Back when I was having shoulder/rotator cuff issues that stemmed from muscle imbalance and overuse (paddling a surfboard), I had to see the GP and get the PT referral, then I did the PT thing for 6 weeks, before I got the OK from insurance provider to go see an Orthopedic Surgeon. He said he can go in there and shave off some bone which is causing the impingement. Looked like he was salivating at the chance to cut into me.
That first, and only Visit, I wound up getting a cortizone shot. When he got the needle into the joint, fluid squirted out under pressure all over his lab coat before his thumb got near the plunger, and right afterwards it felt better. He gave me 2 weeks worth of hydrocodone saying it would feel like I got hit with a sledgehammer the next day and to fill the prescription that day and start taking it to head off the pain .
The pain the next day was nothing, I never filled the opoid prescription, and I was soon surfing again.
That was my left shoulder. Some 5 years later, my right shoulder became painful in the same exact manner. Without insurance this time I went straight to an Orthapedic surgeon asked for cortizone, but of course had to get X rays and pay out the keester for it while being irradiated over and over again by xray techs who looked like they had about 2 IQ points combined and could not get a clear image of my shoulder. Finally got the Cortizone shot, but no fluid ejection under pressure that time on that shoulder. That was in 2003 but the pain disappeared soon after and I could begin to use it again.
My only shoulder problems since are from hyperextension, by holding onto a 25Lb surfboard going over the falls on a tubing wave, and not being able to hold onto it tightly enough. It was getting worse with only rest and Ice. I had to keep using it, and adjusting my paddling stroke to minimize impingement/ clicking, and soon was able to do the 6 Lbs of weight circles thing.
Muscle imbalance is at the the root of many joint issues, in my opinion, even after an obvious incident/ injury, as one quickly learns how to avoid using musces which cause the pain. Surfing made my back and neck muscles much stronger than my upper chest muscles, and my youth and impatience kept me from learning to stretch properly and actually stretching on the beach before applying 100% of available torque to my shoulder joint when paddling for a wave, and surfing is 95% paddling.
Just beware that Docs are not there to cure you, they are there to extract as much money as possible from 'treating' you. Hippocratic oath my keeester, unless it has changed to 'do nothing but that which ensures maximum profit.'
Max profit includes kickbacks from Big Pharma for every prescription they write, and people love to believe that the cure requires only swallowing some magical hyper expensive pill, whose long term downsides are completely unknown. Basically one gets to pay for the privilage of being a labrat, when a placebo usually can work just as well.
