Rotator cuff tear

by Shan
(Brighton Mass)

An entrapment here causes a thoracic outlet syndrome, often the cause of weakness in the arm.

An entrapment here causes a thoracic outlet syndrome, often the cause of weakness in the arm.

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I suffer from a rotator cuff muscle tear as indicated in the MRI exam. Accordingly I am told that only surgery will heal my tear. What about any alternative treatment, instead of surgery?





Hello Shan,
I depends on how badly it's torn. If the tendon is completely ruptured, then you have no option, but that's relatively rare.

There are any number of ways of treating a torn muscle; see a local chiropractor or physiotherapist.

Important is that you have to stop what you were doing that tore the muscle, focus no proper warm up procedures and give time a chance to heal. You'll have to stop after surgery anyway.

Secondly, if this was not caused by an overexertion without proper warmup, then the neck and first rib have to be examined; there often lies the cause of the muscle tearing in the first place.

I hope this contributes.

Dr Barrie Lewis


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Numbness in left arm

I carry my stress in my left shoulder area and tend to develop knots under the scapula. I recently fell while teaching a movement class and thought I may have aggravated the pre existing condition. Originally I couldn't put much weight on my left arm and finding a comfortable position to sit in was difficult.

It has been two weeks and with a little rest (not much), ibuprofen, and heat the injury has "moved" causing discomfort in the left side of my neck and depending on how I move my head a tingling sensation washes over my left arm and into my thumb. It doesn't last long but is uncomfortable. Does this sound like a pinched nerve or greater damage to the rotator cuff? What should my next steps be in treatment?
Thank you.





Hello,
The tingling that washes down your arm to the thumb, I like the term! coupled with neck pain certainly suggests that this is more than a rotator cuff syndrome.

This is especially true if movements of your neck provoke the tingling in your arm.

The shoulder is supplied by nerves from your neck and it's more than likely that the underlying condition prior to your fall was in your cervical spine rather than your arm.

Deep upper back pain is a relentless condition, often difficult to diagnose because it's caused by a myriad of problems, but very often an irritation of the dorsal scapular nerve from the lower neck is at the root of it.

I would recommend you start with an x-ray of your neck, including "obliques". From there it's for you to decide what treatment fits best with your philosophy of health care. Certainly this is the sort of problem most chiropractors would treat on a daily basis, but I can't promise you that a few clicks of the neck will fix it. It's one of the more problematic conditions we treat.

Dr Barrie Lewis


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Tingling in right arm after injection

Joint of Luschka

Joint of Luschka

I had a cortisone injection in my wrist two weeks ago for arthritis but my hand became very swollen and I got no relief from it.

Now I have tingling in my armpit, down my right arm and a pain in my shoulder blade. Is this the result of the injection and will it go away again?





Hello Frankie,
You are probably right that all these symptoms are a direct result of the injection, but it is just possible that it's what we call an incidental finding; completely unrelated.

Do you get any pain in the neck, and arm, if you turn to the right and simultaneously look up? If so, where specifically does it radiate to?

The C5 nerve root supplies muscles in the shoulderblade area, and the outer arm, but not the armpit, but there are several others pertaining to other nerves that could be the problem.

I'm guessing, of course, but either the massive swelling is squeezing the nerve, causing pain radiating up it's course, or the doctor didn't excel in anatomy and hit most likely the median nerve in the wrist. The former will go away once the swelling passes, but the latter could be seriously problematic.

My thoughts are that you should seek a consultation with a neurologist.

I hope this contributes.

Dr Barrie Lewis


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Nerve pain in the arm post surgery for a rotator cuff tear.

by Cindy
(Austin,Tx)

Joint of Luschka injury

Joint of Luschka injury

I had rotator cuff surgery in July 3,2015; had a medium tear, surgery and recovery went well; good mobility.

Now for the past month I wake with severe pain in my armpit that travels down toward elbow, only way I can get relief is to hold arm up. This last anywhere from 20 min. to 2 hrs. As long as I use arm, gets tired easily, everything is ok; then, when I sit back to rest, the armpit pain returns.

Also my pinky and ring finger has pins and needles most all the time now.

The doctor said this is unrelated to the rotator cuff surgery.

Does anyone have any idea what is going on with me?





Dear Cindy,
Sometimes a condition is actually a symptoms of something else. Like, for example, raised blood sugar is often really a sign of obesity; unless you treat the underlying problem, the condition won't go away.

Very many shoulder conditions are actually secondary to a problem in the lower cervical spine, or first rib.

Your doctor is probably right; the surgery didn't cause this pain in the arm you are experiencing, but it was there all along causing the weakness in the rotator cuff, provoking one of them to tear when you did something routine with your arm.

There are two important signs; tingling in the pinky and ring finger, that's pure C8 dermatome, and relief by raise your arm; that's called the shoulder abduction relief sign.

