[44M] Experiencing severe and constant left shoulder pain

Patient Description

A 44-year-old male reports severe, constant pain in the left shoulder, rated 9 out of 10, which has been present for a couple of months. The pain is described as dull initially, progressing to sharp with certain movements or when holding light objects like a phone. The patient is unable to lay on the affected side and experiences increased pain when the shoulder is kept in one position for too long or when lifting the arm above shoulder height. There is noticeable swelling and warmth in the area, but no redness or night pain unless pressure is applied by lying on it. The patient has a history of engaging in repetitive heavy physical labor but reports no acute injuries or pre-existing conditions that could explain the symptoms. The patient manages the pain with Tylenol, taking 1g daily in divided doses. No other medications are being taken, and there are no known drug allergies.

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Arora's Assessment

What might be happening

Based on the information you have provided, possible diagnoses include:

  • Rotator Cuff Tendinitis or Tear: This condition is common in people who perform repetitive or overhead arm movements. Tendinitis refers to inflammation of the tendons, and can cause pain and swelling in the shoulder. A tear occurs when one of the tendons is torn from overuse or injury.

    • Treatment typically involves rest, physical therapy, and pain relievers. In severe cases, surgery may be necessary.

  • Frozen Shoulder (Adhesive Capsulitis): This condition occurs when the tissues in your shoulder joint become thicker and tighter, and scar tissue develops, which makes the shoulder joint stiff and painful.

    • Treatment typically involves physical therapy and pain relievers. In severe cases, surgery may be necessary.

  • Bursitis: Bursae are small, fluid-filled sacs that reduce friction in your joints. Bursitis is inflammation of the bursae, which can cause pain and swelling.

    • Treatment typically involves rest, physical therapy, and pain relievers. In severe cases, surgery may be necessary.

  • Osteoarthritis: This is a degenerative joint disease that can cause pain and stiffness in the joints, including the shoulder.

    • Treatment typically involves physical therapy, lifestyle changes like exercise and weight loss, and medications to manage pain. In severe cases, surgery may be necessary.

What you can do

It would be best to consult a doctor about your symptoms so that they can provide a formal assessment and order relevant tests if necessary. In the meantime, you can try the following to relieve your symptoms:

  1. Rest your shoulder and avoid activities that make your pain worse.
  2. Apply ice to your shoulder for 15 minutes at a time, several times a day.
  3. Continue taking over-the-counter pain relievers as needed, but be sure not to exceed the recommended dose.
  4. Try gentle range-of-motion exercises to keep your shoulder flexible, but stop if you feel pain.

What you should look out for

Reasons to see a doctor more urgently:

  • If your pain is severe or lasts for more than a week
  • If you have difficulty moving your shoulder
  • If you have redness or swelling around the joint
  • If you have a fever

Please remember that while I strive to provide accurate information, I am an AI and not a doctor. You should seek care from a healthcare professional to receive a formal diagnosis and treatment.

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10 mo ago

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People Also Ask

What are the common causes of shoulder pain in individuals who perform repetitive physical labor?

Common causes of shoulder pain in individuals who perform repetitive physical labor include rotator cuff tendinitis or tears, bursitis, and osteoarthritis. These conditions are often due to overuse, repetitive movements, or strain on the shoulder joint.

How can I differentiate between rotator cuff tendinitis and a rotator cuff tear?

Rotator cuff tendinitis is characterized by inflammation of the tendons, leading to pain and swelling, especially with movement. A rotator cuff tear involves a tear in one of the tendons, which can cause more severe pain, weakness, and difficulty lifting the arm. A medical evaluation, often including imaging tests, is needed to differentiate between the two.

What are the typical treatment options for bursitis in the shoulder?

Typical treatment options for bursitis in the shoulder include rest, ice application, physical therapy, and over-the-counter pain relievers. In some cases, corticosteroid injections or surgery may be necessary if conservative treatments do not provide relief.

When should I seek medical attention for shoulder pain?

You should seek medical attention for shoulder pain if the pain is severe or persists for more than a week, if you have difficulty moving your shoulder, if there is redness or swelling around the joint, or if you develop a fever.

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