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Successful Treatment for Bilateral Shoulder Pain in Nurse
The patient is a 41 year old female nurse. She complains of pain rated as a 7 on a VAS scale of 10. It is affecting her shoulder, joints, with accompanying hand and joint swelling. The symptoms are new and started a few days earlier. The patient denied recent trauma and recreational activities that might explain her pain. She does have a large frame and is overweight by about 50 pounds. She does not smoke or drink. As part of her job, she sometimes turns various knobs on machines and IV catheters, raising her arms often. When asked her sleeping position, she replied that she was mostly a side sleeper.
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Palpation of the soft tissues around the shoulder joint elicited pain, enough for her to jump during test. Especially anterior. Probably the pectorals major insertion point. Also, the supraspinatous tendon. She report pain ranging to the back and down of the upper arm along biceps. Shoulder ROM appeared normal. The hands were stiff due to capsular swelling. There was reduced sensation to pinwheel in hand dermatomes. Grip strength was decreased.
The diagnosis was bilateral shoulder tendonitis and capsulitis or bursitis. The patient was treated with 15 min. of LiteCure deep tissue laser therapy with instrument. It assisted soft tissue mobilization using a surgical steel edged instrument and was seen three times a week, for two weeks and two times a week for the following two weeks. She was also shown stretches for the anterior chest wall. In the second week, she was prescribed a series of four (4) Herbal Patches and was told to apply them directly over the anterior shoulder joint. She was also given one bottle of a liquid herbal formula to improve local circulation.
Result: after the second week, her condition improved dramatically. The hand swelling and pain disappeared but the shoulder pain was still present. After the third week, most of the original shoulder pain was gone. She was able to take deep palpation to the areas without feeling much pain.
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