Back to minor injuries or see GP?

[owthathurts]

I fell over on the weekend and really hurt my arm/top of the shoulder, TBH I really thought I had broken it as it was so painful. I went to MI and they x-rayed it. Nothing showed up on x-ray so was sent home with a collar and cuff and told to take regular paracetamol/ibrufen. My arm is still really painful and a little bit swollen - as in really painful, I can't move it very far, cant use a spoon, fork, brush my teeth, put underwear on, wash my hair, drive, use a cup with that hand,sorting myself out after going to the toilet, takes ages to get dressed/undressed and its very very painful.

I am now a few days on and I can use my hand more than I could originally but the pain is pretty much as bad in mu upper arm/shoulder. I have googled and with my self diagnosis have come up with rotator cuff injury. MI did say that after a couple of days if no better go back and see them - is going back to them the right thing or should I go and see my GP? The MI department is nurse led, they were lovely and very sympathetic but I am not sue which is the quickest route in getting a firm diagnosis and hopefully some treatment.

My arm/shoulder really hurts!

Just off to MI, it can't come quick enough - really bad night. Hope I get some answers and some relief. Fingers crossed.

Good luck

That was quick! It is what I thought - rotator cuff injury. Nurse has referred me to Physio (she doesn't know how long I will have to wait for). But they will be in contact. Also to ask GP for stronger pain relief mainly for nigh.

Just wondering when it will be safe to drive? Obviously not at the moment!

If you can at all afford it please pay for private physio - you will be seen within a day or so and will have hands on physio - manipulation, massage, exercises, IR and UV therapies, and will arrange to see you on a sliding scale - every 3 or 4 days to start, going down to once a month to finish. (£400 for the full 8 session course here for a nerve trapped in shoulder) - they also stay in touch with your doctor and can advise on prescriptions for specific pain problems.

NHS physio here takes 6 weeks min to get a first appointment, and now seems to consist of a photocopied exercise sheet, telling you how often to repeat and seeing you every 3-4 weeks.

I sometimes see a sport's massage, would he be any good?

depends on his qualifications - is he a qualified physio?

If not, I would ask him if there is anything that he could do to help and then check with a doc to make sure it will not do any harm.

I was told at the hospital there was a 13 week wait for physio in my area, hence why i decided to pay and get started ASAP.

I did actually get an appointment letter through this week to call to make an appointment, but I phoned and said i would no longer require it. So that was about 5 weeks for the letter to come through, but no idea on the time frame of the appointment.

My physio did say the sooner you can get started the better as if you are holding it tense and not moving it much, you are really at risk of it freezing up and then it is a much bigger problem.

Beyond I don't think he is an actual physio - what he offers are the following - Sports massage, remedial massage, stretching, injury, prevention and rehabilitation, strapping and taping.

I have been seeing him over the last few months due to a dodgy knee that is now affecting my hip!

Swift - the Nurse said exactly the same to me if I do not use the shoulder - but I am really struggling to move it as it's so blooming painful!

you have a dodgy knee a dodgy hip and now a bad shoulder (I know it was as the result of a fall... but still...) - to be honest I'd go see the doc and see if they could be in any way related... arthritis, hypermobility, hormone imbalance?

Minor injuries will just deal with the shoulder injury and not look to see if there is an underlying problem.

A sports massage therapist will probably help keep things moving until you get an NHS physio appointment/find a physio you like if private.

Dodgy knee was due to another fall (had vertigo at the time but hadn't realised how severe it was!!) Dodgy hip is due to dodgy knee and partly my job. Knee will not get much better but could get a lot worse, so I see sports massage man to keep it as loose as possible.

Have spoken with sports massage man today and he has said he will assess me and see if he can help whilst waiting for physio. He is very very good. I normally see him every 6 - 8 weeks.

So, I am almost a week on from my fall and yes I can now move my arm a bit more than when I first did it (still hurts but nowhere near as much as when I 1st injured it). I also have found that if I keep my arm very close to my body that I can use my hand quite well. But what is worrying me the most is that I still cannot put any weight on that arm - as in leaning on it (getting out of the bath, picking things up heavier than a cup of tea etc...)

