Q: My 32 years old wife is suffering from severe pain in the left shoulder since a month, which extends till her neck. She is taking medications for the same. She was diagnosed with cervical disc disorder. What does this mean? Can it be cured by medicines? She is also a diabetic for the last 4 years. She is taking Neurorubine Forte and Celebrex 200 mg for 10 days twice a day and applies Voltraren gel twice daily. Please advise.

A:Usually in case of cervical disc disease patients have some degree of pain in the neck, the pain is mild in nature and should at least to some degree respond to the pain medications. With the degree of pain that you are describing I doubt that she only has cervical disc disease. She might be having a condition called adhesive capsulitis. Adhesive capsulitis is more commonly known as frozen shoulder, and with good reason: It can render your shoulder so stiff, its almost impossible to button your shirt. Frozen shoulder usually begins innocently enough. Your shoulder is bothering you, so you don't use it. From there, it becomes a vicious cycle. If your joint begins to stiffen up, its more difficult and more painful to use your shoulder. So you use your shoulder even less. Your shoulder gets more and more stiff, and eventually, the lining of the joint gets stiff. Once that happens, you wont be able to move your shoulder much, even if you want to. It simply won’t budge past a certain point because of pain and stiffness. Diabetes is also a risk factor for frozen shoulder, although precisely why that's so is a subject the medical community is still researching. Frozen shoulder has several stages. First, there is the painful stage. There is a general ache in the shoulder, and your muscles might spasm. The pain may be worse at night. This stage can last anywhere from a few weeks to eight months. The next stage usually isn't as painful, but the shoulder does become more stiff. This is when the ligaments shorten and do not stretch, causing you to lose mobility in your shoulder. This stiffening stage can last from two to six months. Third is the recovery stage. Please be aware that there are lots of different reasons for shoulder pain, and a torn rotator cuff is another important condition that should be ruled out. Patients with diabetes can also suffer from a condition called neuropathic pain which responds to a drugs like neurontin ( gabapentin ) or lyrica (pregabalin ). Your doctor will be able to differentiate between these conditions after a thorough physical examination. Physical therapy should be the first treatment attempted for frozen shoulder because lack of use and motion is what leads to stiffness. Keeping the shoulder moving, to work the stiffness out of the ligaments and tendons so adhesions can’t form is the way to go. I would suggest you to see a good physical therapist for shoulder exercises. If the pain is unrelieved even after couple of weeks of physical therapy the next thing to do would be an MRI of the shoulder to better define the problem.