DEAR DR. DONOHUE: About three months ago my right shoulder started hurting. I did not injure it. The pain kept getting worse, and I started taking Aleve, which helped me for a while. Now I can barely move the shoulder. What can I do to get it moving again? – B.Z.

ANSWER: My bet is you have what is called a frozen shoulder. The sequence of events goes something like this. A shoulder starts to hurt. Shoulder injury is only one of many causes for such pain. Those with painful shoulders make a point of not using them. With disuse, strands of scar tissue bridge the shoulder joint. In time, the scar strands become so thick and tough that moving the shoulder is impossible.

How to restore shoulder motion requires determination, patience and adherence to a supervised program of physical therapy. You are not going to be successful on your own. You need a doctor.

When rehabilitation gets under way, it starts out with simple exercises. One is bending over at the waist. The good shoulder and arm rest on an adjacent table for support. The bad shoulder and arm are dangling downward. The patient starts by making small circular movements with the bad arm and shoulder. Small pendulum movements are also useful. With each exercise session, the amount of movement is increased. In addition to increasing the range of motion, holding a weight in the hand is helpful.

Injecting cortisone into the joint can assist the release of the shoulder from the scar tissue that holds it immobile.

In resistant cases, a doctor can manipulate the shoulder while the patient is under anesthesia. The forceful manipulation breaks the scar tissue.

In even more resistant cases, surgical release of the shoulder might be the preferred treatment.

The outlook is good. At most, only 10 percent of patients are left with a permanent disability.

DEAR DR. DONOHUE: I am a healthy 52-year-old woman who underwent a somewhat harrowing experience about a month ago. I lost all memory of one day. It’s like I left the planet for 24 hours. My husband says that I looked confused but could respond to his questions.

I consulted a neurologist, who made the diagnosis of transient global amnesia. Please put my mind to rest about this. – C.M.

ANSWER: Transient global amnesia is a frightening experience, and it is not an uncommon one. People suddenly lose all memory but remain responsive and repeat the same questions over and over. Naturally, they appear confused.

The spell lasts from a few hours to a whole day. Then memory returns, and the confusion goes away. People who have had one of these episodes cannot recall what happened during this event.

I would like to give you an explanation of why this happens, but a good explanation is not available.

It is comforting to know that this is neither a stroke nor a prelude to a stroke. Only a few people ever have a repeat occurrence.

DEAR DR. DONOHUE: I take my pulse often, and it runs about 55 when I am at rest. I don’t know how fast it gets when I am working. I do hard physical labor and am in good condition. This bothered me so much that I saw my doctor, who said I have bradycardia. Is this a serious condition? – M.O.

ANSWER: The normal pulse rate at rest is 60 to 100 beats a minute. The pulse and heartbeat are the same. When the heart contracts to eject blood into arteries, the jet of blood is felt as the pulse beat. It’s easy to feel in many arteries, but the one at the thumb side of the wrist is usually the place chosen.

“Bradycardia” means a slow pulse. It says nothing about the cause, nor does it say anything about the implications of a slow pulse.

Conditioned athletes have slow pulses when they are at rest. Their hearts pump more blood with each beat, so fewer beats are needed. You most likely fall into this category. If you have no symptoms, like dizziness or fainting, the likelihood of dangerous complications from bradycardia are slim.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

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