What is the treatment for severe pain in and around the right shoulder?
She just had a mammogram and it was fine. Started about a month ago. Gets progressively worse each time it comes. Had a torn rotator cuff a couple of years ago on the same shoulder. The pain appears to change direction depending on the way she is laying down but always toward the front of the body. For a woman, 61years old. Re-occurring, very intense pain. Starts in the upper back by the right shoulder then runs around under the arm pit and sometimes to the breast. Comes and goes. On a scale of 1 to 10 the pain is a 10 when it hits.
I am sorry to hear about these symptoms. It is not possible to provide an accurate assessment without knowing the full details of her medical history and without performing a thorough physical exam. I strongly recommend she schedule an appointment with an orthopedic surgeon to help determine the next best course of action. In general, there are multiple structures within the shoulder that can be injured and lead to pain. Per your report, this patient suffered a prior injury to the rotator cuff, which is a group of four muscles that help control shoulder movement. In general, these injuries often improve with physical therapy. However, depending on the extent of injury, this may not be possible, and she may require surgery to repair the muscle tear if this is indeed the cause of her pain. In any patient with prior shoulder injury, it is possible she has developed osteoarthritis of the joint which is now causing her pain. It is also possible she injured additional components of the shoulder joint, such as the acromioclavicular joint, the labrum, the humeral cartilage, or the bony part of the joint itself. It is not possible to know the cause without further review, which is why I recommend you see an orthopedic surgeon.
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