From the Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, 330 Brookline Ave, LY318, Boston, MA 02215.
In March 2000, Stephen S. Burkhart, MD, discussed a 26-year-old
woman with severe chronic shoulder pain. Mrs B was a physical education teacher
whose activities were limited by chronic left shoulder pain. She had tried
physical therapy, nonsteroidal anti-inflammatory drugs, and cortisone injections
without adequate relief. The pain started 4 years earlier in both shoulders
without preceding injury, and diagnoses included subdeltoid bursitis, rotator
cuff tendonitis, and impingement. The pain awakened her from sleep and interfered
with basic activities such as brushing her hair and lifting her arm. A magnetic
resonance image (MRI) showed a possible small tear in the rotator cuff. She
wondered whether surgery would afford long-term relief and how difficult the
recovery period would be.
Parker RA, Hartman EE. A 26-Year-Old Woman With Shoulder Pain, 1 Year Later. JAMA. 2001;285(24):3140. doi:10.1001/jama.285.24.3140