Shoulder Pain Links

Prolotherapy to the Shoulder

My Own Failed Shoulder Surgery

It wasn’t until I severely wrenched my right shoulder while lifting weights that I came to understand how medicine had failed pain sufferers and how Prolotherapy was a “miracle.”

Shoulder Pain Forum

Shoulder Pain

Chronic Shoulder Pain

An article describing various shoulder problems and the use of Prolotherapy in treating them.

More on Shoulder Arthritis

Arthritis to the shoulder is usually triggered by an injury such as a dislocation or separation that has not healed properly. In these cases or even in the cases of past surgical intervention, connection soft tissues–the ligaments, tendons, and cartilage, have not completely healed or have become overstretched (ligament and tendon laxity).

Shoulder Impingement Syndrome

Shoulder impingement syndrome involves one or a combination of problems: inflammation of the bursa located just over the rotator cuff, inflammation of the rotator cuff tendons, (tendinitis), or calcium deposits in tendons—called calcific tendonitis, (caused by wear and tear or injury.) The main problem is usually that the acromium or a bone spur puts pressure on the supraspinatus tendon.

Shoulder Dislocations

Sometimes the bones in the shoulder joint slip out of normal alignment or are forced out by injury-subluxation and dislocation. For those individuals who suffer from chronic shoulder instability, dislocations may occur frequently.

Chronic Shoulder Instability Syndrome

Chronic shoulder instability syndrome results from trauma caused by subluxations, dislocations, from less detectable micro-trauma caused by repetitive strain on the tissues, or from congenitally loose shoulder joints.

Critical Life Changes and Neck/Shoulder Pain. A Connection?

Researchers writing in the Journal of Epidemiology and Community Health say that “Life events and critical life changes are of importance for the risk of neck/shoulder pain…”

Prolotherapy Performed On The Shoulder

Questions About Arthritis

From our Radio Show:

Caller: I have osteoarthritis of the shoulders.

Dr. Darrow: If you can lift your arm straight up in the air there is a good chance you can be healed without surgery. So don’t think because you have arthritis that surgery is the only option.

Every single day I have people come in with arthritis. Very
often people come in with arthritis of the right hip which is not as bad as the arthritis in the left hip, but the right
hip hurts, the left one does not.

So get this picture – arthritis in both hips – the hip that
doesn’t have any pain can have worse arthritis. But because of a diagnosis they are going to have surgery on it even though they do not have pain.

And I say to them, “why would you have surgery on the hip that is not painful even with worse arthritis than the other hip with less arthritis that is painful? What does that tell you about pain and arthritis?

Then a lot bulb goes off in their head, it may not be the
arthritis causing them pain.

Every joint has a lot of soft tissue around it, ligaments,
tendons, so pain can come from any of this tissue it may or may not be the arthritis.

So that you say you have arthritis, that may not be the cause of pain and the reason to have a surgery.

Caller: It is too late for me, I already had surgery to my
knees and hips and now it is in my shoulder. My son suggested I listen to your program and talk to you about it.

Dr. Darrow: I think before you have another surgery, you should consider Prolotherapy which is going to stimulate more tissue growth and hopefully get rid of your pain, whether you call it arthritis, or tendonitis, or tendinosis, etc. I really don’t even want to know the diagnosis other than for medical/legal reasons because a diagnosis I believe, often blocks people from healing
by being labeled – they don’t think they can heal because they have arthritis.

So don’t let the diagnosis fool you, don’t let your MRI, your CT Scan, your X-rays fool you, those thing that show up in tests may not be the cause of your pain

Caller:But I have seen X-rays on my knees and there is nothing there.

Dr. Darrow: That is what Prolotherapy does, it stimulates tissue growth.

Prolotherapy and Shoulder

If you are one of the more than four million people in the United States who seek medical care each year for shoulder pain, a brief understanding of the treatment options may help you decide what many already know. Prolotherapy may be your answer. A proper diagnosis of shoulder pain is essential to determine the root cause of the problem and the proper method of treatment because many shoulder conditions are caused by specific activities, such as over use caused by excessive workouts, a detailed medical history is an invaluable tool.

