SHOULDER PAIN QUESTIONS

Can acromegaly cause shoulder osteoarthritis and chronic inflammation?
A. Acromegaly can contribute to the problem because people with your condition tend to have lax ligaments because of the overgrowth of your bones.

Prolotherapy and Shoulder Separation
I have a grade three shoulder separation now in its ninth week. I have received weekly physical therapy, assisted release therapy and acupuncture.  I have a very good diet and have supplemented it with mega doses of vitamins and nutrients. I have very good range of motion according to both my PT and ART treatment providers. I agree with them.
 

Pain Continues After Prolotherapy Treatment
Over the last two years, I have had Rotator Cuff pain in both shoulders, which more recently progressed to Bicep Tendonitis and acromioclavicular joint sprain. The pain is worse when I move my arms across my body or rotate them inwards vs. outwards and when reaching forward with arms. I recently developed a deep ache in front shoulder joint, which gets worse when I'm outside in the cold weather.

I have had Prolotherapy to all the tendons and ligaments for four treatments in my right shoulder. One of the treatments I had a lot of swelling and pain for a few weeks. My doctor said he used half dextrose and half P2G (See Prolotherapy injections).

The other treatments I had no swelling and not as much pain. I'm still having a lot of pain. Do you think I need to have injections in the shoulder cartilage itself with Prolo solution? Could this be arthritis in the joint causing all this tendon and ligament pain? I also get pain on and off in elbows. Could this be referred from the shoulder problem or could it be arthritis in the elbow?

A. Dear Shoulder Pain, the key to whether or not you will get better with Prolotherapy depends on what exactly is causing your pain. If you have acromioclavicular joint arthritis with a spur pressing on your rotator cuff tendons then you will probably need arthroscopic surgery. Other causes of shoulder pain typically respond well with Prolotherapy. Is your impingement sign positive? If it is and you have had four thorough Prolotherapy sessions with minimal help, then it is time to go visit the orthopedist. If your impingement sign is not positive then it is time to visit another Prolotherapy doctor. The impingement sign is when the doctor abducts the arm and then internally rotates the shoulder. If this maneuver reproduces your shoulder pain then it is called a positive impingement sign

Answer by Ross Hauser, M.D.
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Pain Continues After Prolotherapy Treatment
I also have severe neck pain and stiffness. My doctor says I have arthritis and thinks I have nerve impingement or damage. I'm in my forties. Will doing Prolo in the neck ligaments help the neck pain and also shoulder pain? Should I continue doing Prolo to my shoulders too? My doctor thinks the deep ache in my shoulder joint is a muscle spasm. Could this be caused from the nerves in the neck or from the arthritis in acromioclavicular joint? Can ligament sprains in the shoulder cause a muscle spasm in joint? If I have a bone spur in the shoulder, how would surgery solve the problem if I still have ligament and tendon weakness?

A. Dear Shoulder Pain, If you have impingement of your rotator cuff from acromioclavicular arthritis then you will need surgery. Ask your Prolotherapy doctor about this. Prolotherapy is a great treatment but it will only completely relieve your problem if the problem is due to something Prolotherapy can fix. Only your Prolotherapy doctor could tell you that.

Is Prolotherapy successful with anterior shoulder dislocations?
A. We do have success using Prolotherapy for shoulder injuries such as yours.

In dislocation, there is damage to the tendons and ligaments in and around that area. Prolotherapy strengthens and repairs them by restarting the healing process in that area.

It is a series of injections into the affected areas, each treatment being spaced about 3 to 4 weeks apart. Typical cases heal after 4 to 8 visits. An exam would be needed to make a more accurate determination.

As long as your tendons or ligaments were not completely torn, you may benefit from Prolotherapy.

Pain in both shoulders
I have been having a gradual increase in shoulder pain the last 2 years. It's now affecting all parts of my shoulder and arm.  I have pain moving it slightly, rotating in both directions, sleeping on it, putting my body weight on it, and it's in both shoulders. The right is worse. My doctor doesn't think it's a bone spur, because the pain is in both shoulders.  Any suggestions to what is causing this pain, I didn't have any injury. Read more

I have frozen shoulder (adhesive capsulitis).
I thought this was caused by inflammation. If this is true, how can ADDITIONAL inflammation be helpful? I am confused. Read More

I have been receiving Prolotherapy for chronic shoulder pain. From the first we suspected it was a SLAP legion/tear.

The Prolotherapy doctors told me Prolotherapy can heal some SLAP legions/tears. I didn't respond and now need to think about surgery. Can Prolotherapy, if administered correctly, heal a SLAP lesion/tear?  Or is surgery the only realistic option?

A. Prolotherapy properly administered by the best of hands will only have a maximum cure rate of about 80% (give or take 5%)...so 4 out of 5 shoulder labral tears will heal with Prolotherapy.  It is possible you were the one in five that didn't heal. I would seek out a surgeon. If it turns out you do not have a surgical lesion then absolutely find another Prolotherapy doctor. Read more SLAP LESIONS

Answer by Ross Hauser, M.D.
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