Q: After three months of both severe shoulder pain, after two falls, I requested an x-ray. The results were that I have Oesteopenia. The pain is severe and wakes me up in the middle of the night. What should my next step be in order to lessen the pain?
 
A: Osteopenia is a mild thinning of the bones and can be suggested by an x-ray but needs to be diagnosed by a tested called a bone density scan (T score between -1 and -2.4). Osteopenia does not cause pain and is not related to your shoulder pain. If the X-ray did not show arthritis in your shoulder and if your primary care physician can not determine the etiology of your shoulder pain, you should see a Rheumatologist or an Orthopedic surgeon. Possibilities for your shoulder pain include arthritis in the shoulder joint, bursitis, inflammation of the biceps tendon as it inserts into the humerus, rotator cuff tear or pain radiating from the neck if you have cervical spine arthritis. You might need an MRI. Treatment will depend on the underlying etiology of your pain and options may include steroid injections, anti-inflammatory medications, exercises, nerve blocking or narcotic pain medication and surgery.
 
-Dr.Amal Mehta
  

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