Reason for Visit: s/p ESI X 24 visits; Right Shoulder Pain (Teres Major and Teres Minor Pain)
S: Aerotek TM completed total of 24 ESI visits without improvement. TM reports his right shoulder pain mostly in the Teres Major and Teres Minor area. TM also reports an intermittent pain in the infraspinatus, posterior deltoid and triceps areas. TM rates his pain at rest 3/10 and when he working with his tools can be at 6-7/10. TM denies any numbness, tingling sensation, or loss of movement in his right upper extremities. He is taking acetaminophen and naproxen as ordered.
O: Right Shoulder: Reports increased in pain with adduction, extension and inward rotation of the right shoulder. Reports tenderness to AC joint with palpation reports increased
S: Aerotek TM completed total of 24 ESI visits without improvement. TM reports his right shoulder pain mostly in the Teres Major and Teres Minor area. TM also reports an intermittent pain in the infraspinatus, posterior deltoid and triceps areas. TM rates his pain at rest 3/10 and when he working with his tools can be at 6-7/10. TM denies any numbness, tingling sensation, or loss of movement in his right upper extremities. He is taking acetaminophen and naproxen as ordered.
O: Right Shoulder: Reports increased in pain with adduction, extension and inward rotation of the right shoulder. Reports tenderness to AC joint with palpation reports increased