxes out of place. Because they didn't have to do any repair work, my healing was only a few months and I was out of a sling in a few days.

I became almost pain free for about a year. I'm having some issue with mild pain again, but still have full ROM. That is to be expected some because of my "loose" shoulder joint though so I figure I can live with it.

 
Old 03-10-2010, 04:46 PM   #6
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Re: Shoulder Issues

I am 2 weeks post-surgical arthroscopic by an outstanding shoulder specialist. Lots of docs do shoulders; but you want one who has done an additional year of training on shoulders alone with a top rate surgeon. You also should seek out someone you are comfortable talking with - who will patiently answer ALL your questions. I did 2 months of PT before the MRI. and got worse. That had been prescribed by my first ortho guy - an arrogant, little jerk who gave brief, cold answers to my questions AND TREATED ME LIKE AN IDIOT. (I have an earned doctorate and have sons older than him).
You need to know that recovery from rotator cuff surgery is loooong. THE LATEST THEORY IS TO REST THE SHOULDER TO LET IT HEAL FOR THE FIRST 6 WEEKS, WITH ONLY LIMITED ROM EXERCISES. Also, be prepared to sleep sitting up during those 6 weeks - that's been my biggest challenge.
Learn everything you can = knowledge is power. Good LucK!!!

 
Old 03-11-2010, 07:34 AM   #7
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Re: Shoulder Issues

hey elk,you wouldn't happen to live in MN would ya? i am only aksking since i had a stupid idiot ortho worked on my finger when i blew out the actual ligaments on both side tht he merely 'procounced' as a tendon issue when it turned out to bre a major blow out like explostion when i simply fell at work one day and and came down ON that middle finger? that man was a stupid idiot like from the beginning from the actual Dx to actually placing a full hand cast on me tha i should never have had done at all? should have been splinted with PT started like the followintg week instead? just a freaking idiot that my 'new hand surgeon(came VERY highly recommended by a freind who had had many surguries done by the hand guy) i saw after nothing got better after the cast was removed, that hand surgeon was absolutely stunned at what the other ortho did to me, and permanently too. that initial ortho was just a plain idiot from beginning to end when i left his ***.

there can be great surgeons and bad surgeons but as someone else mentioned, just finding that great surgeon who simply specializes in what YOUR real needs are IS crucial for the very best outcome. i got VERY lucky with my surgeon who did both my knee surgeries in that i assumed his actual specialty was only kness(he was just soo good at it and the after care too), but found out when i went back to him with my rotator MRI that his PA told me he was tops in the shoulder/rotator dept. well who knew? he did an amazing job on me with alot of extra medical issue we also had to deal with from my spinal cord injuries that just created alot of diferent issues to also have to be taken into consideraion. he was wonderful for what MY real needs were that had to also be accomodated. but finding out what real ortho specialty any particular ortho or any surgeon depending at any time, really IS also 'key' to getting treated appropriately, thru the very important eval/consult, surgery and post op and them just knowing without a doubt the best possible rehab program for YOUR losses that need restrengthening. the post op PT really IS just soo crucial to getting back what is 'normal' again.

while i also had the decomp and a few little 'holes' where the camera/scope and the tools were placed inside my body, becasue my supra had actually snapped in half on me, i also ended up with a much larger incision having to be made too only to reattach that tendon and also anchor it to the very top of my shoulder with 'anchor pins' too. something that could have and would have been totally unneeded if i had just gotten that MRI done much earlier when that pain really was trying to tell me something before that whole tendon just went on me that morning. it just made it a much more invasive and slower recovery too by then. i just realkly honestly did NOT think it was even remotely THAT bad in there,but it was. so getting that contrasted MRI right niow so you just know whast you are actually dealing with first, really should be your main priority right at this point in time.

until you can obtain that referral from just your own primary here, hopeully very soon, i would watch what you do and do not do anything as far as even PT til you just KNOW without a freaking doubt that it would even help and not hurt you more. certain therepies can actually mkake certain types of injuries worse and not better when the Rxing doc had no real MRI to let that guide them. so this just IS what is most needed right now. just obtain that MRI, and also ALWAYS making certain that YOU,the patient always obtains you very own copys of any and all test results, per the rad report. you jusdt REALLY DO need these for many readons along the way.

once you get the MRI it will allow us to help you with whatever the next steps would be PER that report itself. just get that done,and get your own copy so you can at least type out that summary that is on the very back page where the interpretting rad always places any real hard findings. that will really help us to try and help you just seek out the very best type of help for your level of problem areas in there too. please DO continue to keep us all posted hon. FB
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3-22-01,herniated C-6-7
11-20-01,placement of hardware for failed fusion
9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.

