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Today, 22 November 2008

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Yesterday, 21 November 2008

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What is the best remedy for calcification of shoulder joint?

Nando: I've got calcification of my shoulder joint.

Harry: Yes, that is a very, very common problem.

Nando: Now I'm getting conflicting advice. Some people say surgery, some people say cortisone and some people say physiotherapy. What do you suggest?

Harry: The answer may be all of those but you always start with the most conservative treatment. The last thing you would think of is an operation.

Nando: I agree.

Harry: So you can start with simple things like physiotherapy - absolutely. If you have pain, you may be able to take an anti-inflammatory and that can work. Some good physiotherapy will strengthen the muscles there and show you how to use the shoulder joint. If those fail, you can certainly have an injection of cortisone into the joint, although that may not solve the problem permanently.

Nando: But why is there a reluctance shown to cortisone? What is the problem with cortisone?

Harry: There should be little reluctance because this is a well-established form of treatment. What you've got to be a little bit careful about is that you can't have too much cortisone injected into the joint.

Nando: How does cortisone help the calcification?

Harry: It relieves the inflammation. The calcification itself is probably not causing pain and it's more likely to be related to the inflammation. What the cortisone does is to sedate or calm down the inflammation. Now the problem with cortisone is that if you have too much of it and too frequent injections of cortisone, that can cause problems. Cortisone can interfere with healing and can cause problems in its own right.

Nando: But I can happily go for a one-off injection.

Harry: Yes, you can even have two, three, four or even five injections and your orthopaedic surgeon would be the best person to determine that. And only if all these conservative measures fail would you consider an operation.

Nando: Okay, thank you.