Q: I am a 42 years old male had an epileptic seizure three months back and since then I am having constant pain in my left shoulder. Due to this, I am unable to sleep on left side. The pain recurred on raising the arms with weights, on pulling seat belt of a car and on stretching back my shoulders. The pain is at the tip of acromioclavicular (AC) joint. I can lift weights but on a particular angle. I also underwent X ray procedure but nothing was diagnosed. I consulted a doctor who asked me to take painkillers. After taking the prescribed medication, situation remains unchanged. What causes persistent shoulder pain? How can it be treated?

A:It is quite common to have shoulder injury during an epileptic seizure. Most frequently, forward or backward dislocation of the shoulder joint with or without fracture is the cause of such pain that is persistent. Otherwise, tear in the muscle or the joint capsule, stretch on the nerve in that region are the usual causes. My first advice to you will be to stop all movements and exercises that cause or aggravate your pain: you may be preventing proper healing by doing these movements. Secondly, you must see an orthopaedic surgeon (preferably a shoulder expert among these) at the earliest, as only a specialist can understand minor or tricky defects on the x-ray. These shoulder problems are treatable, curable in most cases, and your pain will not become a permanent one if the defect is identified and acted upon quickly.

After dealing with the shoulder problem, you should also attend to the root cause: the lesion in brain causing seizures or epileptic attacks. These attacks are usually similar in occurrence, hence may cause similar shoulder injuries in future. To prevent this, proper identification of the type of epilepsy and its optimal control with the right drug/s is advisable. Please see a neurologist for this purpose.