10 replies to this topic

[siscares]

I'm new to this forum and looking for some input for my brother, who suffered a T10 SCI 9 years ago and has lived independently and courageously for the majority of those years. This last week my brother has suffered some type of injury to his right shoulder that has left him in extreme pain and unable to transfer etc... He remembers a twinge of pain this past Sunday while in his vehicle and reaching his right arm behind his seat, later that evening the pain became more intense and by Tuesday he could not transfer and called a friend to take him to the ER. The ER physician diagnosed back pain and some cellulitis (as he had sores in several areas) and sent him home w/ an rx for Bactrim and Pain Meds. He has only gotten worse as the week has progressed and we eventually had to transport him to the hospital via ambulance tonight, the ER eventually agreed that admitting him was wise (at least for tonight.) So far, the doctors do not believe the shoulder pain is a result of anything beyond strain/injury, however, they did find out that he has a a UTI in addition to the areas of cellulitis. I would like to add that my brother has had two long hospital stays over the years w/ MRSA (staph) that have been very scary and we are always concerned about the MRSA raising it's ugly head again. Basically, I am asking for feedback on two fronts... #1,Any ideas about what could be causing this intense shoulder pain (trust me, he would never allow an ambulance to transport him unless he was in serious agony.) #2, Where do we go from here? He has lived alone and independent since his rehabilitation at Shepherd Center following the SCI. I feel like we are back at the beginning, trying to find resources with little luck. My father was a huge support system for my brother after his original injury, but sadly, he passed away last year and my brother is left w/ my mom and I as his core family/support. His primary care physician is not well versed in SCI and the hospital is currently at is pretty lacking in resources as well. I am considering getting back in touch with Shepherd, but he will need a referral and we have the Medicare hurdles to conquer as well. Thanks for any suggestions...

[A trophy guy]

Well first of all, the source of the pain needs to be determined. You said the doctor diagnosed "back pain"? So does this mean the possibility of a direct shoulder injury was crossed off the list?

Living life in a wheelchair, our shoulders are everything to us. And they weren't designed to be that important. So injury to that area of the body, whether acute or chronic, can happen countless different ways. It could also be referred pain, coming from something else going on in his body.

Edited by A trophy guy, 19 November 2011 - 06:51 AM.

[lavenderthistle]

It could be many things. I know the most common injuries reaching behind are nerve impingement or rotator cuff injuries along with tendon tears...

This link may be helpful

http://orthoinfo.aao...fm?topic=a00065

[Tinbasher]

There is a high probability its a torn muscle but I know the shoulder can be a site of "referred pain" from somewhere but danged if I remember where!

[greybeard]

My monies on Lavenderthistle and Tinbasher. Probably a torn muscle or tendon.

[siscares]

Thanks for all the input, he is having an MRI this afternoon, so hopefully we will know more with those results!

[dianna318]

About a month ago my shoulder did about the same thing while at the airport in my chair. I almost missed my flight because the pain was a 10 if I moved it more than a few inches. I got someone from the airport to get me to my flight. This lasted about 2 weeks and finally got better. Not sure what the cause was but hopefully your brothers will heal on it's own also. When I get back to S Calif. I am going to bring this up with my GP also.Good luck and speedy recovery!

[siscares]

Well it's a Rotator Cuff tear, not severe enough to require surgery, but he will need 3 -4 weeks of healing and rehab. Not exactly the answer we were hoping for, but we are thankful it will not require surgery. Now my brother has to decide how to proceed with recovery, the options are going home or to my mom's home and having rehab come to us, trying to get admitted to Shepherd Center (one of the most renowned facilities for SCI in the Southeast, US) or doing rehab at a nursing home. Each option has pros & cons, while he would certainly like to go home, it is likely he will not be able to transfer & take care of his other needs without some serious help, and without the proper resources he could injure himself further. He meets with a case worker from the hospital tomorrow, so I am hopeful they will have more information. Thanks again to this forum and members for your input.

[davjed]

This will probably be an ongoing problem from here on out. The longer he can rest it the better it will be. Be sure to have the PT show him how to exercise it and how to transfer without damaging it further. Look into renting a Hoyer lift for transfers in home and a transfer board for transferring into to car, etc....

[plank]

lavenderthistle, on 19 November 2011 - 07:02 AM, said:

It could be many things. I know the most common injuries reaching behind are nerve impingement or rotator cuff injuries along with tendon tears...

This link may be helpful

http://orthoinfo.aao...fm?topic=a00065

Lav

I don't think you got enough credit for your correct diagnosis here, so have a rep and a from me.

Now, I have this sore toe.........................

Plank

[Tetracyclone]

10 years ago on a long drive I reached behind me in the car in something similar happened. I was able-bodied and so no need to use the shoulder a lot, but it never got all the way better until 18 months later when I was desperate and tried acupuncture. In my case, it was the cure. Within 2 weeks i was out of pain, and even though I was doing labor with the shoulder, with regular ROM within 6 weeks i was good as new. Whoever imagined?

Another terrible danger I have read about is another reaching behind stress. Occasionally some poor soul will hit an obstacle while pulling a rolling bag in an airport and the bag just stops. The person probably has the strap around their wrist. The front deltoid tendon can jump out of its groove in the bone and guess what? It never goes back and cannot be put back. Bummer.

Having your brother in an institution does sound smarter because at home he would try to do things he is not ready to do. Which could happen anyway. Best of luck to him.

Edited by Tetracyclone, 25 November 2011 - 03:56 AM.