A physical examination should also include screening for physical abnormalities—swelling, deformity, muscle weakness, and tender areas—and observing the range of shoulder motion—how far and in which directions the arm can be moved.

Although x-rays may be helpful in defining problems, more elusive ones may require computerized tomography (CT scan), which provides a more detailed view of the bones. Electrodiagnostic studies such as the electromyogram (EMG) and a nerve conduction study can indicate whether pain or weakness in the area is coming from a pinched nerve in the neck, or a peripheral nerve injury away from the neck, or down the arm. Magnetic Resonance Imaging (MRI) and ultrasound are other safe and effective diagnostic tools, providing images of the soft tissues without using radiation. An arthrogram is an x-ray, CT or MRI in which dye is injected into the joint for added contrast. However, as outlined in other sections of this book, studies have shown that the advanced technologies commonly used to diagnosis injuries are grievously insufficient to show where the pain is coming from.

This is when a Prolotherapist and his ability to reproduce pain by touching is invaluable. If you can put your finger on the exact spot that is causing the pain, then there is a high probability that you are a candidate for shoulder Prolotherapy since most shoulder problems involve the soft tissues—muscles, ligaments, and tendons—rather than the bones. These soft tissue injuries are precisely the kinds of injury that respond so effectively to Prolotherapy. In a future article we will cover Shoulder Arthritis rehab in great detail since Shoulder Arthritis rehab deserves more focused attention.

Many of the structures inside of joints that are injured do not hurt when you press on the outer surfaces. These inner structures can also, often be healed with Prolotherapy.

Before you do anything as radical or irreversible as surgery, and before you accept the grim prognosis of conventional medicine that sentences you to a lifetime of dependence on pain relief medication, you owe it to yourself to try Prolotherapy.

Critical Life Changes and Neck/Shoulder Pain. A Connection?

Researchers writing in the Journal of Epidemiology and Community Health say that “Life events and critical life changes are of importance for the risk of neck/shoulder pain…”

Skillgate E, Vingard E, Josephson M, Theorell T, Alfredsson L. Life events and the risk of low back and neck/shoulder pain of the kind people are seeking care for: results from the MUSIC-Norrtalje case-control study. J Epidemiol Community Health. 2007 Apr;61(4):356-61.

The researchers concluded: “Life events and critical life changes are of importance for the risk of neck/shoulder pain of the kind that people are seeking care for. The study provides useful information for clinical practice and for future aetiological research on neck/shoulder pain.”

Shoulder Arthritis Treatment with Prolotherapy

Discussions from our Radio Show Shoulder Arthritis:

CALLER: I have had a pretty bad banged up shoulder and wrist from years of playing basketball and I probably have the onset of arthritis going on in there as well as bursitis too. I was wonder how Prolotherapy would help?

Dr. Darrow: Well it is a very simple answer that I have, any kind of overuse syndrome, especially in sports like Basketball where you are constantly throwing your arms out (too defend) and to throw that ball as far as you can. When you throw the arm out, there is an end point so there is a snapping motion in the shoulder that takes place, and that wears down a lot of the tissues in the superspinatus tendon which comes out of one of the back muscles and holds the rotator cuff together. That is the cuff that surrounds the shoulder. What we do is inject into the shoulder where it is causing pain and what (Prolotherapy) does is rebuild a lot of that tissue. It is a very, very common injury in all athletes especially in those playing basketball, baseball, swimmers, weight lifters where overhand motion is needed. We get all kind of athletes and the weekend warrior, even for some one who doesn’t do sports, someone who is getting older, there can be a breakdown in the tendon and that can happen from lifting something too quickly, and just happens as we get older. The collagen material that we have in our bodies starts drying out and wearing down so as we age it starts thinning out and it is much easier to be injured.

