Is this normal?

[Chrissie]

Will try to keep this brief:

OH wrenched shoulder badly a week ago.  After a few days of it getting worse we went to the Urgences (GP appointment not available for 4 days) and were seen quickly and Xray taken.  "No abnormalities."  We were sent home with a month's supply of painkillers and a sling, and told orthopaedic department would contact us within a few days.  And they did - with an appointment for 3 weeks time.  I asked if we could see someone else quicker but was told it was a required delay to see how the shoulder settles down.  that is why we were given the large supply of pills.  When we do go a new Xray will apparently be taken and compared to the last one, and then judgement will be pronounced.

My question is:  Is this normal?  The poor man is in a lot of pain and despite pills has an awful time at night.  I  wondered about appealing to our GP, but he is now on holiday and a locum is in place. Don't want to be wimpish, but wonder if seeing someone quicker might be better medically.....?

Any views? 

Chrissie (81)

[NormanH]

It depends a bit on how far you are from a town with really good specialists (I am thinking of Montpellier for me, or perhaps Toulouse for you)

I wouldn't hesitate to ask for a second opinion.

An anecdote to illustrate. A few years back I tripped over and badly wrenched my ankle. I was taken to les Urgences where it was Xrayed and I was told there was no problem, and to just go home on a taxi with some painkillers and an 'attelle' ( a sort of brace)

I was in agony for a fortnight until I aummoned up the courage to go to the other Urgences in a private clinic, where I presented my self as having tripped over without saying anything about the previous visit elsewhere.

The urgentiste ordered an X ray again and said that it was broken but that the odd thing was it looked as if it had been broken two weeks previously....

So if you are really in pain go to a different hospital or specialist if at all possible for a second look.

For example you might try alternating between

http://www.vitalia-sidobre-castres.com/admi6.html

and http://etablissements.hopital.fr/annuaire_service.php?id=3781

although as I said at the beginning an appointment in a big centre is the best if pratical...

There are two other options.

I) see an osteopath, but only if you are sure that it is someone who will take care not to do anything to exacerbate any injury

2) have some heat or cold treatment to the shoulder from a kiné to calm the pain..

but I am not a Doctor and both these ideas might make things worse...

[Chrissie]

Sorry to have taken so long to reply to this and to thank you, Norman for your suggestions. Our GP came back from his hols today and has got us an appointment with a shoulder specialist next week.  He agrees with me that the forced 3 week delay should not be necessary and may even have caused further damage.......  At least we are on track now.

Chrissie (81)

[NormanH]

I hope that the problem, and the pain will soon be sorted out.

[Patf]

A wrenched shoulder can be very painful - happened to me once due to a fall.

My doctor was reluctant to give any treatment, or recommend physio, but after a few months gave a steroid injection which helped a lot, but didn't cure. But your husband's damage could be different to mine.

Can your husband lift his arm up, vertically?

[Daft Doctor]

I'm would never give specific, individual advice without seeing a patient, but as a former GP and accredited musculoskeletal specialist I could perhaps share some general insight.

Most shoulder injuries do not require surgery, and certainly not urgent surgery. True 'frozen shoulder', though benefitting from early steroid injection, is rare, and usually comes on spontaneously rather than due to injury. The vast majority of shoulder pain due to injury will settle with time and physiotherapy. Some types of shoulder problem may benefit from steroid injection(s) down the line, but this is mainly to temporarily reduce pain and inflammation, so allowing physiotherapy and rehabilitation exercises to be easier to carry out and therefore more effective.

In the immediate aftermath of a shoulder injury, good pain relief and encouraging as much active movement as possible is the best plan, with physiotherapy to follow as necessary. Specialists seem to be used a lot more frequently in France rather than in the UK, but unless things really aren't settling down with the above approach early intervention by these guys would rarely be justified.