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Suggest Treatment For Severe Pain Due To Pinched Nerve
Posted on
Mon, 15 Jun 2015
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Mon, 15 Jun 2015
Answered on
Wed, 8 Jul 2015
Last reviewed on
Question : I would like to address my question to Dr. XXXXXXX Chail: Dr. Chail,
Since my last question, I did have a Thursday april23, 2015 appointment with Dr. XXXXXXX Stapleton. I researched to find he specializes in shoulder diagnosis and also is a member of the Medical School faculty of Mercer University of Macon, XXXXXXX He ordered an MRI on my shoulder and my May 11th appointment he discussed his decision to order four weeks of Physical Therapy for a severely pinched nerve. I also had received a reply from the Medical Composite Board during my April 23rd appointment. Currently, have two treatments of rehabilitation left and each treatment I was asked to describe my pain level. I told the Occupational Therapist I wanted to have a follow up appointment with Dr. Stapleton to see how he read her treatment notes. Ortho Georgia's MRI department had scheduled the follow up appointment so that I would also be waiting among patients that are shoulder patients that are in canvass shoulder splints and also long term orthopedic patients with injuries that are transported by non emergency ambulance from long term rehabilitation centers. I was lucky I chose that local hospital outpatient treatment center recently opened because they had asked for the police report that reads the driver was unattentive when I was struck in the cross walk while riding my bicycle in it. The driver did come to a full stop and also was required to adhere to the red light where I had a green light. But, the driver choose to drive into the cross walk while I was still in it.
Since my last question, I did have a Thursday april23, 2015 appointment with Dr. XXXXXXX Stapleton. I researched to find he specializes in shoulder diagnosis and also is a member of the Medical School faculty of Mercer University of Macon, XXXXXXX He ordered an MRI on my shoulder and my May 11th appointment he discussed his decision to order four weeks of Physical Therapy for a severely pinched nerve. I also had received a reply from the Medical Composite Board during my April 23rd appointment. Currently, have two treatments of rehabilitation left and each treatment I was asked to describe my pain level. I told the Occupational Therapist I wanted to have a follow up appointment with Dr. Stapleton to see how he read her treatment notes. Ortho Georgia's MRI department had scheduled the follow up appointment so that I would also be waiting among patients that are shoulder patients that are in canvass shoulder splints and also long term orthopedic patients with injuries that are transported by non emergency ambulance from long term rehabilitation centers. I was lucky I chose that local hospital outpatient treatment center recently opened because they had asked for the police report that reads the driver was unattentive when I was struck in the cross walk while riding my bicycle in it. The driver did come to a full stop and also was required to adhere to the red light where I had a green light. But, the driver choose to drive into the cross walk while I was still in it.
Brief Answer:
Wishing you a quick recovery.
Detailed Answer:
Hi XXXX,
Thank for writing in to us.
I have read through your query in detail.
Please find my observations below.
1. Dr.Stapleton has done it right by recommending a MRI shoulder followed by a four week rehabilitation for your severely pinched nerve in the shoulder region.
2. Pain is subjective and differs in every one, the description of pain during and after subsequent treatment sessions is a method of analyzing how your condition is improving. There are certain pain scores and this helps the therapist and doctor to know the treatment progress.
3. Once your four sessions are over, you might have an appointment with Dr.Stapleton and as mentioned, notes on the pain scores will help him to assess your clinical improvement.
4. Having your rehabilitation treatment at a local facility is better as you have pointed out that the police report was provided showing a human error causing your accident at the cross walk.
5. I hope you have started feeling better and wish you a complete recovery in the as quickly possible.
Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Wishing you a quick recovery.
Detailed Answer:
Hi XXXX,
Thank for writing in to us.
I have read through your query in detail.
Please find my observations below.
1. Dr.Stapleton has done it right by recommending a MRI shoulder followed by a four week rehabilitation for your severely pinched nerve in the shoulder region.
2. Pain is subjective and differs in every one, the description of pain during and after subsequent treatment sessions is a method of analyzing how your condition is improving. There are certain pain scores and this helps the therapist and doctor to know the treatment progress.
3. Once your four sessions are over, you might have an appointment with Dr.Stapleton and as mentioned, notes on the pain scores will help him to assess your clinical improvement.
4. Having your rehabilitation treatment at a local facility is better as you have pointed out that the police report was provided showing a human error causing your accident at the cross walk.
