This website is under development - The information contained on this site is for guidance only and is not intended for self diagnosis or self treatment. This will not replace professional medical advice or consultation. Always seek the professional advice of a qualified health care provider like your doctor or specialist before embarking on any treatment. If you have a problem please consult your doctor or specialist.
Effective treatment is only possible if a precise diagnosis has been made and the pathology targeted by appropriate and well established methods. Making no attempts to diagnose but to commence treatment using ‘standard’ techniques will bear no fruit either for the doctor or for the patient. Not too long ago, it was considered that all shoulder pain was to be treated with cortisone (steroid) injection irrespective of the pathology followed by physiotherapy. Patients had to put up with this advice in the past - not anymore. I make a sincere attempt to establish a diagnosis and thus formulate a good treatment plan.. With progress in the understanding of the various shoulder conditions and employing up to date investigation techniques tailored to the history given, it is now possible to diagnose more than 95% of conditions accurately and treat them successfully. The first step in making a diagnosis is to listen to the history given by the patient carefully including age,
attitude of the patient, any preexisting medical conditions, presentation of symptoms and treatment received so far. This is followed by a careful and methodical examination. I would focus my efforts on the indicative diagnosis and carry out special tests when needed. This may be followed by judicious use of local anaesthetic/cortisone injection which will give a very good pointer in arriving at the diagnosis. I also request everyone to complete Oxford Shoulder Questionnaire which is a Patient Reported Outcome Measure (PROM) to assess the benefit that one gets from any intervention. Following an examination, and making provisional diagnosis, I may suggest investigations like x-ray, ultrasound, MRI arthrogram or rarely CT scan and when indicated recommend a diagnostic/therapeutic injection of local anaesthetic with cortisone.