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The causes of consideration would be;1) Bicipital tendinitis2) Brachial neuritis3) Cervical radiculopathy4) Cervical spondylosis5) Suprascapular neuropathyMajority of people with above problems will respond to physical therapy alone. The program should be aggressive, daily and assisted by the physical therapist. The regimen consists of active and active-assistive range-of-motion exercises combined with stretching. Other treatment modalities such as heat and massage may help. Nonsteroidal anti-inflammatory analgesics may also be beneficial. Deep electrotherapy in the form of short wave diathermy, Interferential current, trans cutaneous electrical stimulation, iontophoresis, phonophoresis also are very helpful initially. Following investigations would be required;1) X-ray of the neck spine2) MRI of the neck and shoulder3) Nerve conduction velocity (NCV) study4) Electromyography (EMG)You may consult following specialists;a) Orthopedistb) Neurologistc) MD in Physical medicine and rehabilitationPlease feel free for your follow up questions.Dr. Arun
Initially physical therapist will start with the deep electrotherapy for the pain. Anti-inflammatory analgesics should be continued round the clock. Once the pain improves, passive range of motion, active assisted exercises may be commenced. Against resistance exercises and exercises with the weight would only be started with further improvement of the pain. So exercises are very gradually increased. At no time there should be more than discomfort with the physical therapy.
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