The pain is the most important, the least overlooked patient's
problem. From this point of view, it would suffice to watch this symptom, which
would reflect an influence of therapy, and an eventual adjustment of the
affection, at most of acute pains in the shoulder girdle. But unfortunately at
chronic affections we meet (especially at patients with rheumatism) the fact
that patients used to the pain, and therefore we cannot rely on this symptom. A
slowly damaging process in the area of
the shoulder girdle can be connected only with a little soresness. At present
locally applied steroids are the biggest possibility of the distorting of the
pain as a symptom of the gravity of the state. Steroid is able to decrease the
soresness of all inflammatory diseases of the shoulder girdle even if it is
applied without looking. An effect of steroid alleviates life of many patients.
Most patients accept the pain, and they used to the restriction of movements (a
feeling of successful therapy is often supported by a claim of a doctor that the
problems obligatory last about 1 year, and the patient has to suffer through
them as the others…be glad, some patients cannot move with the arm at all
etc.). The patients are surprised much more with results of steroid therapy when
an ultrasound is used, when they perceive with an amazement which problems they
had before. Above mentioned reasons force us to a watching of the effect of the
therapy not only in the decrease of the pain felt by the patient (the effect of
therapy lies in a complete!!! absence of the pain in our outpatient department),
but mainly in the watching of the extension of the movement. But this undertakes
to take detailed notes which have to enable us a comparison of the patient's
state in the coarse of several years, see zero
method.