Worried about daughter.

[Lilacgirl]

I am hoping that some physios on here will have an opinion on this.


Brief history: daughter was on a bucking horse in june 2008 developed shouder pain. Daughter fell from horse onto shoulder feb 2009.


Following second injury she has had severe pain around her shoulder blade and shooting pains down the arm. Also extreme weakness in arm.


Treatment has been physio....fact joint injections c spine, long term morphine and then pregabalin. Drug regime finally acheived freedom from pain which injections and physio didn't.


The she started physio again. Physio on the first appt pressed all down her spine when she got to T6 the pain came back and shot down my daughters arm. Despite increased drug doses it hasn't gone away. She now has like a thickening around this joint that is painful to touch.


What do you think happened here and what should we do now? Physio appts are only being offered 3-4 weekly and are very painful. She now can't really drive to college or do her part time job as things just slip through her hand, every little bump in the road gives her shooting pains and dull pain is present all the time :-)

I would be really grateful for any opinions on what this may be or where we should attempt to go from here. Please message me if you would prefer.Many thanks.

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[physiobob]

Hi there and thanks for your useful post.

The initial history suggested something spinal in origin. Perhaps the neck or the thoracic spine (which T6 is part). The gradual weakness also implicates the spine in some way.

Has she had an MRI? If so has she had an MRI of the Thoracic spine (rib cage)? It is indeed possible from an issue in that area to have an effect on the arm as well, although not so directly.

Has she had EMG tests to check the nerve connections to the arm muscles? Facet injections are for pain and do not address the weakness which for me should be the primary cause for concern.

So in my opinion, which should also be that of the treating physio, she needs MRI and EMG follow-up and asap I would say. Getting her hooked on stronger levels of pain medications is definitely not the way forward at this stage.

[steffen-dt]

How is your daugther? Have you contacted a physio? Could you get help?

I hope the pain is gone. I also had a similar issue a couple of years ago. It took some time until my shoulder was ok again.

[Lilacgirl]

Thank you to everyone for taking the trouble to reply. My daughter is no better.

She still has pain all the time despite the morphine and pregabalin. The physio is now trying accupuncture but so far it is not working. She has an appointment with her consultant orthopaedic surgeon next friday.

The main reason for my post was to try to ascertain whether or not physio could actually make her worse as it has done so far. We do seem to be going round in circles her treatment so far has been:

Dr(gp) advise physio co codamol.

Physio no improvement

Dr(gp) xray nothing found.....so more physio no improvement. Tramadol


Dr(gp) refer ortho consultant at hospital MRI nothing seen. Facet joint injections c spine. no improvement advise physio. no improvement.

Back to dr gp given morphine still in pain advise more physio when pain free.

Dr gp pregabalin pain free at last. Start physio pain returns.

Physio does accupuncture so far not working.

Due to see spinal consultant again next week. :-(

getting these appointments is hard with months and months inbetween and we have got nowhere.

[alophysio]

hi Lilacgirl,

With limited information, i would be thinking it has to do with her thoracic spine...

LJ Lee and Diane Lee run courses which are excellent at the assessment and treatment of T/S issues. I know they keep a database and teach in the UK so if you go to their website Discover Physio - Diane Lee and LJ Lee and contact them via email, i am sure someone can let you know where to start looking for someone who can assess your daughter's T/S properly.

Thanks