New Delhi: Prolonged pain in the shoulder points to some tear deep within. Shrugging this symptom off may worsen it and land one under the knife. The upshot: never cold shoulder the warning sign; otherwise you would rub your shoulder the wrong way.
Two patients treated in BLK Super speciality hospital exemplify difference between early and late diagnosis. BLK Sports Medicine on April 17 presented two high profile patients to spread awareness about shoulder pain, the condition which inflicts people, especially aged ones, in large number.
Dr V K Saraswat, member Niti Aayog and former DG of DRDO understood the forewarning of some sore deep within when his shoulder pain persisted for about six weeks. A sense of medical emergency prompted him to see Dr Deepak Choudhary whom he knew as veteran of sports medicine and joint repair. After clinical examination, Dr Choudhary diagnosed it as a rotator cuff tear. The rotator cuff is a group of muscles and tendons that surround the shoulder joint. Since he was diagnosed early, a PRP injection and sessions of physiotherapy sufficed to repair his tear. PRP (Platelet Rich Plasma) is growth factor derived from the blood of the patient. It repairs the tear. Dr Saraswat had got the tear due to undue weight he lifted in gym.
Had Dr Saraswat, 66, delayed, he would have to undergo surgery, exactly what Hemant, 18, national level wrestler from Bhiwani, Haryana had to endure. Unlike Dr Saraswat, Hemant ignored the pain symptoms for long, resorting to steroids and some home remedies. He had sustained shoulder injuries while wrestling. Since his rotator cuff injury had worsened due to delay, there was no other way than surgery to repair his insidious injury. Dr Choudhary did minimal invasive Arthroscopic surgery to repair his tear and undo his nagging pain.
But given the great advancement in sports medicine, be it early or delayed diagnoses, the condition can be fixed with clinical precision and certain success. Dr Saraswat has again hit the gym and Hemant is again in the ring for wrestling bouts.
Dr Choudhary, who is credited with performing over 12,000 complex Arthroscopic knee and shoulder surgeries, ‘ Normally in such cases patients consults doctors and physiotherapists who diagnose this condition as frozen shoulder and the patients undergo some steroid shots in the shoulder and many sessions of physiotherapy without much relief. Hemant’s case was similar. Finally, when he came to us, we diagnosed rotator cuff tear condition and performed a minimally invasive surgery (Arthroscopic Rotator Cuff Repair), where the torn tendon was repaired back to the bone using some imported anchors. It has been 6 months after surgery and he is pain free and has regained normal strength in his shoulder. Dr Saraswat got rid of pain with conservative treatment and there was no need for a surgery,’
Dr. Deepak Choudhary, Director Arthroscopy and Sports Medicine at BLK Super Speciality Hospital was formerly head of sports medicine in Safdarjung Hospital. In the last six months at BLK Super Speciality Hospital, Dr Chaudhary has treated over 80 patients who suffered from similar problems and nearly 70% patients were suffering with rotator cuff problem but were misdiagnosed as frozen shoulder. Patients kept suffering for a long time due to lack of awareness and missed diagnosis.
Rotator cuff is a group of 4 muscles over the shoulder joint which with advancing age undergoes degeneration and sometimes after trivial trauma or even without trauma can be torn leading to severe pain especially at night and weakness of the shoulder.
‘I was undergoing acute shoulder pain and it was difficult for me to raise my hand. I was not able to do easy tasks with my right hand. Initially, I thought it is normal shoulder pain due to some weight lifting or muscle tear. When pain did not subside with medicines and exercise, friends advised me to go physiotherapist as it looked like frozen shoulder case. Meanwhile, I consulted my friend Dr Choudhary and he raised an alarm and asked me to undergo some tests under his observation. I am thankful to him for relieving me from shoulder pain and that also without a surgery,” said Dr Saraswat, former Secretary, DRDO.
According to the Arthroscopic Surgeons, only after proper evaluation, the correct plan for treatment whether conservative or surgical can be decided for a patient depending on his age, activity level and other associated conditions. Arthroscopic treatment in well selected case of rotator cuff repair provides dramatic relief in terms of pain and regaining strength.
Dr Choudhary added, ‘70 % of elderly persons are being found with shoulder pain. Shoulder pain is common cause for disability even in young and is often misdiagnosed. If the pain persists for 4 to 6 weeks, it should be cause of worry and should not be neglected. Often such conditions are passed off as frozen shoulder, which is not a right diagnosis at all.’