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Contidions Treated

Upper Limb Pains in Shoulder, Elbow & Hand

BUT at Ashirvad we have developed a sequential therapy of injections into muscles and bursae around the shoulder followed by IMS and Physical therapy. The patient becomes comfortable on the 1st day of treatment . As the sessions of IMS are carried out the range of movement becomes free and unimpeded by stiffness. When the muscles , their relative movements and the dynamics are taken into consideration to perform an anatomically guided IMS all these patients become pain free with 2-3 sessions of IMS and then with further IMS the restriction of movements resolves with another 7-8 sessions . Though the pain is relieved quickly the whole treatment may take about 4-8 weeks for complete resolution instead of the usual 18 months.

One major problem observed in our clinic is that many of these patients have deficiency of vit D3 and / or Vitamin B12. Unless these deficiencies are corrected the problem is unlikely to resolve completely.

Athletes may also develop this because they use their muscles and joints at the extremes of their movement and beyond. As a result they may develop muscle tendon tears or tears in the ligaments around the joint. This can lead to major discomfort and restriction of movements.


Pain on lifting the arm
Pain on lying down on the affected shoulder
inability to do overhead activities
inability to lift objects
Sudden severe shooting pain in the shoulder and down the arm forearm to the base of the thumb triggered by simple movements at the shoulder.
Severe restriction of all movements of shoulder especially the reaching back of internal rotation and abduction.
Considering the use of the hand in man, these problems significantly affect the Quality of life.

Causes can be:

1. "The Frozen shoulder or freezing shoulder in the process of evolution" Mainly muscular in origin with Muscular weakness
2. Shoulder joint arthritis ( not very common except in the 6-7th decade onwards
3. Cervical spondylosis resulting from entrapment of the nerev roots as they emerge from the neural foramina in the neck. These irritated nerves refer the pain to the shoulder
4. Entrapment of Nerves on their way to the shoulder muscles ( suprascapular nerve or axillary nerve etc).
5. Rotator cuff injuries( fairly common in athletes but also seen in the elderly )


Treatment offered is largely non invasive, with a combination
1. Medications
2. Correction of deficiencies
Injections into muscles bursae and specific joints under USG guidance . This guidance ensures accuracy in that injections reach their target under vision . We attribute our instant success in pain relief in shoulder problem to this accuracy by using USG
3. Muscle healing with IMS,
4. Manual therapy and extensive patient oriented rehabilitation. As a part of physiotherapy.
5. We would also recommend you to an arthroscopist/ shoulder specialist if your condition warrants further care.