I hope you are enjoying this beautiful summer! I wanted to share a patient's story with you as I find it to be incredibly relevant. I recently had a woman call and ask me if I could help her with a chronic shoulder problem she had suffered with for over 6 months. She had no idea how she injured it, but it was bothering her while sleeping, lifting overhead and working in the garden. She said she has been to two physicians and a physical therapist and no one could seem to help her stabilize her condition. Of course I said I would be glad to evaluate her.
She came in, told me her story and emphasized how intense her shoulder pain was. If you were listening, as I was, it seemed like she knew, for a fact, that she had a rotator cuff problem, though nobody knew how to solve it. She also thought she needed to see an orthopedic surgeon, though no one would send her to one. She heard that I knew a number of surgeons and that I recommend to them often. As I sat there listening I couldn't wait to evaluate this patient. I am always inquisitive to examine when someone is so adamant about what their problem is.
Since it is our practice to always check the neck before the shoulder, I began with the neck. As luck would have it, the neck movements began to aggravate her shoulder pain. When I moved her neck, she felt the pain she knew so well and began to wonder about her original thoughts regarding her rotator cuff theory. After much discussion and examining, we both came to the conclusion that her pain was stemming from her neck. I let her know that this was not uncommon. I shared with her that perhaps the other medical providers didn't examine her neck because they were simply only listening to her complaints since she was pushing her shoulder problem so confidently.
This example clearly shows the complexity of examining every single person with a set system whether a patient is emphasizing one area or another. I am so thankful to my mentor, Beverly Stewart, in New York, who drilled that into my head over 37 years ago. It truly helps distinguish between what a patient might think and what the anatomy is truly telling us on examination.
In case you were wondering, we did get her better and she is back to sleeping, lifting overhead and gardening, without any pain. If you are frustrated with any musculoskeletal pain and it is a chronic problem, please don't hesitate to call us
get examined. The problem might not be where you think it is and this might be the reason you have not gotten better!