(After mentioning several hypotheses) "...that have been suggested as possible medical conditions... Treatment for the patient depends on the specific cause of the pain. As always, a full routine of non-operative therapeutic measures should be administered before resorting to surgical intervention." Emphasis added. This by Routolo, Penna, Namkoong & Meinhard, Am. J. Orthop. vol. 32, 2003.

DETAILS: We are contacting Dr. Routolo for suggestions as to non-operative measures. Whatever he tells us we will report in another issue of Shoulder Problems.

Referring to athletics-caused injuries, the Top Magn. Res. Imaging J. of vol. 14, 2003, concluded, "An understanding of the normal anatomy and biomechanics of the shoulder joint is essential for proper interpretation of the MRI manifestations of 'these injuries.]"

Aspirin Spinoffs and Shoulder Pain

Comparing Celecoxib and naproxen for shoulder pain, Bertin, et. al., of Dupuytren Hosp., Limoges, France, found both to be equally effective. In J. Int. Med. Res., vol. 31, 2003.

DETAILS: Aspirin was not tested. Unfortunately.

Physiotherapy?

Coch. Database Sys. Rev., vol. 2, 2003, found an insufficient number of verifiable clinical tests to justify any conclusions regarding the use of physical therapy for rotator cuff repair.

Arthroscopy

In Sportverletz, vol. 17, 2003, it was reported that "Arthroscopy is a reliable tool to assess 'the various types of shoulder injury.] Therapy should address the definite pathology." By Werner, et. al., Orthp. U., Dusseldorf, Germany.

DETAILS: Many studies reported on the outcome of rotator cuff repair surgery. It appears to be a fairly successful procedure. However, some reports suggest that one should have the area examined thoroughly, whether by arthroscopy or Mag. Res. Imaging (M.R.I.) Or, by another non-invasive method (which arthroscopy is not.) Second opinions are usually a wise course.

MRI

"We studied 'M.R.I.] images of rotator cuff tears to determine whether it was possible to establish 'before surgery] the feasibility or infeasibility of primary repair. ...Primary repair was often not feasible when both the length and width of the tear exceeded 40 millimeters on a pre-operative magnetic resonance image, when 'certain muscles] were thin, 'etc.]" By Sugihara, et. al., Tokyo Med. U., in J. Shoulder & Elbow Surg., May-June, 2003.

DETAILS: The above report illustrates the factor of M.R.I. examination BEFORE any surgery is attempted.
A report in The J. of Post. Grad. Med. agreed with the above MRI conclusion.

Steroids or Aspirin for Carpal Tunnel?

Drs. at Physical Med. & Rehab., U. of Ottawa, Canada concluded from a review of databases containing clinical studies around the world on carpal tunnel syndrome that "Local corticosteroid injection provides significantly greater clinical improvement compared to oral steroid up to three months 'testing period] after treatment. Local corticosteroid injection does not provide improved clinical outcome compared to either anti-inflammatory treatment and splinting after eight weeks or Helium-Neon laser treatment after six months. Emphasis added.

Shoulder Pain, and Shoulder Problem Solutions Bibliography

Clinical Orthopeadics
J. of Arthoplasty
Journal of Ortho. Res.
Radiographics
J. of Sci. of Med. Sport.
Amer. J. Roentgenol.
J. Postgrad Med.
Amer. J. Orthop.
Coch. Data. Sys.
Best Prac. Res. Clin. Rheumatol.
Top. Magnetic Reson. Imaging
Radiol. Med. (Italy)
Rev. Chir. Orthop Repar. Appar. Mot. (France)
Archives Orthop. Trauma Surg.
J. Shoulder & Elbow Surg.
Amer. J. Sports Med.
Mag. Reson. Imaging
Sportverletz Sportschaden. (Germany)
Arthoscopy
Int. Orthop.
Acta Orthop. Scand. (Sweden)
Chir. Main. (France)
Int. Arch. Occup. Environ. Health
J. of Rehab. Med.
Z Rheumetal. (German)
Int. J. Med. Res.