Research

PRESENTATION ON FROZEN SHOULDER AND LUMBAR SPONDYLITIS ( L4-L5,L5-S1)

DEMOGRAPHIC DETAILS

  • NAME: MR BRIGADIER B.P. SINGH
  • AGE:71 YEARS
  • SEX:MALE
  • OCCUPATION: RETIRED FROM MILITARY
  • CHIEF COMPLAINT: PAIN AND SEVERE RESTRICTION IN MOVING LEFT SHOULDER.

PRESENT MEDICAL HISTORY

  • POST THAT, PATIENT DEVELOPED SEVERE PAIN IN THE LEFT SHOULDER BUT DID NOT TAKE ANY TREATMENT EXCEPT FEW SESSIONS OF PHYSIOTHERAPY.
  • GRADUALLY PAIN STARTED TO DECREASE AND STIFFNESS AGGRAVATED.

 

PAST MEDICAL HISTORY BACTERIAL ENCEPHALITIS,MONOPARASIS,FUC OF CABG ON 12 MAY, 2015
RELIEVEING FACTORS HEAT AND CHANGING POSITIONS
AGGRAVTING FACTORS PROLONGED POSITIONING OF HAND, BACK AND PAIN WORSES AS DAY PROGRESSES.

 

ON OBSERVATION

  • SEVERLY RESTRICTED MOVEMENTS OF LEFT SHOULDER JOINT,SLR +VE
  • PATIENT DEVELOPED TRICK MOVEMENTS SUCH AS SHOULDER SHRUGGING WHILE DOING SHOULDER FLEXION OR ABDUCTION.

ON PALPATION

  • TENDERNESS OVER FOLLOWING AREAS:

ON EXAMINATION

  • MANUAL MUSCLE TESTING:

GENERAL BODY 3

SHOULDER JOINT:

  • LEFT SIDE FLEXORS:2
  • LEFT SIDE ABDUCTORS:2
  • EXTERNAL AND INTERNAL ROTATION SEVERLY PAINFUL
  • RIGHT SHOULDER FLEXORS:3
  • RIGHT SHOULDER ABDUCTORS:3
  • RIGHT SHOULDER EXTENSORS AND ROTATORS:3

 

 

  • RANGE OF MOTION: FOR LEFT SHOULDER
  • ACTIVE SHOULDER FLEXION:0-20
  • ACTIVE SHOULDER ABDUCTION:0-30
  • EXTERNAL AND INTERNAL ROTATION SEVERLY RESTRICTED DUE TO PAIN AND STIFFNESS
MUSCLE SPASM SPASM PRESENT IN  PARAVERTEBRALS AND TRAPEZIUS
TIGHTNESS PECTORALIS, TAPEZIUS AND TRICEPS,HAMSTRINGS,QUADRICEPS,ILIOPSOAS
GAIT NORMAL

 

INVESTIGATIONS DONE

DIAGNOSIS

FINAL DIAGNOSIS:  LEFT FROZEN SHOULDER ,FUC OF CABG ON 12 ,MAY,2015,LUMBAR SPONDYLITIS WITH PIVD L4-L5,L5-S1 WITH RADICULOPATHY B/L LOWER LIMB,B/L SACROILITIS+ B/L PIRIFORMIS CROSS SYNDROME

 

SHORT TERM AND LONG TERM GOALS

PHYSIOTHERAPY MANAGEMENT

Do’s And Don’ts for shoulder pain AND BACK PAIN

Do’s :

  • Do the prescribed exercise regularly to maintain strength, flexibility and range of motion.
  • Do keep the affected arm supported.
  • Always take side turn as u get up from the bed

 Don’ts :

  • Do not sleep on the affected side.
  • Avoid forward bending
  • Do not lift heavyweight with the affected arm.
  • Do not jerk your shoulder back to avoid stress.
  • Don’t use the arm to push yourself up in bed or from a chair because this requires forceful contraction of muscles.
  • Don’t participate in contact sports or do any repetitive heavy lifting.
  • Use towel roll under the neck during supine lying.
  • Use pillow of normal thickness in side lying position

 

FROM DAY 1-DAY2

  • MANAGEMENT WAS AIMED AT REDUCING MUSCULAR PAIN AND SPASM
  • SO TREATMENT WAS GIVEN ACCORDINGLY.
  • COMBO THERAPY: ULTRASOUND OVER LEFT SHOULDER AND AT L4 ,L5 ,S1 LEVEL
  • TENS OVER BACK IN SWEEP MODE
  • MUSCLE STIMULATOR OVER DELTOID,BICEPS,TRICEPS,COMMON FLEXORS AND EXTENSORS 100 TO 150 CONTRACTIONS FOR EACH.
  • PAIN OIL APPLICATION: OVER THE LEFT SHOULDER AND BACK. EVERY 6 HOURLY
  • SHOULDER AND BACK STRENGTHENING AND MOBILITY EXERCISES.
  • STRTCHING (10SECS FOR 3 SETS): UPPER LIMB AND LOWER LIMB
  • PECTORALIS, TRICEPS, AND ULTT,HAMS,QUADS,ILIOPSOAS,PIRIFORMIS

FROM DAY 3 TO PRESENT DAY.

  • MODALITIES AS USED BEFORE.
  • SHOULDER MOBILISATION STARTED( CAUDAL GLIDE, INFERIOR AND POSTERIOR GLIDE)
  • HOLD AND RELAX AT END RANGE
  • SCAPULAR MOBILISATION
  • SHOULDER MOBILITY EXERCISES.
  • STRETHENING USING WEIGHT CUFFS.
  • TOWEL EXERCISES FOR EXTERNAL ROTATION.
  • BACK STRENGTHENING EXERCISES

 

IMPROVEMENT IN DAILY ACTIVITIES

HE GOT 90% RELIEF IN BACK IN 15 DAYS SIMULTANEOUSLY SHOULDER RELIEVED 80%

Leave a Reply

Your email address will not be published. Required fields are marked *

Book Instant Appointment

KRV Assessment Form

?
Facebook
Twitter