Originally published in Massage & Bodywork magazine, November/December 2008. Copyright 2008. Associated Bodywork and Massage Professionals. All rights reserved.
He described the pain as someone evil stabbing his shoulder with a serrated, acid-dipped knife. His job is physical and he worried about paying next month's bills. Middle-aged and in the same job for 15 years, what would he do? Christmas was just a couple weeks away.
The sudden loss of range of motion alarmed him. He'd had supraspinatus tendonitis, so he assumed it was back. He tried ice to no avail. Heat didn't provide relief either. The pain grew too intense for him to exercise his way out of trouble. He couldn't pick up his kids and, now that he couldn't, it seemed especially important that he be able to do so.
I performed the standard orthopedic tests. His painful arc in abduction did indeed suggest rotator cuff tendonitis. At first I reasoned that infraspinatus tendonitis often follows closely on the heels of a supraspinatus tear. Further testing revealed more global rotator cuff symptoms. The long head of the biceps was tender. Internal and external rotation of the arm increased his pain tenfold. Apley's Scratch was too painful to attempt and involuntary guarding made testing and passive movements challenging.
Getting in and out of a coat without assistance was almost impossible. Whatever arm abduction he could manage seemed to be coming just from his mightily contracting deltoid muscle leading to a constant ache at the deltoid tubercle.
The complete assessment suggested an impingement syndrome. I finally decided this guy's panoply of symptoms was consistent with subacromial bursitis.
Massage was too painful. Chiropractic gave him temporary relief. Fascial and cranial work were ineffective.
Early one morning after a sleepless night he went to the hospital. He quietly slipped out of the house and found that a blizzard had encased his car in thick ice. He cried as he scraped off the car. With one hand he shoveled to the end of the driveway.
The ER doctor agreed with my assessment, gave him drugs to bring down the pain and inflammation, and said, "Good luck." At least the prescription dulled the pain.
I gave him ultrasound treatments three times a day. Soon he began to improve and could perform range of motion exercises adequately to avoid a frozen shoulder. His therapy continues.
Through out treatment he was irritable and had difficulty concentrating, but I know him well enough to say that's not what he's really like. He was impatient with the healing process because, beyond the pain, he was stressed about losing his job. He was grateful that his wife took up many of his family responsibilities while he was debilitated, but then he felt useless.
Such feelings are not at all unique to this man's experience and, yes, there are many worse things to suffer. In the end, money and cures are finite, but compassion is endless. Spread it around. Pain teaches compassion, though suffering should be optional.
None are immune to pain. We can take steps to insulate ourselves, but stuff happens. Some day, you may be the one on the table in pain hoping your therapist is brilliant and fully engaged that day. You may wonder if this is the time you won't get better.
And yes, if you haven't guessed, I was the patient. Robert Chute is a columnist and regular contributor to Massage & Bodywork. Contact him at email@example.com.