Complaints of Overnight Shoulder stiffness..
Once a guy came to me with a complain of severe pain & stiffness in his Right shoulder. He was unable to reach his hand to the backpocket too. After a talk i got to know, it was a overnight problem. I examined all of the muscles & joint ranges. All ranges were full but some manual teats were positive for Supraspinatus & infraspinatus muscle. His Infraspinatus muscle seemd to be very weak.
* Always remember isolated (only one) muscle weakness is indicative of some kind of neuropathy. And in case of shoulder, Suprascapular neuropathy is the commonest one.
The neuropathy can be diabetic, traumatic or diet related. In case of this guy previous 2 reasons were not there.
Deficiency of B12 can give rise to neuropathy. Ask the patient diet related quostions like veg/nonveg? does he consums milk? etc. nonveg & milk are good sources of Vitamin B12.
Tell the patient to check the B12 values in the lab. Then start external B12 supplimentation. After which strat working out on physiotherapy aspects like Strengthening Core Muscles & Rotator cuff muscles of shoulder.
* Most of the people dont keep an eye on these aspects & starts giving Physiotherapy modalities like heat- cold, exercises. These people cant come to an ending of treatment & thoses who come get the back to the clinic after 3-4 months with the same complaint.
Investigations to be done:
Serum B12 / simple Hb testing( people with B12 deficiency always have a reduced hemoglobin levels)
Serum Calcium.
Physiotherapy:
We have a specialised program for shoulder joint named PSRP. I can cosult you anywere in Maharashtra, on your special request.
* Always remember isolated (only one) muscle weakness is indicative of some kind of neuropathy. And in case of shoulder, Suprascapular neuropathy is the commonest one.
The neuropathy can be diabetic, traumatic or diet related. In case of this guy previous 2 reasons were not there.
Deficiency of B12 can give rise to neuropathy. Ask the patient diet related quostions like veg/nonveg? does he consums milk? etc. nonveg & milk are good sources of Vitamin B12.
Tell the patient to check the B12 values in the lab. Then start external B12 supplimentation. After which strat working out on physiotherapy aspects like Strengthening Core Muscles & Rotator cuff muscles of shoulder.
* Most of the people dont keep an eye on these aspects & starts giving Physiotherapy modalities like heat- cold, exercises. These people cant come to an ending of treatment & thoses who come get the back to the clinic after 3-4 months with the same complaint.
Investigations to be done:
Serum B12 / simple Hb testing( people with B12 deficiency always have a reduced hemoglobin levels)
Serum Calcium.
Physiotherapy:
We have a specialised program for shoulder joint named PSRP. I can cosult you anywere in Maharashtra, on your special request.
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Sarang Kendrekar