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Anon. asked...

Chronic shoulder pain

I have had chronic shoulder pain for the last 6-7 years (started following a broken elbow and frozen shoulder). Having had many consultations (musculo-skeletal, pain management, rheumatologist) and a tried a wide variety of treatments (trigger point and other steroid injections, phuysio, myofascial release therapy, ostepathy, pilates, acupuncture, etc etc, I have finally been told that there is nothing the matter (physically) but I have developed what I believe is called nerve sensitization. Interesting, the pain always goes away at night (so doesn't keep me awake) but returns most days (and sometimes affects my hand). It has been recommended to me that I should press on with exercise (strengthening, stretching and CV) but that I might also benefit from 'Mindfulness'. I wondered if you can possibly think of any option I haven't explored, explain the meaning of 'CNS sensitixation) and your thoughts on Mindfulness (as I see there is a #TryIt challenge coming up). I am an anxious person, but I have never responded well to CBT or hypnotherapy. Thanks a lot.

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The answer

CNS sensitization is a neurological condition caused by injury or malfunction of the Central Nervous System. The extent of the pain and areas affected can be related to the cause of the initial injury. Pain can be in one specific area or all over the body.

Pain is typically constant and can be moderate to severe. This will primarily lead to referral to Pain Team specialists. Tricyclic antidepressant medication and neurogenic medications have also been proven to be helpful as well as physical therapies, exercise and use of hot/cold packs. Lowering stress levels have been shown to help reduce pain, so this is probably why you were referred for CBT, this has been proven to be very helpful with chronic pain issues and chronic conditions.

Mindfulness is described as paying attention in a particular way, in the present moment and non-judgmentally, essentially changing how you think about your pain. There is evidence that this has been good for some people and proven to be helpful, but there is no way to know if this will be beneficial for you, it is something you will need to try yourself to find out if it will help you. You appear to have tried most therapies in relation to your pain management, acupuncture is another option in pain management you have not mentioned, if you have not tried this it may be something you may want to consider. Hopefully this will help you.

Answered by the Health at Hand nurses  

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