The shoulder patients who walk into a Kolkata clinic mostly tell one of three stories, and the treatments could hardly be more different. The first cannot fasten a blouse hook or reach the back pocket — the shoulder has simply stopped turning. The second can move the shoulder but pays for it above a certain height, and sleeps badly on that side. The third lifted something, felt something give, and now the arm will not raise properly at all. Frozen shoulder. Impingement. Rotator cuff tear. Getting the label right is most of the battle.
Dr. Pradyumna Chakraverty — MS Orthopaedics, KPC Medical College, Jadavpur, and Assistant Professor of Orthopaedics — assesses and treats the painful shoulder at his Behala and South Kolkata clinics, operating arthroscopically on the minority that need it.
Adhesive capsulitis inflames and then contracts the capsule around the joint. It is dramatically more common in diabetics — often the shoulder is what brings undiagnosed diabetes to light, so a sugar check is part of the work-up. The disease moves through phases: months of pain, then months of stiffness, then a slow thaw. Two truths anchor treatment. It almost always resolves; and proper treatment — anti-inflammatory cover, a well-placed injection where appropriate, and graded capsular stretching done daily — shortens the sentence considerably. What does not work is rest, which feeds the stiffness, or forceful massage, which feeds the pain.
Four tendons wrap the ball of the shoulder and power its lift and rotation. They fray with age and can tear with injury. Impingement — the tendon catching and inflaming under the bony arch — announces itself as pain on overhead reach and on sleeping on that side; it is mostly treated with physiotherapy that restores the mechanics, sometimes an injection. Tears divide by story: the degenerative fray in an older shoulder often does well with strengthening alone, while a full-thickness tear in an active person — especially after a distinct injury — is usually repaired arthroscopically, because tears do not stitch themselves and retracted tendons become harder to repair with time.
Kolkata shoulders arrive late — after months of balms, belts and tolerated night pain. Come earlier if the shoulder cannot reach overhead or behind, if pain wakes you repeatedly, if the arm weakened suddenly after a lift or fall, or if you are diabetic and the shoulder is stiffening. Early diagnosis costs a consultation; a late-presenting retracted cuff tear can cost the chance of repair.
Inflammation and tightening of the joint capsule, moving through painful, stiff and thawing phases over months. Strongly associated with diabetes; usually resolves, faster with treatment.
In frozen shoulder nobody can move the arm fully — the joint is stiff. With a cuff tear, the examiner can often raise the arm even though you cannot. Examination makes the call.
Rarely — most cases respond to medication, an injection where appropriate, and graded stretching over months.
Not all. Many degenerative tears do well with physiotherapy; repair is for full-thickness tears in active people and painful tears that fail conservative care.
Lying on the arm compresses the inflamed tendon and capsule. Pain that consistently wakes you is a reason to be examined.
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