Shoulder Pain Treatment

The patient was a 42 year old male, regular gym person since 15 years, who was referred to physical therapy for shoulder pain. He noticed symptoms after picking up a barbell during weight training. Objective findings included a multi‐segmental flexion movement pattern dysfunction and MTrPs in the trapezius, subscapularis, rhomboids and teres minor muscles with deep palpation. The subject was treated with TrP‐DN for a total of two visits. Bilateral scapular and neck muscles were treated, along with implementing a home exercise program consisting of dynamic stretchings and muscle stability exercises.

Dry needling has been shown to be an effective intervention for myofascial pain syndrome although is continues to be an underutilized intervention in India. This may be due to the lack of exposure, political restrictions, education, or all of the above. 

Interesting components of current case: The patient is highly educated (MD), employed, and functional with common symptoms of shoulder pain. The patient is in the chronic phase of myofascial pain syndrome, who has had conventional treatments for his pain without resolution. The patient responded unusually well to a single physical therapy treatment using an underutilized intervention, namely dry needling.

Polyarthralgia Treatment

A 56 year old female (Teacher), lean body referred for physical therapy for an evaluation and treatment for her multiple joint pain, who has very active lifestyle. The patient had a medical history of diabetes mellitus and HTN, all for which she was medically managed. The patient was referred to PT and reported that she was instructed to perform Active range of motion (AROM) and resisted shoulder exercise which increased her pain and resulted in a bad experience. The patient did not return to therapy. The patient received additional treatments for her pain including steroid injection and several oral medications for pain relief, which didn’t help her much. She was not getting her sleep since 2 months because of pain. The patient was diagnosed with frozen shoulder 9 month back. Now the diagnosis is polyarthralgia.

Primary Complaint: The patient reported primary pain in her left scapular and shoulder area with secondary radiating pain in her arm and hand, occurring each day for the past 9 months intermittently throughout the day. The patient rated her primary pain using the visual analog scale (VAS) as 5-6/10 and her secondary radiating pain as 3/10 during the examination.

Patient has come for treatment and visits her son who is residing in Bangalore. I have planned her treatment for 12 sessions of dry needling followed by full body stretching exercises. Dry needling has been shown to be an effective intervention for polyarthralgia although is continues to be an underutilized intervention in India. This may be due to the lack of exposure, awareness and education. 

Interesting components of current case: The patient is highly educated (MD), employed. The patient is in the chronic pain of osteoarthritis, who has had conventional treatments for her pain without resolution. The patient responded unusually well to a single physical therapy treatment using an underutilized intervention, namely dry needling. Now patient is perfectly fine and having a active lifestyle. She visits me monthly once for preventive management.