I can't say that Sinemet is the solution for frozen shoulder.  My frozen
shoulder started after about three weeks of use of Sinemet.  I have had no
previous injury to the shoulder.  The effective shoulder is the opposite of
the PD side.  I believe the frozen shoulder is due to either  PD or Sinemet.
[log in to unmask]
----- Original Message -----
From: "janet paterson" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Tuesday, April 17, 2001 9:10 PM
Subject: pd and shoulders redux


> >>> Posting number 056006
> Date:         Wed, 3 Feb 1999 09:45:17 -0500
> From:         janet paterson <[log in to unmask]>
> Subject:      Re: new member / reply to david thurston
>
> hi david
>
> you wrote:
>
> >Hello list members,
> >I was diagnosed with PD less than a month ago. I have a shuffle in my
> >gait on the left side and some loss of dexterity in left hand with a
> >very very slight tremor. I can live with these symptoms with minor
> >adjustment to the way I live. The main symptomatic problem, for which I
> >had sought medical attention in the first place, is a painful "frozen
> >shoulder" with severly restricted range of movement of my left arm. I am
> >told that this is a separate issue from PD, but that the latter's
> >tendency to tighten muscles of neck and shoulder could be causing lack
> >of response to physical therapy for the shoulder joint. Therefore
> >starting PD medication, why not yet strictly necessary, could benefit
> >this condition.
>
> what kind of medico made your diagnosis - a movement disorder specialist?
> i disagree with the idea that 'frozen shoulder' is separate from pd
> i believe that it is a symptom of the muscle rigidity of pd
> [i relate it to a permanent cramp]
> and also believe that levodopa would ease it
> been there done that
>
> >I have not started medication yet because of another worry: In order to
> >get a balanced understanding on what was happening, I sought a second
> >opinion from another neurologist. Result: complete confusion. One
> >recommends that I commence with dopamine agonist Pergolide, the other
> >(who knows about the other's recommendation) favours levodopa in the
> >form of Madopar. Both tell me it is my decision. These are two reputable
> >medical men, when the time comes that I feel I am ready for the
> >commitment, which course do I choose? Not so much that, how, as a
> >layman, do I choose?
> >Dave Thurston
>
> go back to both, tell them of both opinions
> and ask them to explain their reasoning to you
> ask them how much experience [how many patients/at what stages]
> they've had with pd
>
> you can be a layman no longer
> you have to become your own best advocate
> this kind of disagreement and ignorance about pd will not stop here
> pd ignorance among medicos can be fatal as we have seen on this list
>
> the best kind of pd info in the world is here in our archives at:
> <http://james.parkinsons.org.uk/>
> as maintained by simon coles
>
>
> janet
>
>
> >>> Posting number 056013
> Date:         Wed, 3 Feb 1999 10:48:16 -0500
> From:         janet paterson <[log in to unmask]>
> Subject:      Re: new member / frozen shoulder
>
> hi all
>
> jeannette wrote, in part:
>
> >...I, too, had a frozen and painful left shoulder and after
> >unsuccessful cortizone shots by MD was referred to a neuro who
> >after a process of elimination diagnosed possible PD and SINEMETCR
> >therapy began and I returned to exercising and my shldr improved.
> >Was the improvement from exercise or SINEMETCR or both?  I don't
> >know.  Probably some of both....
>
> i would venture a guess that it was the dopamine in the sinemet
>
> if i am dopamine dis-advantaged
> a repetitive movement like typing will become slower and slower
> as the muscles involved get tighter and tighter
> [which is what i relate to a muscle cramp]
>
> i can't imagine trying to exercise an already cramped muscle
> but i could be wrong here
>
> in my case this tightness can only be relieved by meds:
> when dopamine-enhanced,
> i find that my tight muscles 'melt' and 'loosen' back to normal
>
>
> janet
>
>
> >>> Posting number 092447
> Date:         Fri, 16 Feb 2001 12:23:31 -0500
> From:         janet paterson <[log in to unmask]>
> Subject:      Re shoulder pain / Doctor David Grimes times two
>
> hi all
>
> At 13:23 2001/02/16 -0330, Anne Rutherford wrote:
> >Many years ago when I was seeing one of the doctors  at the
> >movement disorder clinic in Toronto  he mentioned a small
> >study they had just finished  They had asked  clinic patients
> >about shoulder problems such as pain  and stiffness in the
> >years before PD was diagnosed. They were very surprised at
> >the number of PWP who had such problems.
> >Since then I have asked many  PWP if they had needed treatment
> >for shoulder pain and a surprising number said yes.
> >>I don't know if any such research has been written up in a
> >medical journal.  Perhaps one of the great hunters could do a
> >search. Anne Rutherford
>
>
> this is one of the best descriptions i have found:
>
> -------------------------------------------------
>
> Shoulder joint pain is a frequent problem in Parkinson's.
>
> Commonly called "frozen shoulder", it includes pain, a limited range of
> motion, and stiffness.
>
> It occurs becasue of decreased arm swing and shoulder movement.
>
> Frozen shoulder has been noted before the appearance of the main symptoms
> of Parkinson's and it affects the body side first affected.
>
> It is seen more in patients with slowness and stiffness rather than
tremor,
> and has been noted to clear after thalamotomy.
>
> Initiation of anti-parkinsonian therapies (meds) will often improve this
> problem.
>
> Also, range of motion exercises, and moving the shoulder with heat (warm
> shower), will help significantly.
>
> Anti-inflammatory drugs such as aspirin or ibuprofen will help.
>
> If shoulder pain becomes severe and persisitent, a referral to
> physiotherapy or a rheumatologist is recommended.
>
> Biceps dendonitis may also cause shoulder pain and may result from the
> forward shoulder posture that some parkinsonians develop. The patient has
> tenderness of the biceps tendon over the front of the shoulder.
>
> The clavicle and shoulder are often injured in falls and very unpleasant
> chronic shoulder region pain results. This is another good reason to avoid
> falls.
>
> -------------------------------------------------
> excerpted from page 161 of:
> "Parkinson's - One Step at a Time"
> by
> J.David Grimes MD FRCPC
> and
> David A.Grimes MD FRCPC
> [IBSN 0-9694243-1-0]
> First Edition Published 1966
> Third Edition Published 1999
> by
> The Parkinson's Society of Ottawa-Carleton
> 1053 Carling Avenue
> Ottawa, Ontario K1Y 4E9
> Canada
> -------------------------------------------------
>
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> janet paterson ~ [log in to unmask] ~ http://www.geocities.com/janet313/
>
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