This is a transcript of a Dr. Jay Show broadcast on 1560TheGame in Houston, TX. Shoulder Specialist Dr. J. Michael Bennett is a Board Certified Orthopedic Surgeon and a Fellowship Trained Sports Medicine Physician serving patients from Katy, Fort Bend County, Metro Houston and Southeast Texas from offices in Sugar Land and in Houston, near the Galleria. Call 281-633-8600 for an appointment.
Our special guest for the show was Dr. Benoy Benny. He is a physical medicine rehabilitation physician, and he is board certified for pain and spine as well as for minimally invasive procedures in spine. He’s also a professor at Baylor College of Medicine.
Here’s the transcript of the fourth section of the Show answering a caller question about shoulder bursitis treatments:
DR. J. MICHAEL BENNETT: We’ve got some callers here that are waiting on the line and we want to go ahead and get our first caller here. This is Barry. Barry, what can we do for you today?
CALLER: I may be calling a little off topic but I figured you guys have probably dealt with everything. I have some bursitis in a shoulder and I took anti-inflammatories and it got better, then worse. I had a cortisone shot, it felt better for a little bit but now it seems to be back. And I was wondering if it’s possible that the cortisone shots missed, or what the next step might be.
DR. J. MICHAEL BENNETT: You were talking about the bursitis in the shoulder. With regard to the injection in the shoulder, subacromial bursitis is a very common diagnosis. There’s a little fluid sac above the rotator cuff tendon which is between the bone of the shoulder – the acromion – and the rotator cuff, which is the tendon underneath. The fluid sac allows you to maintain mobility but sometimes that fluid sac gets inflamed and thickened and what we do typically is give you a steroid shot to see if that decreases the inflammation. My personal protocol is if I have a patient that has that and they’ve tried anti-inflammatories at home, I’ll start with a steroid injection and maybe just a little bit of rehab and give them about three to four weeks to see how they respond. If they’re not any better at that point then I suggest that maybe there’s something more going on than just a bursitis.
If you’re having pain at night, pain with overhead activities, weakness, and this is all abnormal for you, then I’d suggest an MRI at that point because then you start worrying about a rotator cuff tear. And if that’s the case, it’s probably why your injection did not respond accordingly, as if it were just a bursitis. Because most bursitises are going to go away with a little rehab and something to address the inflammation. But if there’s something mechanically wrong with your tendon there, like a tear or a partial tear or something along those lines, you’re going to see that in an MRI. I’d highly recommend that you follow up with our doc, or like I said, go to our website and check us out, and basically follow up regarding your shoulder if you’re still having pain because it should have resolved if you just had an injection and tried some therapy if it’s just a bursitis.
BENNY: The other thing I think the caller was asking also is could the injection have missed? And I think that’s a good question. I think it’s a pretty simple injection we do as orthopedists, it’s a very common injection. Nowadays, Jay I know does it and I do it as well, use ultrasound guidance sometimes to be able to place the medication – the steroid – and the local anesthetic in that area. Depending on the type of injection the use of ultrasound is more or less common. The injection for the subacromial bursitis is a pretty common injection so it should have been placed in the right area.
DR. J. MICHAEL BENNETT: Yes it’s a pretty easy area for the most part to get into.
If you’re experiencing a shoulder problem or you have questions about the information presented here, please call our office at 281-633-8600.
