Before you start reading this you should be aware that it is a long and fairly complicated case so you’ll need some free time!
I’m a 24 year old guy from Dorset in England and I’m suffering from a chronic shoulder problem which allows me to do very little with my right arm at all and I’m hoping that someone may be able to suggest something which might be able to help me.
I was in a car crash previous to this current situation in 2001 in which I suffered a fair hefty whiplash injury complicated by the fact my head was turned completely to the right at the time of impact, the pain I suffered and symptoms were eased and later near enough ceased by Chiropractic care over about a 2 year period.
Since then I had been in good health with just the occasional back “twinge”
On 15th June 2006 I was involved in another car crash, I was a front seat passenger in a car driven by my girlfriend she came round a blind corner to find a stationary car in the middle of the road and as we were travelling at about 40mph we were unable to stop. Upon impact my right arm was thrown forwards and my hand clenched into a fist and this arm braced against the dashboard as my body jolted forward – I had instant and very severe pain in my right shoulder, neck and most of my spine. I was taken to A+E straight away where I was told that I simply had whiplash – they ignored some obvious bruising to my knuckles where the impact occurred with the dashboard and my complaints of a very painful shoulder. They x-rayed my neck and that revealed no fracture.
I was sent away and told to take it easy and to see my GP if I needed painkillers which I did straight away as I was in agony.
I was prescribed voltarol and 30/500 cocodamol – this more or less did the trick for my back pain but my shoulder was still agony – I had an office job and tried to work but as it was a temporary position I was fired as I was doing literally 5 hours a week instead of 40.
I was in constant pain, I could lift my arm about 45 degrees forward before it got too painful to lift any further, I could abduct it about the same amount and I couldn’t support any weight on the arm at all.
I’ve reduced the following to a timeline from here on in
August 2006 - Saw a physiotherapist who said I had ‘nerve memory pain’ she said she had had exactly the same thing as me although the symptoms she described to me were not the same as mine at all. I had looked into the possibility of posterior dislocation and upon mentioning this to her she got angry with me saying that I shouldn’t look for another diagnosis as she had already diagnosed me.
August 2006 - Returned to my GP saying that although my back pain had calmed down my shoulder was still unbelievably painful and I could barely lift my right arm at all, he referred me to an Orthopaedic surgeon
September 2006 - This surgeon believed I’d probably dislocated my shoulder upon the impact of the crash and the joint had then relocated itself straight away but had probably done quite some damage on the way through and referred me to have an MRI scan.
December 2006 – Had MRI scan of my shoulder. Which revealed fragments of broken cartilage in my shoulder socket and a minor lesion to my biceps tendon but no other major structural damage.
February 2007 – Saw a different surgeon who wasn’t keen on operating on the shoulder to remove fragments from shoulder joint, he referred me to a pain management specialist.
February 2007 – Saw the pain management specialist who recommended surgery as the fragments were obviously causing pain and aggravation.
April 2007 – Had arthroscopy to clean out joint, which was ‘successful’ and said there was no other major structural damage.
May 2007 – Followed up operation by seeing a chiropractor who began working on building up my muscles and teaching my arm how to move again.
After 4-5 sessions he said my muscles were too tight to work with and that any exercises I did was causing pain that caused my muscles to tighten up even more so he referred me back to the pain management specialist.
August 2007 – The pain management specialist recommended botox injections to reduce the spasming and tension in my muscles. Had injections into the right side of my neck and into most of the muscles associated with shoulder movement.
This had a slightly pain relieving effect and decreased in muscle tension but due to problems with insurance company this wasn’t followed up with the correct aftercare program.
December 2007 – Had a second lot of botox injections into the same areas as the first lot.
January 2008 – Botox had helped with Arm abduction quite a bit but raising it forwards was still pathetic (45-60 degrees maximum and literally no lift if I was trying to lift any weight at all)
March 2008 – Had a third set of botox injections injecting more muscles than ever before to try and increase motion and reduce pain.
April 2008 – Began seeing a physiotherapist once a week to try and take advantage of the reduced tension and pain. I began very slowly and the physio was very adamant that I push myself as hard as I could.
June 2008 – Having made quite good progress with range of motion and pain levels I had a complete relapse and lost all the progress I’d made overnight. Physio noted massive scapula winging and sent me to have nerve conduction studies.
June/July 2008 – Tried acupuncture for pain relief to see if it would help which unfortunately it didn’t.
July 2008 – Had nerve conduction studies, they were able to complete the standard NCS but were unable to accurately record the ECG measurement as the botox would affect the reliability of this test. (I may have got the ECG and NCS the wrong way round but anyone reading this should know what I am talking about.)
August 2008 – Began seeing a neurological Chiropractor who unearthed several problems I didn’t know I had relating to balance and other spinal problems.
October 2008 – Had follow up nerve conduction studies now that the botox wouldn’t be affecting the results. The tests revealed that I had damaged my right long thoracic nerve possibly caused by ‘Interval parsonage-turner syndrome’
31st December 2008 – Found out that my partner and I are expecting our first child at the end of August which has made me even more determined than ever as I will actually struggle to pick up my child in my current state.
February 2009 – Having made a little progress with my shoulder’s range of motion thanks to my chiropractor but frustrated at the speed of the recovery I went back to the Pain Management specialist who recommended steroid injections which he said she ease my pain and muscle tension and hopefully speed up my recovery.
April 2009 – Unfortunately the steroid injections just caused massive pain and didn’t do anything for my muscle tension so the pain management specialist referred me to a national shoulder expert.
May 2009 – Saw the National Shoulder expert who said that my condition was split into two parts – 1) Really bad wrenching shoulder injury which had caused my long thoracic nerve to sever 2) Complex regional pain syndrome (I’m not a medical professional obviously but this seems to just mean that I’ve got some pain which they can’t explain.)
He essentially said there’s no surgery option that is going to help me and just said that I had to wait for my long thoracic nerve to grow back but he said he was unable to give me a timetable on this happening but he said and I quote “a very long time”
He said he would write to the President of the Shoulder and Elbow Surgery Society (or something similar) to see if there was anything he could recommend but basically it seems that he thinks the solution is to carry on seeing my chiropractor and just waiting for the nerve to re-grow.
I am basically at the end of my tether with this whole situation I have been in pain for practically 3 years and have had very little improvement despite the numerous different treatments and therapies I have had. I’m hoping that someone who has taken the time to read this will know of someone who has had something similar or something that would be worth trying as I will try anything to get better as I just want to be able to pick up my little girl when she’s born.
I've put some pictures up so you can see what's going on - if you need anymore information or have any questions then please just ask.
<img src="
http://i57.photobucket.com/alb...der/shoulder1.jpg"><img src="
http://i57.photobucket.com/alb...der/shoulder2.jpg"><img src="
http://i57.photobucket.com/alb...der/shoulder3.jpg"><img src="
http://i57.photobucket.com/alb...der/shoulder4.jpg"><img src="
http://i57.photobucket.com/alb...der/shoulder5.jpg"><img src="
http://i57.photobucket.com/alb...der/shoulder6.jpg"><img src="
http://i57.photobucket.com/alb...der/shoulder7.jpg"><img src="
http://i57.photobucket.com/alb...der/shoulder8.jpg">Thanks to anyone who takes the time to read this, any responses gratefully received.
Chris
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