Dr Bernadette Carr answers your questions on shoulder pain and squinting

I was putting some boxes up into the attic last week and I think I may have injured my shoulder. I have pain in my shoulder with ‘pins and needles’ down into my arm to my little finger. Could I have tendonitis?

Shoulder pain is a common condition. As the symptoms you are experiencing occurred after a particular activity it is possible you have rotator cuff tendonitis. Tendonitis is an inflammation of a tendon that may be the result of an acute injury rather than long term degeneration from repetitive movements in either your work or sport.

A common form of shoulder pain, rotator cuff tendonitis is an inflammation of the tendons of the rotator cuff muscles. The onset can be sudden and painful, particularly if you try to lift your arms above your head. This condition is also known as impingement syndrome and painful arc syndrome.

The rotator cuff is a group of four muscles around the shoulder joint, which stabilise it and help with joint movement. There is a tendon attached to each muscle and the four of them form one large tendon. It passes through a small space called the subacromial space to attach to the top of the humerus.

The treatment for tendonitis has a number of elements:

* It is important to rest the joint and to avoid a repetition of the activity that may have aggravated the tendonitis.

* Painkillers such as paracetamol or an anti-inflammatory such as ibuprofen will help to ease the pain and inflammation.

* You need to find a balance between rest and movement of the joint so that it does not stiffen. Occasionally physiotherapy or steroid injections may be advised by your GP.

With a combination of rest, some movement and medication, the symptoms should settle. Given your symptoms — pain and pins and needles — I would advise you to make an appointment with your GP, who can examine your shoulder, make a diagnosis and advise on the appropriate treatment. Your GP may refer you to see a specialist if needed.

I have a 10-month-old daughter and noticed recently that when she looks down her right eye seems to turn in, although it doesn’t happen all the time. Could she have a squint?

It is possible your daughter may have a squint but in a child of her age there may be other reasons, babies sometimes cross their eyes when they are tired. Strabismus (sometimes called a squint) happens when the eyes do not look together in the same direction. This is usually because of an imbalance in the muscles that align the eyes. Movement of the eye is controlled by six muscles that pull inwards, outwards, upwards or downwards. It is quite common and can affect as many as one in 20 children.

Less than one per cent of childhood squints are recognised by parents and it usually develops before the age of three. Sometimes one eye is turned all the time, in other cases it only happens when the child is trying to focus. The earlier the problem is diagnosed the easier it is to treat. If left untreated, the brain stops recognising signals from the weak eye and a ‘lazy eye’ can develop as the vision in the affected eye does not develop fully.

Strabismus can sometimes run in families so even if a baby or young child does not have a squint it is advisable to have their eyes checked by the time they are one year old and again when they are three. This is usually done as part of the routine developmental check. Intermittent deviation of the eyes is a quite common finding in healthy babies and should not cause undue concern.

As it is important that a squint is diagnosed as early as possible, I would advise you to make an appointment with your GP who can examine your daughter and advise on appropriate assessment and treatment.


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