Confusing MRI Results and Persistent Pain
Hello everyone, I am a 30-year-old former ballerina, currently a nursing student, and I consider myself to be in great health and physically active. About six months ago, I sustained an injury that I believed to be related to my rotator cuff. The incident occurred when I experienced a sudden sharp pain in my infraspinatus, which then radiated down my arm. Since then, I've struggled to lift my arm either to the front or the side beyond a 90-degree angle, and I've had great difficulty with external rotation. I started performing at-home exercises designed for the rotator cuff; however, they brought no relief. I also tried over-the-counter nonsteroidal anti-inflammatory drugs, applied ice and heat, and ensured I rested, but nothing seemed to help. After six long months, I finally obtained insurance approval for an MRI. At this stage, my arm feels nearly incapacitated—simple tasks such as putting on a jacket, tying my shoes, or sleeping on my side are unbearable due to the pain. This leads me to my confusion regarding the MRI findings. It appears that the results suggest a degenerative condition, whereas I distinctly remember injuring myself while performing a dance move that involved flexibility. I was executing a standing split and holding my leg behind my head with my left arm when I first felt a tearing sensation. I've posted my MRI results in the comments for reference. Should I consider seeking a second opinion? My primary care physician has recommended physical therapy, which I believe may be necessary given that I likely have adhesive capsulitis due to a lack of arm use over the past months. However, I struggle to comprehend how they can attribute my initial pain solely to subscapularis tendinosis when it originated from a specific acute incident. I would greatly appreciate any guidance or advice. I have already contacted my PCP for a referral to a specialist because I am not entirely convinced that physical therapy and tramadol will resolve my concerns. Do you think I should advocate for further intervention beyond physical therapy? Thanks in advance for your support!
Answers (1)
3/28/2025, 5:20:40 AM
OpenHealth AI
It sounds like you're experiencing significant discomfort and confusion regarding your shoulder injury and the MRI results. Given your history, physical limitations, and the impact on your daily activities, it's completely understandable to seek clarification and explore further options.
Main Points:
- Persistent Pain and Limitations: You’ve already demonstrated your commitment to recovery through self-care measures, yet the ongoing pain and limited mobility are concerning.
- Confusion About MRI Findings: Understanding the distinction between your initial acute injury and the suggested degenerative changes on the MRI is crucial.
- Physical Therapy: While this could be beneficial, it may not address your immediate concerns without clearer guidance on your condition.
Explanation:
Your symptoms and the mechanism of injury suggest that you may have sustained an acute injury (potentially to the rotator cuff or associated structures). Over the past months, it’s possible that compensatory changes or a lack of proper movement have led to further issues, such as adhesive capsulitis, which can limit mobility and increase pain. The presence of tendinosis indicates chronic changes, which could be due to prolonged altered biomechanics from the injury.
Seeking clarity on the discrepancy between your incident and the MRI findings is important, as it directly affects your treatment.
Next Steps:
- Follow Up with Your PCP: Continue advocating for yourself. Discuss your concerns about the MRI findings and ensure they know how your injury affects your daily life.
- Consider a Second Opinion: Given your doubt about the current assessment, seeking a second opinion from an orthopedic specialist who focuses on shoulder injuries can provide additional insights and clarity on your condition.
- Engage with Physical Therapy: If approved, start physical therapy but actively communicate with your therapist about what isn’t working and express your concerns regarding the pain. A tailored approach may help address both strength and flexibility, taking your specific issues into account.
- Document Your Symptoms: Keep a journal of your pain levels, mobility, and any activities that aggravate or alleviate your symptoms. This documentation can be very useful in discussions with healthcare providers.
- Evaluate Pain Management: Discuss with your physician other pain management options if tramadol does not help, such as guided injections for pain relief, if indicated.
Remember, your well-being is a priority, and it’s essential to address both the physical and emotional aspects of your injury. Keep advocating for the care you need. If there’s anything more you’d like to discuss or explore further, feel free to ask!
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