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-----Oorspronkelijk bericht----- Van: John Kropf <[log in to unmask]> Aan: [log in to unmask] <[log in to unmask]> Datum: zondag 16 mei 1999 12:40 Onderwerp: joint pain Hello John, >> The severe joint pain especially my left shoulder (originally dx as rotator cuff inflammation) << The shoulder is different from other joints in the way the bones forming a joint are connected. Most joints are kept together by muscles and ligaments. To allow the shoulder it's natural extreme mobility, it's mainly kept together only by muscles, known as the rotator-cuff. So where other joints can rely on ligaments too, the shoulder only has it's muscles. PD has a main effect on the coordination between muscles. Therefor PD often is first noticed in the joint that relies mostly on muscles only: the shoulder. >> -for the first 2 weeks on sinemet the pain was gone. << Sinemet is helping the muscles to work in a more natural relaxed way, so the pain gets less. >> NOW IT'S BACK. Many of my joints click and snap . << With the Sinemet the muscles started to move the more or less frozen joints better and more again. Only the other tissues in your joints need more time to adjust to this new situation and give a signal to slow down: pain. Clicking and snapping are the joints, capsulas and ligaments protesting that they are not yet enough adjusted. So don't overdo it, give your body the time to adjust and do your exercises ,but not too intens. And use a relatively long time for warming up and relaxing exercises. If you worry about the right exercises for your situation, get help from a physical therapist. This adjustment may take a while (2-6 months). If the pain persists after 2 months you should consult your physician to exclude other causes. Hans.