1. Listening to the Patient
The 2 main reasons why a patient comes to see us are:
- Night pain causing insomnia
- A dislocating shoulder
I. Night pain is the primary reason for consultation — the patient is woken every night by pain in the shoulder and arm when sleeping on their side.
It is important to learn more about the patient consulting for this pain that is depriving them of sleep:
- Age
- Painful side, dominant side (right- or left-handed)
- Occupation: office work (computer mouse), sales (driving), manual work (carpenter, mason, painter, electrician…)
- Leisure activities: contact sports (judo, rugby, football), racket sports (tennis), volleyball, handball, basketball, canoeing/kayaking, hunting, fly fishing, DIY, gardening…
- History of a fall, old or recent, on the shoulder.
- Medical history: diabetes, cardiac issues…
What type of pain?
- Gradual onset, often insidious, sometimes sudden, very intense and unbearable (consider spontaneous rupture of a rotator cuff calcification).
- Duration of pain and effectiveness of previously prescribed treatments: analgesics, anti-inflammatory drugs, cortisone injections, ultrasound therapy, rehabilitation, etc.
- Night pain is accompanied by pain during many daily activities: combing hair, washing, getting dressed, fastening a bra, tucking in a shirt,