Shoulder PainThe questions below were raised by visitors to the STOMP (Straits Times Online Mobile Print) website in the AskST section of the website. eMenders doctors provided the answers to the questions raised as a public health education project. The information provided below is of a general nature and should not be treated as a replacement for medical advice. You should seek consultation from a medical or healthcare professional about your specific medical condition.
Question:
I have been experiencing mild pain for almost about half a year in the following areas: shoulder blade, area below my thumb and heel. When I'm lying down or when I sit for some time, I feel pain at the hipbone and on the left side of the body. I'm 53 years old and am menopausing. My BTM for L1-L4 is 1.056 n L Hip 1.007. Please advise me.
Answer:
In perimenopausal women with non-specific pain in the joints, the possible diagnosis considered by her doctor would be:
(1) Arthritis: This requires a blood test to assess.
(2) Osteoporosis: That is why the bone density was done. Unfortunately to interpret this adequately, we need the full report.
(3) Non-specific symptoms related to early menopause. This should be looked into by the family doctor or gynaecologist to see if medication is appropriate.
In all these conditions, the patient should remain as active physically and mentally as possible. Exercises such as Tai Chi, pilates, yoga, walks, gentle aerobics (non-impact)and breathing exercises should be considered as they improve general muscle tone and give the patient a more positive outlook.
Arthritis, depending on type and severity, may need medication. However these should be used at the judgement of a doctor as they can cause complications such as gastric/kidney disturbances and disturbances in blood pressure; especially if the patient is on blood pressure control medication.
Definitive osteoporosis should be treated with medication and appropriate exercises. If it is osteopaenia, the patient has to discuss with her doctor as to the presence of risks factors which will determine whether she requires treatment.
The internet contains a lot of information about osteoporosis. A very comprehensive but complicated paper is put out by the National Institute of Health (US) at:
http://govinfo.library.unt.edu/ota/Ota_1/DATA/1994/9428.PDFTo. To know more about interpretation of the bone density scores, there is a good article at: http://www2.aaos.org/aaos/archives/bulletin/aug99/osteo.htm
DR. YEO KHEE QUAN is a Consultant Orthopedic Surgeon at the Mount Elizabeth Medical Centre. He is also a Visiting Consultant at the Singapore General Hospital and a Clinical Teacher in Orthopaedics at the National University of Singapore.