Good afternoon!
A sweltering day here in Philly- with the heat index, it’s hovering around 100 degrees. Still, I would take this weather any day over the snow we had this past winter. For those of you keeping score- I’m a Miami boy at heart- and I’m one of this folks who doesn’t care if it’s summer there, or whether it’s humid. Basically, I’m not complaining!
In any case- today a viewer question from Doug:
“I’ve had back pain in my upper back and neck for for the past two years. I never had any kind of injury which triggered it- the pain just kind of started one day, and got progressively worse. I’ve been to several doctors, and have had x-rays and MRIs, none of which found any problems in my spine. A friend recommended an orthopedic surgeon who helped him with his neck pain.
I saw him a couple of weeks ago, and he told me my back pain was due to a rotator cuff tear. He decided this without any MRIs of my shoulder, and in spite of my protestations that my pain was in my back, and that I had no pain in my shoulder.
He wants me to get an MRI- which I hope will confirm the diagnosis, but which I am really nervous about. I pretty much had a panic attack in the MRI machine.
My question is this: is it reasonable for me to get this MRI, given that I have no pain in my shoulder? I’ve heard that orthopedic surgeons just want to cut, and I’m just not that interested in surgery.”
Thank you for your question Doug. Your apprehension regarding the MRI and the possibility of surgery is common, and not unreasonable.
Rotator cuff tears are an interesting thing. Often, they do not present as pain in the shoulder itself, but more so in the structures surrounding the shoulder. The reason for this is that the surrounding musculature- including those in your back- have to work extra hard to stabilize your shoulder following a tear, and protect it from further damage.
Rotator cuff injuries are pretty easy to preliminarily diagnose using simple examination techniques and movement tests done in the office. Typically, an office based diagnosis is confirmed with an MRI. Based upon the information you’ve provided me (and as always, keeping in mind this is a ‘drive by’ diagnosis made without any physical examination on my part) it is very reasonable for you to go ahead and get the MRI, and if indicated, rotator cuff repair. Hopefully you can then find relief from the pain which has been troubling you.
I hope this helps.
Best,
Andy
A beautiful view of the Southern Lights as seen from the ISS.
) You are very clear and easy to understand, which is very important when educating people. What would you say to a psychologist that claims that FMS is purely a psychological disorder and not a “real disease”? This is what my counselor told me yesterday. I have severe chronic pain from multiple causes,when it came up in our session yesterday that FMS is one of my Diagnoses she flatly said “FMS is a psychological disorder.It is not a real disease.” What would you say in response?”
For the right patient, it can provide some relief by stretching the muscles, and enlarging the space in between vertebrae- allowing more room for nerves which may otherwise be being compressed.
