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Need advice on shoulder/neck injury, pls!?


Hello, on 12/7/06 I had fell very hard onto a concrete floor. I hit my head back, shoiulder and arm. I have been in physical therapy for about two months to treat this injury.
I first recieved and MRI for my neck and it showed that I posterior disc protusion slightly effacing the ventral csf at c5-6 and c4-5. I also have a disc bulge at c6-7.

At first the pain was quite severe but physical therapy, rest and medication had helped some bit. The problem is that I still get neck aches daily. The pain can get to be pretty bad at times
.
I recently recieved and MRI for my shoulder which showed impingement. The results say: There is a down-sloping acromion which does touch a midly efface the supraspinatus musculotendinous junction. There is tenosynovitis of the biceps tendon sheath
.
I kind of know what this means but not fully. I have alot of pain in shoulder and neck, shoulder is very sore and my underarm is sore and tender. it hurts most when walking/reaching. Also, my elbow started cracking with much pain and my forearm is really tight, my fingers constantly feel jammed and there is pain/weakness in wrist. Also, my shoulder has been cracking.

My question is, I see a my neuro surgeon for a follow up soon but I called the office and they said he does not deal with shoulders. Then, the week after I see my doctor. What kind of treatment should I expect for these injuries and might I need to see another specialist? Also, may I need more physical therapy my prescription is currently up for it and i have completed the suggested course of therapy yet am still in much pain.

Any info/suggestion you may have will be appreciated.

Thank You

You did not mention what you are doing in physical therapy, but it sounds like the treatment has focused on the neck. I am guessing that more needs to be addressed for the shoulder.

In impingement syndrome, something gets "pinched" which causes pain and inflammtion. It can occur due to poor muscular function or muscles that stabilize the scapula, tightness of the capsule surrounding the joint, poor posture, a bone spur on the underside of the acromian, or anatomic abnormality of the acromian. It sounds like you at least have the latter. Whether you have other factors contributing to the problem, your physical therapist should be able to tell you. Muscular function and capsular tightness can be addressed by strengthening and stretching. Posture correction is imperitive in ALL cases of shoulder impingment. The other things I have mentioned cannot be cured by physical therapy, but may be able to be addressed by using modalities to decrease inflammation...education is also important to avoid movements that impinge the shoulder.

The neurosurgeon could give you further treatment suggestions for the neck, but an orthopedic surgeon would need to be seen for the shoulder. Although, based on what you have said about your MRI, the first inclination would probably be to continue PT...maybe a cortisone injection.

I would try massage therapy I am a therapist and I deal with a lot of neck and shoulder injuries if you find a therapist who specializes in medical massage or deep tissue massage they can set up a treatment plan. Now this will only help ease the muscle pain but I have seen plenty of cases such as yours get better and sometimes go away.

Acupunture worked for me, After almost 6 months of pain, I tried it . Two or three treatments, and I was pain free and about 90% better. Try It.

Best to consult an orthopedic surgeon-he can address your neck and shoulder problems.

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