Ask the Doc..

Shoulder pain

A.C. Khare:

I am in my late 50s. I developed some problem in my right shoulder due to which I am unable to move the right arm properly. I am unable to raise it straight upward and cannot touch on my back and or my left shoulder. I can move my left arm freely. I occasionally feel a piercing pain in muscles around the shoulder. Any jerk to right arm is very painful. Sitting under a fan aggravates the problem, making the shoulder stiffer. I have taken Nimesulide and Tizu as painkillers and I have been doing exercises regularly, but I don't see any improvement. Doctors told me that regular exercise would be helpful.

Dr. S. Sivamurugan, Orthopaedic Surgeon, replies:

Pain and stiffness in the shoulder is most probably due to a condition called periarthritis of the shoulder. See your orthopaedic surgeon soon as neglecting this will weaken the muscles of your shoulder. You will benefit enormously by physiotherapy and medication. Sometimes local injection in the shoulder also helps. If these do not bring relief, a more serious work up to exclude a more serious condition called rotator cuff tear will be needed.

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I am 18 years old and had fibro adenoma in both my breasts (two were surgically removed). I was operated on in September 2002. I still feel small fibro adenoma now and they are painful. I take painkillers. Should they be surgically removed or not? Why are they formed?

Dr. Uma Krishnaswamy, Consultant General Surgeon, replies

Small Fibro adenomas if adequately assessed by a clinical examination, ultrasound scan of breasts and fine needle aspiration cytology need not necessarily be removed in a young lady of your age. But, such conservative treatment requires follow-ups every three months by your surgeon for at least two years. You must also perform a self-breast examination every month to look for any changes in the size of the lump. There is a 50 per cent chance that it may disappear or diminish in size or remain as such during this period of time. If it persists or enlarges during the follow up period, it can be removed surgically. Fibro adenomas are usually painless, unless they are rapidly growing. Please consult your surgeon to determine the cause of pain. Fibro adenomas are merely an aberration in the normal developmental changes that occur in the breast. The cause of this aberration, however, is unknown.

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S. Annapoorni:

About two years back, my 70-year-old husband suffered a stroke and his right side (right hand and leg) was affected. Prompt treatment almost cured him completely. However, even though he is able to write and take food with hand (with difficulty) he has an uncomfortable feeling and ache in his fingers, palm and wrist. His fingers are not fully flexible and mobile. Will it be possible to regain normalcy? His blood pressure is normal and cholesterol level within limits.

Dr. Prithika Chary, Consultant Neurologist, replies:

It is unfortunate that your husband is not fully functional even two years following his stroke. Further improvement is unlikely, though some improvement in function may occur with selective physiotherapy and occupational therapy for the affected arm. It is critical to keep his blood pressure and cholesterol normal and take any drugs advised to prevent a second stroke.

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