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Dear Doc.

Q dear Doctor, I am getting a lot of grief from my right shoulder. For months it has been giving me pain when I lift it above shoulder height. I have had anti-inflammatory tablets from my GP and seen a physiotherapist who described it as a "frozen shoulder" and gave me a course of exercises.

However, three months down the line, I get pain just doing simple things such as brushing my hair or putting on a coat. I am 57 but some days feel 100. Any suggestions?

A THE pain you describe is typical of shoulder pain and can come from a variety of structures in the joint. It can occur as a result of tears in the muscles that hold your arm on to the body, or from the surfaces of the joint becoming roughened through arthritis.

Given your relative youth, I suspect that arthritis is less likely than a muscle tear.

The treatments you describe help some people but not all.

I will often suggest a cortisone injection into either the muscle or joint of the shoulder as appropriate to calm down inflammation and promote healing. Your GP practice may be able to do this or may refer you to a specialist joint clinic.

X-rays of the joint are not that helpful because they don't show up muscle problems but an ultrasound scan may be able to demonstrate significant muscle tears. If cortisone does not prove useful and there is significant muscle damage then surgery may be something you may be asked to consider.

This aims to repair the muscle and strengthen the joint, the results of which can be quite dramatic.

In the first instance, though, I would let your GP know of your continuing problems and seek his views on joint injections.
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Title Annotation:Family Life
Publication:Evening Gazette (Middlesbrough, England)
Date:Aug 29, 2006
Words:297
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