Injuries for the most part are stretch injuries or wearing out injuries sometimes traumatic injury where you get smashed, (like in contact sports) where the collagen gets damaged.

I think that the chances of your shoulder being healed is like 80-90% with a series of Prolotherapy injections. We would ask that you stop playing basketball while we are healing you up. A future article will go into detail concerning Shoulder Impingement rehab as well.

You know weekend warriors get the worst injuries it seems because they are not in the best of shape and they go out and blast all of a sudden and they do not have the muscle or tendon strength to do these things.

● Read more about Shoulder Arthritis
● Read about my own Failed shoulder surgery

Radiculopathy Part 3

Caller: I was in a car accident, a roll over car accident on the freeway that resulted in Bulging Discs in my spine and a herniated disc in my neck. They cause me a great deal of pain.

Dr. Darrow: Do you have any pain that goes down your arms or legs?

Caller: Down my arms especially on one side, the left side

Dr. Darrow: (If it is a nerve problem) One of the first things I would try (even before Prolotherapy) is spinal decompression therapy. Spinal decompression therapy is like traction except it pulls you in different directions. What it does is pull on the spine and open up the foramen which are the holes in the spinal cord which the nerves pass through that go down the arm and very often with a series of decompressions, you can aleviate the problem by in essence, giving the nerve more room to breath.

The other thing is that there are trigger points often that can cause these radiating pains down the limbs and even though you say you a herniated disc, that doesn’t mean that that is causing your pain or the pain radiation, because there are trigger points that can create the referral pain patterns just as well as what we call radiculopathy or pinched nerve, so you need to go to someone who understands these different mechanisms and just doesn’t follow the allopathic medical model of “herniated disc – go to surgery.”

We find that most of the people that have these problems with radiating pain is that the radiating pain actually goes away by itself, even without doctors over a period of time, now it can be cyclical thing and come back but often times I have had patients who have fought me and gone to surgery and not only winding up with pain in one limb, but pain going down the other limb as well probably because of scar tissue that forms. Return to Radiculopathy main page

Avoiding Shoulder Surgery

Fixing shoulder problems non-surgically

Is shoulder surgery the only answer for the athlete who wants a quick return to their sport? To many athletes the answer is yes because the alternative recommendations from their orthopedic specialist of ice, rest, physical therapy and wait six months is not the option they want.

Isn’t surgery the fastest way back?
A patient with problems of the rotator cuff or shoulder impingement may think so, however surgery is a still an invasive procedure that requires lengthy recovery and physical therapy even if successful. Further, even successful surgery has been shown to not always relieve all the pain and that shoulder weakness can remain. Complications may also include nerve damage.

A different option – rebuild the shoulder without surgery
Shoulder injuries can be divided into two groups – more commonly, and the first to be discussed is the wear and tear injury to the tendons. The shoulder tendons are main players in rotator cuff problems, shoulder impingement, osteoarthritis and disorders of pain and weakness that get worse over time.

The symptoms of tendon weakness and injury are many and include inflammation of the tendons ( tendonitis), and/or bursitis, inflammation of the bursa (the protective sac that sits between the bones of the shoulders and allows the tendons the space they need to move.)

All would agree treating the tendons and allowing the tendons to function normally would be the optimal treatment in shoulder pain, but that is where the agreement ends. Surgeons will insist that surgery after failed conservative treatments is the way to go, other doctors are trying something else for faster results.

Prolotherapy is an injection therapy consisting mainly of dextrose, an irritant. A physician, and there are only about 500 in the United States who perform this treatment, will gently inject areas of the shoulder hoping to accelerate the body’s own inflammatory response to repair the tendons.

By isolating the areas of the tendons that are damaged, and injecting these spots, the Prolotherapist is calling the natural injury repair mechanism of the body to the spot of deterioration. The cure is the new, controlled inflammation, created by dextrose. This will stimulate a new collagen matrix, making the tendons stronger, thicker, and restoring them to their normal pain free state. To any athlete stronger is always the best option.