 
Old 03-11-2010, 12:50 PM   #8
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Re: Shoulder Issues

No, I'm in MI. I've had wonderful experiences with 3 guys in the same ortho practce as the jerk. The good news is that the practice hires a firm to send e-mail evals to patients.
You rate the doc and the clinical and office staff, cleanliness, etc. I am totally honest and fill them out immediately. I doubt that the weak guy will be around long. A good rule of thumb - even though you hurt like crazy, don't go for "first available" surgeon. There is probably a reason he is so available.

 
Old 03-12-2010, 10:25 AM   #9
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Re: Shoulder Issues

VERY good point elk. i also found THAT one out the hard way when i needed to have me fusion done in my c spine but also had a nasty glob of blood vessels that i guess was my 'birthmark' right smack in the middle of my spinal cord right under the herniation(this all simply showed up with my very first MRI being done there, never knew it existed til then)? the man scared the freaking crap outta me sooo bad, i practically RAN out of hisw office that day and NEVER looked back. he simply thought it was a really good idea to butcher the living hell out of my spinal cord so he could 'do' the fusion and not have to worry his little head about another possible bleed occuring?? sick little bast***. but he WAS the first availiabe and wayy too soon. and i WAS also VERY desperate for help and in alot of pain which did not help the situation either. i ended up seeing three seperate NSs with the third one at the U of MN who just knew becasue of many YEARS, decades actually what I needed done for me. some things ya live and learn the hard way ya know? FB
__________________
3-22-01,herniated C-6-7
11-20-01,placement of hardware for failed fusion
9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.

 
Old 03-23-2010, 11:02 AM   #10
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Re: Shoulder Issues

Thanks everyone for the responses it is helpful. I came back from the orthopedic surgeon and he diagnosed I had distal clavicle osteolysis, and a bad case of it. He gave me a cortisone shot and told me I should be feeling much better the next day. I kinda did. The pain actually never went away. Did anyone of you guys have this diagnosis? And what was treated for it?

I am wondering if going to a physical therapist and getting electrotherapy would help.

 
Old 03-23-2010, 06:30 PM   #11
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Re: Shoulder Issues

If your insurance covers it, see the ortho doctor, if you need a referal for him see the physical therapy first. If the pain seems to increase, ask them to give you teh cortizone/novacaine shot, it is helping me, i had it two weeks ago and have minimal pain. I have had shoulder injury since 04 surgery o7 and recurring pain therafter.




Quote:
Originally Posted by calreg11 View Post
Hello,
I have been having shoulder pains and I have not yet seen a doctor. I have done some minor weight lifting and I would presume it is not helping it heal. I cannot pinpoint when the actual pain had started. the pain appears to be near the acromioclavicular joint or if the pain is within the rotator cuff it's near the top.
It maybe from the way I sleep or gradual wear and tear from lifting weights. I just recently got a PPO health insurance and I am confused on who to see for my shoulder problem. From the specialist that are in-network it seems they only have orthopedic surgeon, physical therapist, and pt/occupational therapy. I am confused on who to see. Also who would be cheaper to see cause I am on a very tight budget. My insurance covers 90% of my pt costs and I am unsure of the coverage for orthopedic costs.

Any suggestions would help. Thank you.

 
Old 03-30-2010, 06:16 PM   #12
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Re: Shoulder Issues

Quote:
Originally Posted by ejh1 View Post
If your insurance covers it, see the ortho doctor, if you need a referal for him see the physical therapy first. If the pain seems to increase, ask them to give you teh cortizone/novacaine shot, it is helping me, i had it two weeks ago and have minimal pain. I have had shoulder injury since 04 surgery o7 and recurring pain therafter.
What kind of surgery did you have. I went into the ortho doctor and they did give me a cortisone shot. It still hurts a little. I have been taking glucosamine to help with the joint. I dont want to have to resort to surgery.

 
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