Q: I had gone for surgery of rotator cuff last year and the doctor said that it was due to excessive strain on computer. My problem started with spondylitis then shoulder and elbow pain. I consulted many doctors, went for too much physiotherapy and ended with a shoulder surgery, with a hope that it would end my misery. But the pain still persists in the neck, shoulder and elbow. Kindly let me know what should I do? I do not believe in taking pain killers because I feel that they are not a solution and can just relieve pain.

A:You will need to have a little more patience and will have to work hard on your shoulder. Rotator cuff injuries are very painful and need a lot of care. I will still advise you to go to a physiotherapist as your joint must have been stiff and you must also have developed weakness in your muscles and this must have been the reason for your present painful situation. You should go for some short-wave diathermy sessions and passive exercises followed by assisted active exercises and then active and resisted exercises. Your physiotherapist will guide you on this. Please do not attempt anything on your own till your shoulder has full passive range or you will again get into the viscious circle of a painful joint. Preventive Measures: 1. Avoid sudden lifting of heavy weight. 2. Avoid strenuous abduction and flexion of the shoulder. 3. Avoid repetitive movements of the shoulder 4. Hanging your arm by the side of your body for a longer period will put strain on your rotator cuff muscles. A sling for hand is advisable to avoid pain. Pain killers are not the solution as you have rightly mentioned. Taking a pain killer to be able to get some range of movement with the physiotherapist will be beneficial. Once a certain range is obtained your joint will be free and the pain will be less and you will be able to manage the exercises better. For the first few sessions, you can take a pain killer half an hour before your physiotherapy session.