Is this normal? Am I expecting to much? Bored of it now!

I would say that was pretty normal.

The first exercise I was asked to do was to hold my arm really close to my body like I was trying to keep a piece of paper between my arm and body then bend my elbow so my arm was 90 degrees straight in front. Then keeping the arm tight to the body and the elbow bent in that position try to move your arm away from your body to the side. Does that make sense?

Like the top pic. Keeping back straight and shoulders back

Thanks, I have just tried that exercise and have got very little movement without excruciating pain, will keep on trying. Nurse recommended that I draw little circles with my arm dangling down and gradually let the circles get bigger and bigger.

It's particularly aching today plus I am very tired as have had vey broken sleep all week and I so do love my sleep!

Am seeing the sports massage man tomorrow, have managed to get a little bit more movement in shoulder but still incredibly painful. Night times seem to be the worst. Desperate for a good nights sleep. Also getting a bit of cabin fever at the moment as well as I'm unable to drive.

I am still having problems lifting my arm up - It's almost like having a heavy weight hanging off it all the time, plus shooting pains going up into the shoulder. Also my neck aches a little and feels like I need to release it, and the whole of my collar bone aches from on side to the other.

Will see what my sports massage man says - may use him till the physio get in touch. Can't really afford to go private, fingers crossed I get an appointment sooner rather than later.

Probably a good thing I'm on A/L at the moment as I would definitely struggle with my job - Just my luck lol!

Cant believe I am almost at the 2 week point! Rang physio yesterday to enquire where I was on the waiting list - they still had not got my referral, I burst into tears, Receptionist was lovely and said she would do a little digging but in the meantime go and see my GP. Thankfully I managed to get an appointment later on in the afternoon. GP did a few movements on my arm and said she was worried about how little movement I had. I think even if they took the pain away I still would not be able to move my arm very high. It feels like it is being weighed down with a very heavy weight.
GP has told me to ignore Physio from the hospital, she wants me to see a physio from an outside agency. She has also given me Naproxen plus something to help my stomach.

What makes me so cross is that MI is literally the other side of the door to Physio. Can not understand why it can take over a week to pass a referral on.

Sports massage man has helped a little, he has been quite careful in massaging but it blooming hurts!

Fingers crossed I should hear from the outside Physio soon!

So I am now just over 3 weeks into this blessed injury. My shoulder is still really painful especially when getting dressed and undressed, and I have limited movement. Night times are just plain awful. GP has requested another X - ray which I am having done tomorrow.
I am also getting little clicks in neck/collarbone when I move my neck.

How much movement/pain were you getting after 3 weeks, I am still waiting for the Physio. A friend suggested an osteopath that she has used in the past and he does acupuncture too - but he is £40 a time and I just don't have that cash lying around!

GP has put a chaser in for the Physio but i still have not heard anything, plus it's going to be tricky at actually when I can see them as A I can't drive and B I'm now back at work and it's not a job that I can just nip out for an hour or so. So so fed up!

Hello from a passing orthopaedic surgeon.

If this were my shoulder, I would go back to my GP and ask them to consider arranging an ultrasound/MRI scan or urgent referral to a shoulder clinic. This could have been arranged directly from the Minor Injuries Unit but it wasn't wrong for them to wait and see if things improved over the next few days. It doesn't sound as if things are really progressing, though; and some rotator cuff tears do need specialist input +/- an operation. Night pain is a feature that can point towards a more significant rotator cuff injury and recovery may be hampered by a long delay.

I would also print off this guideline and highlight the bit that reads "Refer urgently to secondary care... if acute rotator cuff tear caused by trauma is suspected (trauma, pain and weakness). Ideally, the person should be seen in the next available specialist shoulder clinic".