You almost certainly have a seriously pinched nerve in the neck; it causes tingling in a specific dermatome, weakness in the muscles supplied by the C8 nerve root, relief by placing your hand on your head and increased pain by carrying anything in the arm. That stretches the nerve which is tethered in your neck.

The way forward is xrays of your cervical spine, including obliques, and probably a MRI. Then, once a diagnosis is made you have the difficult decision whether to stick with mainline medicine, or try something different. I'm afraid neither will be easy. Occasionally in the chiropractic clinic miracles happen, but mostly it's hard work for your DC, and patience on your part.

You probably have degenerative changes in the joints of Luschka or a slipped disc.

Remember, I'm being the devil's advocate. I have not had the privilege of examining you, but I do have 35 years of treating conditions like yours under the belt. Anything you read on the internet should be treated with caution, including what I've written.

Print this out perhaps, and starting looking for a local chiropractor with a good reputation for being conscientious and hard working; it's going to take that. Ask you doctor for a name too.

Good luck and let us know how you progress.

Dr Barrie Lewis


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Awoke with terrible right shoulder pain

by Ann
(Albuquerque, New Mexico)


I had biopsy proven myositis years back and lupus, but this seems very different, as it is only right-sided.

After waking very early with no pain, I needed more sleep. Having over-done the sleep, I woke around noon with right shoulder pain. I thought I'd pulled something in my sleep, and it would work its way out during the day. However, it has only got much much worse.

It hurts to breathe, to move my right arm (and to type this). If I breathe deeply, it hurts much worse! The pain seems to be immobilizing the entire shoulder area, and feels like broken bones with inflammation (bad).

I once had a similar problem with my back around my lower ribs. I thought ribs were broken. When it finally subsided my lung volume had decreased (lungs do not feel pain), so I'm concerned the pain around the upper right lung could signal inflammation and decreased lung volume there too. I would be relieved if it was something simple like "bursitis." Every time something like this has happened, x-rays were not conclusive.





Hello Ann,
Any time you have 'terrible' pain, it warrants further investigation. Simply because x-rays were inconclusive in the past, don't assume it will still be so.

There are many possible causes of this shoulder pain and it's not for me to suggest a diagnosis; what I would suggest is that the pain on deep inhalation may the instigator of your troubles. If you have a fever, which you don't mention, then we'd think of pleurisy, but much more common is a displaced rib head. Lying on your tum, if your partner pressures quite firmly just to the side of the spine, can he find a seriously painful point?

Then I'd be looking at ranges of motion of your neck and shoulder; do any of them provoke the pain? Is it in your arm, or really in your midback but affecting the scapula and limb?

Bursitis is not simple by the way. What you don't want is for this to turn into a frozen shoulder. It's time for a thorough examination.

Dr Barrie Lewis


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Numb right shoulder

by Madai
(Los angeles, ca.)

Hello there, I am a 41 years old woman. I injure my shoulder when i was trying to take out a very tight dress out of me. ( it was very tight in my shoulders and my chest. I went for some massages and it was getting better and since i was using the rigth arm often it was still in some kind of disconfort and subtle pain.

so I went to the chiropractor and He did an adjustment in my spine and neck and after 24 hours i has such a awful head ache and still fell tinging some times and pain in some pressure points still and the right side of my shoulder all the way to the side and part of the right breast fell a bit numb and ich some parts. The adjustment happen a week ago.

Please let me know if You know what could be going on and what to do.





Hello Madai,
With your elbow against your side, Hold your right wrist with your left hand. Pull outwards against the resistance of your left hand, then press inwards. Compare with your left arm. Is it painful? Which? Pulling out, or pressing in?

Raise your arms above your head, then sideways, then behind your back. Any significant difference right and left?

Turn your head to the right, and then look up. Does it cause any pain or tingling in the arm or breast area?

Obviously your chiropractor, rightly or wrongly, felt the underlying problem was in your neck. Obviously it's not normal to develop such nasty shoulder pain taking off a dress! A neck subluxation is often the underlying cause of shoulder pain.

Some after chiropractic treatment pain is not uncommon. However, sometimes it can be excessive, and you need to discuss that with your chiropractor.

In both worlds, medical and chiropractic, worsening of the condition does happen. It's known as Chiropractic Iatrogenic Illness it happens occasionally in my practice, and I'm sure the person you consulted. A modification of the treatment is normally all that is required.

In Medicine, the slogan is: "if the pink pill doesn't work, try the blue pill." In Chiropractic, perhaps working on your shoulder instead of your neck. Discuss your after treatment pain at the next chiropractic consultation. If s/he doesn't listen, go elsewhere!

It sounds to me like you have a rotator cuff problem but I can't be sure until you let me have the answers to my questions.

Go from Numb right shoulder to other Chiropractic Conditions often treated…


I hope this contributes,

Dr Barrie Lewis


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