The Mindbody Prescription by John E. Sarno

Author:John E. Sarno [SARNO, JOHN E.]
Language: eng
Format: epub
Tags: BUS058000
ISBN: 9780759521896
Publisher: Grand Central Publishing
Published: 2001-03-15T05:00:00+00:00

Shoulder Tendonitis

The shoulder is a frequent TMS site. Diagnosis can be complicated, as pain in this area may be due to brachial plexus involvement, described in Chapter 4. It is often part of RSI.

The diagnostic history of pain in this region (where the arm meets the shoulder) is interesting. Before the advent of magnetic resonance imaging (MRI), the procedure that allows precise diagnosis of a rotator cuff tear, the most common diagnoses were bursitis and calcium deposits. The latter diagnosis often led to surgical removal. Now the diagnosis made most frequently is rotator cuff tear.

I never thought to challenge that condition as a cause of pain until the following experience with a patient. She was a woman in her fifties who had been treated successfully for back pain years earlier. She called to tell me she had developed pain in one of her shoulders and had consulted a number of the best orthopedists in town. Because an MRI showed a rotator cuff tear, she had surgery. Now, although the pain was relieved, she was beginning to experience the same pain in the opposite shoulder and wondered if this could be a manifestation of TMS. I said I thought it likely and arranged an appointment for an examination. She came in a few days later and reported that the pain had disappeared overnight after we had talked. There was still mild tenderness when I pressed on one of the tendons at the shoulder.

This was an important experience for me. To be sure, torn tendons require repair, especially in athletes like baseball pitchers, but here again is a situation where doctors treat X rays rather than patients. It is my practice now to treat shoulder pain as TMS if a painful tendon is found on examination. Moreover, the medical literature suggests that rotator cuff tears may be part of the aging process, like the arthritic changes in the spine that are always mistakenly blamed for pain.

I have often said that the MRI has been a mixed blessing for people with pain syndromes. The herniated disc, the torn meniscus in the knee and the rotator cuff tear at the shoulders, all dependent on MRI for identification, have resulted in much well-meaning but needless surgery.

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