5. I hope you have started feeling better and wish you a complete recovery in the as quickly possible.
Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Yes, I appreciate your answer...
I also want to mention I had researched and looked at online videos of surgical repair of the dislocated acromioclavicular joint. I would like to have a joint that is in place... But, I also would want to have a treatment plan the surgeon would agree upon. by discussing goals that I can achieve to have return of activities I have done in the past where I can't now simply because it requires me to have an intact acromioclavicular joint.
Of course I look forward to showing my desire, and will to see what I can achieve. Rehabilitation was with small weights I hope that I can increase my mobility gradually by flowing with the healing of the nerve and make sure it receives the nutrients it needs to heal.
I also want to mention I had researched and looked at online videos of surgical repair of the dislocated acromioclavicular joint. I would like to have a joint that is in place... But, I also would want to have a treatment plan the surgeon would agree upon. by discussing goals that I can achieve to have return of activities I have done in the past where I can't now simply because it requires me to have an intact acromioclavicular joint.
Of course I look forward to showing my desire, and will to see what I can achieve. Rehabilitation was with small weights I hope that I can increase my mobility gradually by flowing with the healing of the nerve and make sure it receives the nutrients it needs to heal.
Brief Answer:
Stepwise progressive shoulder joint mobilization is recommended
Detailed Answer:
Hi XXXX,
Thank for writing back with an update.
1. It appears that you might have suffered a mild to moderate grade of AC joint injury due to your accident. Surgery is required for severe AC joint injury and sine Dr.Stapleton has recommended rehabilitation, the injury might heal by conservative means.
2. I hope you get better with physical therapy and recover your shoulder movements completely. Rehabilitation is a slow process and at your age of 59 years, the injured tissues and nerves might take slightly longer to heal completely.
3. Sportsmen encounter these injuries regularly and there are specific exercises for AC joint repair and rehabilitation. Doing exercises is initiated under the guidance of a physical therapist or sports medicine specialist to promote complete range of shoulder movements. After recovery, your shoulder movements will become smooth and pain free.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Stepwise progressive shoulder joint mobilization is recommended
Detailed Answer:
Hi XXXX,
Thank for writing back with an update.
1. It appears that you might have suffered a mild to moderate grade of AC joint injury due to your accident. Surgery is required for severe AC joint injury and sine Dr.Stapleton has recommended rehabilitation, the injury might heal by conservative means.
2. I hope you get better with physical therapy and recover your shoulder movements completely. Rehabilitation is a slow process and at your age of 59 years, the injured tissues and nerves might take slightly longer to heal completely.
3. Sportsmen encounter these injuries regularly and there are specific exercises for AC joint repair and rehabilitation. Doing exercises is initiated under the guidance of a physical therapist or sports medicine specialist to promote complete range of shoulder movements. After recovery, your shoulder movements will become smooth and pain free.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
This morning I had an appointment with Dr. Stapleton. He said he received the notes of the Occupational Therapists. I spoke to him about the third Occupational Therapist that treated me yesterday suggesting I have a lot of limitations in my left shoulder.
I have studie some surgeries of the acromioclavicular joint available searching on the internet. I believe I can recover from this kind of surgery.
I did get told of the decision of the first two Occupational Therapists last Friday and Monday. The third Occupational Therapist suggested I could use more rehabilitation.
Dr. Stapleton did give me another prescription for Occupational Therapy so I had returned home and called and spoke to the second Occupational Therapist and she told me she planned with the first to discharge me after this week. I plan to wait at least a day to learn of my plan for my left shoulder.
I don't like the limitations on my shoulder. I still can't lift and trust my shoulder and know I can return to the same strength as my right shoulder.
I have studie some surgeries of the acromioclavicular joint available searching on the internet. I believe I can recover from this kind of surgery.
I did get told of the decision of the first two Occupational Therapists last Friday and Monday. The third Occupational Therapist suggested I could use more rehabilitation.
Dr. Stapleton did give me another prescription for Occupational Therapy so I had returned home and called and spoke to the second Occupational Therapist and she told me she planned with the first to discharge me after this week. I plan to wait at least a day to learn of my plan for my left shoulder.
I don't like the limitations on my shoulder. I still can't lift and trust my shoulder and know I can return to the same strength as my right shoulder.
Brief Answer:
Let us have an opinion from Dr.Stapleton after next occupational therapy
Detailed Answer:
Hi XXXX,
Thank for writing back with an update.
