Examples include a drug, surgery, exercise or counselling. I now need to do two things: get hold of a walking stick with which to perform the exercises and look for evidence about the benefits and harms of each intervention A treatment, procedure or programme of health care that has the potential to change the course of events of a healthcare condition.

I reject the idea of steroids and resolve to embark on the exercises Sarah has shown me. Before IвЂ™ve even looked at the evidence for each option, my preferences come into play. Injected steroids, manipulation, and exercises. It seems there are a few things that may help increase my range of movement, at least a little, and reduce pain. YEARS! Is there anything I can do while IвЂ™m waiting, other than invent gadgets that will help me do stuff, like hang out the washing (where are you, Grandpa?)? The bad news, this is likely to take one to two years. The good news is that it will resolve by itself. She tells me this isnвЂ™t a rotator cuff problem but adhesive capsulitis. I am a bit horrified at just how limited my range of movement is shown to be. I am fortunate in being able to take myself to a physiotherapist, also called Sarah. Three weeks on and I am more restricted in what I can do and, if I move my arm suddenly, the pain is enough to stop me in my tracks. IвЂ™m reminded of that terrible phrase given to patients (IвЂ™ve become a patient!) like me вЂ“ вЂnon-compliantвЂ™. IвЂ™m reluctant to take the ibuprofen I donвЂ™t want to be taking medication for weeks and IвЂ™m not so sore I feel I have to so, after a few doses, I donвЂ™t. I donвЂ™t do them diligentlyвЂ¦ I do them sometimes, when I remember, and decide to give it a couple of weeks before seeing a physiotherapist.

of the exercises, but resolve to do them diligently. I donвЂ™t feel very confident about the effectiveness The ability of an intervention (for example a drug, surgery, or exercise) to produce a desired effect, such as reduce symptoms.

He mentions that, if it doesnвЂ™t improve, physiotherapy might help. He thinks itвЂ™s a rotator cuff problem and gives me a leaflet showing shoulder exercises for unspecified problems and suggests I take ibuprofen for a week. Next stop, the GPДЇast forward a few weeks, I see a GP. I drop out of my exercise class, although aware that this is not a good move for my general health and fitness, and otherwise carry on as near normally as possible. Instead, I do that thing that forms part of our decision-making about health and much else: I ask other people what they think it might be, and listen to tales of other peopleвЂ™s sore arms and what it was and what they did. But actually, a decision has to be made even at this point should I rest it or use it? I donвЂ™t think вЂsore armвЂ™ will bear much fruit in Google or the Cochrane Library, so I donвЂ™t try the internet. My first choice, on developing a sore arm, is to do nothing and hope it resolves. LetвЂ™s seeвЂ¦ Health choices begin when the problem does Unlike this tidy diagram, these elements wonвЂ™t necessarily make an equal contribution and, as IвЂ™m all too aware, there may not be reliable evidence to inform a decision. The three elements of evidence-based practice Ideally, health choices are made on the basis of three things: the best available evidence from research, the patientвЂ™s preferences and values, and clinical expertise. So, as an example of making everyday health choices, I thought IвЂ™d write about it. It turns out that the reason for all this is that I have adhesive capsulitis, or вЂfrozen shoulderвЂ™. I now wash my hair one-handed and act my age in supermarkets. IвЂ™ve developed a cunning technique for pegging washing on the line, involving a sort of launch-and-slide manoeuvre. On leaving the care home IвЂ™d been visiting recently, I sprinted across the courtyard, just for the joy of being able to do so.Д«ut IвЂ™ve recently turned into a вЂbad arm in firstвЂ™ kind of person and, horror of horrors, have caught myself uttering вЂњoofsвЂќ and вЂњahsвЂќ when exerting myself. Give me a supermarket trolley and a clear aisle, and I canвЂ™t resist scooting along with my feet off the ground, and every now and then I like to check that I can still stand on my head. IвЂ™ve always taken a grateful delight in having a body that does what I ask of it. They were brilliant things, which I suspect he must have made or altered himself wooden, with curved runners on the bottom, which allowed us to propel ourselves round at some speed! I rediscovered them a few years ago and had to have another go. I have happy memories of races round my grandparentsвЂ™ garden on the pair of crutches Grandpa used while his knee (the cap blown away on the Western Front) was healing. Cochrane UKвЂ™s Sarah Chapman blogs about evidence and experience in treating adhesive capsulitis, or вЂfrozen shoulderвЂ™, with the help of another Sarah, a physiotherapist.

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