### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Left Shoulder injury of a right handed person. An ultrasound has verified that I have severe diffuse subscapularis tendinopathy, however no significant partial or full thickness tear is evident. There is minor infraspinatus calcific tendonitis. There is moderate supraspinatus tendinopathy & a very small bursal surface anterior supraspinatus tendon tear immediately adjacent to the biceps interval, 9 x 5 x 3mm & mild thickening of the subacromial bursa, 2.2mm on abduction. I had a bursal injection & taken Celebrix & switched to Proxen. I have obtained no pain relief & becoming very frustrated at the lack of use of the shoulder & the extreme pain caused by some (normal) movements. I ride a road bike (upright - not racing) to & from work daily & doing it gently, to minimise bumps to the shoulder. If the anti inflammatory drugs are not working, is it because there is no inflammation but there is another problem. Could it be pinched nerve & if so, how is it corrected. I m seeing an Osteo who is massaging the muscles around the area & avoiding the shoulder itself. I welcome any ideas on what the problem may be & the appropriate course of action. thanks Peter

### output:

Thanks for the information. Depending on time since injury initial immobilization in a broad arm sling for 2-3 weeks is necessary to heal minor tears, bursitis,afterwards active shoulder exercises are begun very gently intermittently along-with oral anti-inflammatory for the period of pain. Gradually sling is discarded for longer periods of time intermittently. The process may take as long as 6 weeks to heal completely. After six weeks normal shoulder activity and muscle building exercises are indicated to bring back strength of shoulder.Also, any diabetes should be ruled out with blood and urine tests think it should heal with this regime