1. The shoulder in an important area and it is important not to have any limitations with the movements. The third occupational therapist suggests that you explore the available rehabilitation symptoms and then proceed with a decision to get a surgery.
2. It is important to share with you that even after AC joint surgery, you require a rehabilitation program during recovery. The rehabilitation program after surgery is important to get back your complete range of movements.
3. It will be nice to have an opinion from Dr.Stapleton regarding the surgical options he would consider should there be persistent limitations after the next occupational therapy.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Let us have an opinion from Dr.Stapleton after next occupational therapy
Detailed Answer:
Hi XXXX,
Thank for writing back with an update.
1. The shoulder in an important area and it is important not to have any limitations with the movements. The third occupational therapist suggests that you explore the available rehabilitation symptoms and then proceed with a decision to get a surgery.
2. It is important to share with you that even after AC joint surgery, you require a rehabilitation program during recovery. The rehabilitation program after surgery is important to get back your complete range of movements.
3. It will be nice to have an opinion from Dr.Stapleton regarding the surgical options he would consider should there be persistent limitations after the next occupational therapy.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I had an appointment with Dr. Stapleton on Thursday morning. He believes the MRI reading includes there is no need for surgery. I read the MRI myself. He did not discus the MRI description written by the physician at all. He didn't speak to me what is read and interpret what the physician means by allowing me to ask for definitions of the medical terminology because he did not orally read it and discuss it at all.
Orally the third Occupational Therapist said to me there is a potential for more Occupational Therapy but, when I called and said Dr. Stapleton allowed me another prescription the second occupational therapist told me she and the first therapist agreed to discharge me.
I plan to follow through with the specific weight and exercises to increase endurance to then also increase weights and resistance. It is not an immediate need for me to tell Dr. Stapleton right now. I want to adjust with how these three therapists decided to discharge me. It surprised me and it made me think I was reaching out for something that wasn't there.
The therapists did do goniometric measurements and really did stress each range of motion to severe pain to produce the measurements and there are limitations in the range of motion. I still have the prescription so I may call back in a week or two to ask them to perform another stress test and goniometric measurement. To test whether I am challenging my shoulder.
Orally the third Occupational Therapist said to me there is a potential for more Occupational Therapy but, when I called and said Dr. Stapleton allowed me another prescription the second occupational therapist told me she and the first therapist agreed to discharge me.
I plan to follow through with the specific weight and exercises to increase endurance to then also increase weights and resistance. It is not an immediate need for me to tell Dr. Stapleton right now. I want to adjust with how these three therapists decided to discharge me. It surprised me and it made me think I was reaching out for something that wasn't there.
The therapists did do goniometric measurements and really did stress each range of motion to severe pain to produce the measurements and there are limitations in the range of motion. I still have the prescription so I may call back in a week or two to ask them to perform another stress test and goniometric measurement. To test whether I am challenging my shoulder.
Brief Answer:
Occupational therapy might help avoid surgery
Detailed Answer:
Hi XXXX,
Thank for writing back with an update.
1. I completely agree with you in planning to include specific weight exercises to increase endurance. This should be done in a slow and progressive approach with increase in the weights depending on your pain relief feedback.
2. Surgery is always a second consideration after the rehabilitation measures have been explored and if relief is unsatisfactory. A natural healing is given preference over surgical manipulation unless unavoidable. I feel Dr.Stapleton has viewed the MRI images and concluded that conservative treatment and occupational therapy needs to be continued in a graded fashion to record improvement.
3. Goniometric measurements might be done in two weeks time followed by the stress test. Though I would like you to try your best when repeating the measurements, please be honest about the pain you encounter during the test and inform the therapist.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Occupational therapy might help avoid surgery
Detailed Answer:
Hi XXXX,
Thank for writing back with an update.
1. I completely agree with you in planning to include specific weight exercises to increase endurance. This should be done in a slow and progressive approach with increase in the weights depending on your pain relief feedback.
2. Surgery is always a second consideration after the rehabilitation measures have been explored and if relief is unsatisfactory. A natural healing is given preference over surgical manipulation unless unavoidable. I feel Dr.Stapleton has viewed the MRI images and concluded that conservative treatment and occupational therapy needs to be continued in a graded fashion to record improvement.
3. Goniometric measurements might be done in two weeks time followed by the stress test. Though I would like you to try your best when repeating the measurements, please be honest about the pain you encounter during the test and inform the therapist.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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