Question:
Will sagging upper arms cause inflamation in shoulder joints?

Have very bad inflamation in one and mild in the other. My arms keep hanging up in my coatsleves. Will these factors assist in getting the insurance company to authorize surgery? My booklet says that reconstructive is allowed if the procedure is medically necessary. Will this meet that criteria? Would appreciate any advice.    — Tyra B. (posted on April 19, 2001)

September 21, 2001
9/21/01 I do pre-certification for my job. Chances are the shoulder inflammation is caused by a motion or exercise you are doing and not by simply having hanging skin on your upper arms. I would be very surprised if your insurance/precert company would accept this. Medical necessity usually means that without a procedure or diagnostic test being done the pt could have serious repercussions or a complication of a disease process. Usually for shoulder inflammation a course of conservative tx is done such as nonsteroidal anti-inflammatory meds like celebrex or vioxx, and physical therapy for at least 3-4 weeks. Most of these types of symptoms can be reduced or completely healed with that type of treatment. So I'd highly doubt the ins company would use this as medical necessity for plastic surgery to the upper arms. However, I have seen strange things get approved, so you never know. Every insurance company is different. You can always try and see what happened. Good Luck.
   — Karen M.