Prolotherapy can work fast, a treatment once a week over a 4 – 6 week period is usually all that is needed to see results. Side-effects are also limited and in many cases the athlete can continue their activities during treatments.

Prolotherapy with surgery?
The second scenario involving tendon damage is in the event of catastrophic injury that results in 100% tearing of the rotator cuff tendons in previously healthy shoulders. These are injuries that occur in sports, car accidents or a situation where the shoulder is exposed to sudden extreme force.

Even in these injuries Prolotherapy, may be the preferred treatment. However in this scenario, surgery to repair devastated tissue might be the only option. Even so, Prolotherapy can accelerate healing and strengthening of the surrounding ligaments and tendons that are usually stretched or partially torn in such an impact injury.

A proper diagnosis of shoulder pain is essential to determine the root cause of the problem and the proper method of treatment. Because many shoulder conditions are caused by specific activities, a detailed medical history is an invaluable tool. A physical examination should also include screening for physical abnormalities—swelling, deformity, muscle weakness, and tender areas—and observing the range of shoulder motion—how far and in which directions the arm can be moved.

This is when a Prolotherapist and his ability to reproduce pain by touching is invaluable. If you can put your finger on the exact spot that is causing the pain, then there is a high probability that you are a candidate for shoulder Prolotherapy since most shoulder problems involve the soft tissues—muscles, ligaments, and tendons—rather than the bones. These soft tissue injuries are precisely the kinds of injury that respond so effectively to Prolotherapy.

Shoulder Injury

Discussion from our Radio Show:

CALLER: I have a question regarding a shoulder injury, I do not know if it is a rotator cuff, but I would say about two years ago I injured it, I am not sure exactly how, I did the old work through it thing trying to get it better. It never got better. Went and got an MRI done because it was really aggravated so thankfully I had no tears or injuries but problem is I am still in a tremendous amount of pain and I am not really doing anything to lay off it and it is not getter better.

Doctor Darrow: The good news is there is nothing major going on, based on what you are telling is, from the MRI, the problem is the MRI doesn’t tell you what the problem is, which automatically tends to mean that you have an impingement syndrome or that the top of the shoulder is either digging into the tendons or you have a bursitis or an inflammation of the tendon in that area. I do not know if you ever had a steroid injection.

CALLER: No I never had one, in my experience I have been told that cortisone shots is something that you want to avoid.

Dr. Darrow: We don’t like to do repeat injections of steroids or cortisone but sometimes doing it one time is a very good diagnostic test to see where the problem is coming from. Once we find out where the problem is coming from, and we isolate the area, and the needle is telling us, your pain goes away immediately, that is the area where you need tissue rebuilt and grown and then we go and use Prolotherapy after that. Shoulders typically heal with a month to six weeks.

Shoulder Separation

Discussions from our Radio Show:

CALLER: I had a 4th degree shoulder separation accident from a bicycle ride, I had surgery on it. I have full range of motion but the bone does stick out. But occasionally I have aches from it and it feels like it almost feels like it is “asleep,” there is a strange deadness feeling in it.

Doctor Darrow: What probably what happened was as the bone separated, some of the nerves may have been stretched out or been torn. They may have been very superficial nerves that are not major nerves because you are probably as strong as you were before.

CALLER: My arm seems a little bit shortened, it is harder to stretch it out. My main question (my therapist) said that one of the ways other than the strengthening exercises to alleviate the pain was to actually put a lot of pressure on it by hanging from a bar and that would seem to me counter-intuitive because I thought it would hurt it, but it actually does help it when I actually hand and put a lot of weight on it.

Doctor Darrow: There are several things going on, when you stretch it you are allowing the area to open up a little bit, it may be “congested” or jammed together after the surgery and you may be stretching out all the scaring.

The good news is that you have a functional shoulder after that and that was a pretty bad separation.

You can get Prolotherapy to the joint area where the separation was and that would gain more collagen to the area, stimulate the natural growth of collagen there, it is very easy to do, nearly painless with a small, thin needle, see Prolotherapy injections.

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