OK, I’ve had shoulder pain for a year and a half. In that time, I’ve seen 3 orthopedic surgeons.
The first guy said I had torn muscle fibers, and it would heal on it’s own. Then I changed insurance. (job) I had an Xray only, no MRI.
The 2nd guy said I had a labrum tear and ordered an MRI to confirm. It did not confirm, or show anything out of the ordinary. He then said that MRI’s are wrong 20% of the time, but I most likely had tendonitis and gave me a cortizone shot and said I would be re-evaluated in 6 weeks. (By someone else, since he was no longer taking my insurance). He said if it didn’t get better, they would have to ‘scope’ the shoulder to find out what was wrong.
That was 6 weeks ago.
I went in today to talk to an associate of surgeon number 2. I was going to plead for surgery, since I was dealing with this for so long. (The pain is not constant. It only hurts when my arm is in a certain position, then I feel a stabbing pain that last for 15 seconds or so, then goes away). He had my chart and my history.
He said I did NOT have torn muscle fibers. he said I did NOT have tendonitis and I did NOT have a labrum tear. He said, with some authority and confidence, that I had internal impingement sysndrome and that surgery would not help. He said not many guys knew of this syndrome and as such was misdiagnosed often. I googled it and come up with only 8 hits, none that helpful.
So what’s the story on this syndrome? Should I be looking for surgeon number 4?
Definetly do not seek out a surgeon until it’s a last resort, find a medical massage therapist and find out what muscle is impinging the nerve! stretching this musce to give the nerve space should relieve your symptoms ,Congratulations you just became your own full time hobby.
IANAD, I’m a just a grad student in cell biology with access to medical journals and some knowledge of where to look.
A good place to start looking for stuff like this is on PubMed, a searchable index of pretty much all medical and scientific papers published in English, and many in other languages if that helps you. I get 68 references when I use ‘Internal impingement syndrome’ as the search text, without quotation marks. Based on a very cursory glance through these, it seems to happen most commonly in pitchers. Several papers talk about arthroscopic surgery.
You can probably only read the abstracts of most of these papers for free. (An abstract is the first paragraph of a scientific paper, in which they summarize their significant new findings in 200 words or less. It tends to be a bit dense :)) If you find something that looks helpful, you can either go to your local university and use their access, or email me at gs371 at yahoo and I’ll see what I can do. I can read most medical journal articles fairly easily, but the orthopedics stuff is a bit beyond me as (thank G-d!) I’ve never had to take anatomy.
Just try to read biologists’ papers. They make medical papers look like high school reading
The sad part is that I’m not really kidding. I still have lots of trouble with bio papers outside my immediate tiny area of sub-sub-sub-specialization, and I’ve been doing this for several years now.
Seriously, the anatomy here is a bit heavy. For other medical stuff, I could understand nearly all of it quite well when I had a summer job reading medical papers at a drug company when I was 19, after the equivalent of college freshman biology. I can try to help if you’d like, or I can ask a good friend of mine, an MD/PhD student planning on going into orthopedics who actually knows what he’s talking about. If you find one that sounds helpful, email it to me and I can try to get it deciphered for you.
“Standard arthrography and both conventional arthrotomography and computed arthrotomography have been used in the assessment of glenohumeral joint instability. MR imaging allows detection of capsular and ligamentous abnormalities that may be combined with labral alterations in patients with glenohumeral joint instability” ?
