What have I done to my shoulder?
January 17, 2012 1:47 PM   Subscribe

What the hell did I do to my shoulder? All the details (as many as I can type) inside.

About two weeks ago, I woke up with excruciating pain in my right shoulder. Some pain there is not uncommon, but it always goes away within a few hours. I dislocated (or more likely separated) my shoulder fifteen-odd years ago, and it often will fall asleep and cause me pain when I sleep on it, as I often do. This was different, though. I had:

- Shooting pain from the top of my shoulder to the top of my head
- Some "freezing" of the joint in my shoulder and the muscles in my neck
- Pain radiating from elbow to wrist
- Pain on the side of my arm that alternates between a dull throbbing and deep, acute burning pain. Sometimes, I can feel that band of muscles constricting into a cramp and the feeling goes out of my hand.

After miserable sleep and more pain I went to a GP, assuming (after a self exam and some Googling) that I had separated it again. I had an X-Ray and was told there was no separation. Over time the pain started to evolve. The neck pain subsided somewhat, but the numbness started to spread to my forearm and finger tips, where it persists. That was over a week ago. I made an appointment to see an orthopedic specialist, but it isn't until February 14th (!), so any input on pain management—or a possible "a ha!" moment from a fellow mefite would be much appreciated.

For what it's worth, my current theory is bursitis, but I don't know. I've heard every theory from pinched nerve to hairline fracture. Oh, it bears mentioning that there wasn't any recent trauma to this arm. I go to the gym once in a while, but am mostly a desk jockey code nerd type person. I'm pretty ergonomically aware, take frequent breaks, etc. Bonus points for effective pain management (I've been taking the absolute maximum dose of Aleve every day for three weeks now, on GP's direction, and it's losing it's punch.)

posted by littlerobothead to Health & Fitness (8 answers total) 2 users marked this as a favorite
I am almost sure there are multiple things going on here. I do not think you are looking at one "aha" moment where all these symptoms can be explained by a single thing. And it doesn't sound like bursitis can explain much of this to me. That pain would be more localized around the joint.

It sounds like there is some nerve pain going on, but specifically what and why I am not sure. Are *all* your fingertips numb? "Shooting" and "burning" are adjectives people often use to describe what turns out to be nerve pain. I think you need to see a neurologist.

I am a massage therapist, and if you were a client of mine I would have you point to the areas on your body as you are talking about them. I would also palpate various muscles and see what the reaction was. In a post such as this, phrases like "side of my arm" are almost meaningless in terms of figuring out what's going on.

This may sound obvious, but if you could avoid sleeping on your shoulder for now, that might help.

Oh and also, don't assume that being a "desk jokey" doesn't strain your body. It absolutely does. Computer use is one of the most common causes of Carpal tunnel syndrome, for example.
posted by parrot_person at 2:09 PM on January 17, 2012

Response by poster: @parrot_person Thank you. I'm aware being a desk jockey is pretty crummy for your body. I do what I can to mitigate it, but it's probably not enough. For what's it worth, the part of my arm that hurts is a place I've heard called the "regimental patch", like where a patch might be if I were wearing a uniform.
posted by littlerobothead at 2:13 PM on January 17, 2012

Look into "frozen shoulder," because your symptoms sound very similar to the ones I experienced when I was diagnosed with that. Per the orthopedist I saw, nobody really knows why frozen shoulder happens, it isn't likely to be anything you did, and it will go away in a few months with physical therapy. Also, you can get a cortisone shot.

Did you have your Vitamin D levels tested when you saw your primary care doc? The orthopedist suggested that frozen shoulder was more common in people who had low Vitamin D levels, but he didn't know what the connection might be.
posted by Sidhedevil at 2:16 PM on January 17, 2012 [1 favorite]

Don't try to live with it. I dislocated one of mine about ten years ago, and the other one two years ago. The more recent one has me in misery all day, every day. My collarbone is about an inch out of socket and the doctors have said that I waited too long and nothing can be done now. I don't really believe that, but nonetheless, it sucks. Go get a second opinion from an orthopedic specialist.
posted by bryanthecook at 2:21 PM on January 17, 2012

I had a very similar problem about four years ago. It started with shoulder pain and intense pain shooting down my arm. It was terrible.

I saw a doctor and made the mistake of letting her inject cortisone into my shoulder to help. Instead of helping, it made things even worse. After the shot, my arm hurt just from its own weight pulling on it. I literally was in tears daily because my arm just ached.

Over the past four years the pain has gone away (except for an occasional "electrocuted" feeling where my arm spasms like I'm being shocked), but three of my fingers on that hand have gone numb and haven't regained their feeling.

I was told by several doctors that it was a pinched nerve or similar nerve-related pain. They basically told me there isn't anything they can to do help, short of spinal surgery, so I deal with it.
posted by tacodave at 3:33 PM on January 17, 2012

There's very good information online about what's called a "frozen shoulder." It's not bursitis, not arthritis, not torn anything, but it's misery all the way around. My left shoulder "froze" a few years ago and it was excruciating; there was absolutely no trauma and no cause at all that could be identified. Information online gave two lines of advice: 1) physical therapy, and 2) no physical therapy - it would clear up by itself. My doctor sent me to PT, but it hurt so much it made me sick in my stomach and I gave it up. It took about six months for it to go away completely, but it finally did - and it left no stiffness, no pain - back to normal completely. Then - guess what? - the right shoulder did exactly the same thing; over the course of only a couple of days it was frozen and painful as could be. I grumbled (indeed), but just let it take care of itself and this shoulder only took about three months. I've had no trouble with either shoulder since.

There is a wealth of good information online, including diagrams, that will help you determine if you have the same thing. Try google images for "frozen shoulder" and that should get you some excellent diagrams and links. I hope this is what's wrong with your shoulder because it will go away on its own in time - no surgery, no cortisone shots. Good luck.
posted by aryma at 4:31 PM on January 17, 2012

just to comment on what was said above, pain does not have to be right over the bursa to be bursitis. This is thanks to a phenomenon in your body called "referred pain". IAAD/NYD, but I know this from personal experience. I get pain above my elbow from shoulder bursitis, and it resolves completely after getting a steroid injection into that shoulder. That being said, this doesn't sound like bursitis.
posted by treehorn+bunny at 6:30 PM on January 17, 2012

I had frozen shoulder last year for about six months. Everything above about referred pain, shooting pains, inability to move muscles or extend them beyond a certain point, or even to sleep on them, is banally familiar.

Basically, a small injury to the complex set of muscles governing your shoulder -- which needs to rotate in so many directions, and bear significant weight -- can mean you stop extending it, to avoid a twinge -- and this actually weakens the muscles over a period of weeks until they literally can't do it.

The differential diagnosis is usually not something like bursitis, which has distinct symptoms, but a rotator cuff injury -- which can require surgery. Fortunately, I suspect your doctor is going to tell you it looks like frozen shoulder.

I went to PT for a month -- all my insurance covered -- and took a pulley device and a few other things home. I exercised my injured shoulder about three times a day, pulling its weight up with the other arm's strength, to extend it, and making the muscles go farther and do more work. It did not solve the problem -- I still had a limited range of motion -- but it relieved the pain significantly. After several months of stalemate, where it wasn't quite going away, it basically vanished on its own. Apparently this is the usual course of the affliction.

The first month I definitely needed prescription pain-killers to sleep through the night, but by the end of my scrip I was able to step down to OTC ibuprofen.

Note: diabetics (like me) are significantly more susceptible to this, for unknown reasons.
posted by dhartung at 11:51 PM on January 18, 2012

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