Thanks JohnHunter, I will make an appointment with my GP again. I did have the 2nd Xray done on Tuesday and the lady carrying it out said that the Xray was pretty much the same as the 1st one and no sign of breaks or fractures. She did comment on how I was holding the arm and that I needed to try and relax it as I was helping matters at being so tense.

I am adapting to how I do things, just putting deodorant on is a massive pain (quite literally)I have to pick my right wrist up with my left hand and get my right hand to hold onto the towel radiator and gradually move away from the radiator whilst holding on (it is so painful), after I have sprayed, I then have to reverse the procedure to get my arm back to my body. The ache after is immense.

I do have good movement when moving my arm backwards and it only hurts a little.

GP has given me some codeine to take but am only trying to take it at night time - advised to take 1-2 (30mg) up to 4 times a day, so I take 2 tablets at about 5pm and then another 2 tablets just before bed. Night time is still the worst, I am in desperate need of a good nights sleep!

Still not heard from physio!

X-rays are great for looking at bone but won't say anything about non-bony structures, such as the rotator cuff. NHS physio services are under tremendous strain at the moment - by all means keep chasing them but I'd definitely prioritise pushing for a scan and/or shoulder clinic referral. Hope you get sorted soon.

I have literally just had a phone call from the Physio and now have an appointment for Monday! Can't come quick enough. So relieved.

I have just got back from seeing the physio, he was very thorough. He reckons I have about 40% movement lifting my arm up and to the side, backwards movement about 30%.

He wants me to have an ultra sound ASAP and he will see me again on Thursday. He is wondering if I have torn/a tear on my supraspinatus tendon(or muscle - not sure which it is).

He also advised me to go back to GP for stronger painkillers.

Am a little confused! I went back to GP last week for stronger painkillers, my GP prescribed me Gabapentin. Unfortunately they didn't help one bit. Saw Physio on Thursday as planned and asked me regarding painkillers and said that they aren't the right ones for my injury and hat my GP should be giving stuff that had lots of anti inflammatory in them and mentioned diclofenic. I'm pretty sure the Physio said that my injury was mechanic (but not a 100%). I spoke with GP on the telephone this morning and told him what the Physio had said and he told me was reluctant to give diclofenic but knew of something else instead. I picked the prescription up late afternoon (feeling quite hopeful of getting a good night sleep) and the tablets he has given me are mefenamic acid (which clearly states on bottle for period pain!) I have googled it and it does say for mild to moderate pain - just wondering how long does it take to work, I took 2 tablets as soon as I got home and so far not noticed any difference!

I can see why you (and the physio) were puzzled by the choice of gabapentin. Mefenamic acid is also a curious choice but - I guess - could work for this type of pain.

Was there a reason behind not wanting to prescribe a short course of diclofenac? Are you asthmatic or have ever had gastritis, reflux, or stomach ulcers? If none of these and the mefenamic acid isn't helping, you could just try ibuprofen instead. Diclofenac, naproxen, mefenamic acid, and ibuprofen are similar drugs but everyone responds to them a little differently.

Are you also taking regular paracetamol? Is the shoulder improving, even if only slowly?

Thanks for replying JohnHunter - no asthma, stomach issues etc.....when I spoke to my GP yesterday, all he said was that Diclofenic has a lot of side effects and he prefers not to use it. My GP is usually spot on. Although I have to say that the mefenamic acid has not even touched the pain so I am still struggling through the night. Am giving it till Thursday and by then the mefenamic acid should be in my system and hopefully working.

Is my shoulder getting any better? The answer is yes - a little. I have to remember what I couldn't do 5 and a half weeks ago. I do have more movement. I still can't drive, raise my arm up (put key in lock) and when I am lying on my back I cannot lift my arm off the ground at all.

I spoke with the sports massage man today as he has been on holiday for the last couple of weeks- he saw me when I 1st had the fall. He has said that he would be very surprised if it was a tear etc... as there has been no bruising and usually with that kind of injury there would be some.

Hopefully the ultrasound should be soon and we should find something out. It really does still hurt and I have had enough!