My Arm Hurts. Doctor Is No Help
April 9, 2019 6:56 AM   Subscribe

My arm has been hurting me for a while. I visited the orthopedist and he basically said that I'm old (early 40s) and that is it. I don't have the money to visit another one. Details inside

I try to stay active. I am naturally thin. I have lifted weights for years with the exception of the last year. I have tendonitis in my knee. I saw an ortho a year ago and he recommended a brace, which helped. I was able to carefully squat and continue to exercise.

I now have pain in my left arm. Sometimes in the shoulder, but mostly bicep, forearm and elbow area. I have not been doing anything active with it. The pain is tolerable, but I want to start exercising again. Just lifting laundry or my laptop causes me pain. I went to the same medical group, but a different doc

He was less than helpful. He basically said "welcome to your 40s" and just don't lift heavy weights any more. Do cardio. I rely on weightlifting to help me with my anxiety etc. I am also super thin and it helps me to look healthier.

What can I do? I can deal with the pain, I just don't want to hurt myself. They did scans but didn't see anything

Should I be on an Ibuprofen regimen? How much? How often?

I want to get back to the gym. What can I do? What does this sound like?

I have crappy insurance and don't want to have to keep going to the doctor
posted by kbbbo to Health & Fitness (20 answers total) 2 users marked this as a favorite
If you accept the doctor's assessment that there's no treatable condition, and you want to relieve the pain, there's an OTC spray called Stopain. It's 6% menthol, and pretty effective. It's in drugstores, and also comes as a roll-on. I'd be wary of loading up on ibuprofen or any other NSAID or Tylenol. I don't think menthol will hurt you.

As for what it sounds like, it sounds like when I overextended my elbow while weightlifting and had pain for a long time after. It did eventually go away after I stopped lifting. I'm afraid that the doctor's advice may be good, even if he didn't explain things.
posted by Kirth Gerson at 7:13 AM on April 9, 2019 [1 favorite]

I now have pain in my left arm. Sometimes in the shoulder, but mostly bicep, forearm and elbow area. I have not been doing anything active with it. The pain is tolerable, but I want to start exercising again. Just lifting laundry or my laptop causes me pain.

Have you had your neck checked? Pinched nerves can do this kind of thing. So can neck and shoulder knots caused by bad office ergonomics or odd sleeping positions.

I'm 57 and when my body hurts I can generally work out what's causing it. If your doctor is as useless as Louis CK's, find a better one. Just because your orthopedist can find nothing wrong with your skeleton, that's no reason to assume there's nothing wrong with everything attached to it.

Also, try massage from somebody with a qualification in myotherapy.
posted by flabdablet at 7:14 AM on April 9, 2019 [5 favorites]

I'm 42, and I have this. I think I triggered it last summer painting my house but now the flare-ups are directly tied to how much time I spend holding my phone or sitting on my couch with a laptop. When it was really bad, I iced it every night and took ibuprofen around the clock for a few weeks and it did get better.
posted by something something at 7:23 AM on April 9, 2019 [2 favorites]

I've had exercise- and desk-job related shoulder, hip, and foot pain at different points over the past decade, and I've pretty consistently found that doctors don't have much to suggest once they've ruled out broken bones, ligaments, or tendons.

However, in every single case, a good physical therapist (and in one case, an excellent massage therapist who was also a personal trainer, so very knowledgeable about biomechanics) has gotten me back to a pain-free state within a few sessions. My sense is that physicians receive a lot of training on injury that affects soft tissue or body mechanics but not much training on "this muscle is overly tight, this other muscle is compensating and that's what is causing pain". On the other hand, that's squarely in the wheelhouse of PT and (some) massage therapists, generally the ones that work with athletes or are attached to a sports medicine type place.

Downside is that PT obviously costs money (in my experience, around $60/session) and it's only sometimes covered by insurance. In my case I felt like paying out-of-pocket for 4 sessions was HUGELY useful, and honestly the first session or two is where they diagnosed the fundamental problem and gave me the exercises that resolved 80% of the issues. If you can find a way to swing it, I'd guess you'd have much better luck with PT than going to another doc, if the first doc ruled out issues that could be treated surgically.
posted by iminurmefi at 7:25 AM on April 9, 2019 [24 favorites]

When I had pain down my left arm, which ranged from minor to agonizing, often for months at a time, it turned out to be a herniated disc (C6-C7) in my neck. Might want to get it checked.

Nerve pain meds dulled it a bit, I did yoga and PT and in the end only time seemed to help. Also neck traction, but you'd want to get a professional's diagnosis and advice before you start that.
posted by bondcliff at 7:51 AM on April 9, 2019 [2 favorites]

I also recommend seeing a physiotherapist. But you must be sure that you will be compliant with the exercise/homework that they assign. PT's have gotten me running from some minor overuse issues, and more importantly they pointed out asymetrical or systemic weaknesses and gave me exercises to overcome that. PT relieved jaw pain. More similar to you, my wife had some upper shoulder pain/weakness that was helped with PT.

Both of us received strengthening and mobility exercises, as well as self-massage instructions. Some of the exercises required minor equipment in the $5-40 range if purchased at the PT's, or could be had from amazon / local fitness depot for $5-20.

After the first (longer and more costly than normal) session where the PT looks/feels/tests you all over. Then they'll recommend a treatment schedule. I've had schedules range from 2x weekly to monthly, depending upon the issue; some things won't be helped much by direct treatment from PT, and will mainly just require checkups as you work on mobility/strengthening/healing. For the times I was recommended 2x weekly, there wasn't any guilting if I opted for a less regular scheduling. If there is, I'd recommend looking for a new PT. However, for most PT's, they usually have a policy that if it's been more than 3 months since the last session that they require a new initial session for a better inspection of where you are (mentioning this, since you've already brought up cost being an issue).
posted by nobeagle at 8:11 AM on April 9, 2019 [1 favorite]

Ibuprofen is pretty safe if you don't have stomach or other conditions that would rule it out. You might as well try an ibuprofen regimen as well as resting it and using heat/cold. I felt like I could tell within a week if the ibuprofen was helping. As with most other injuries like this, though, if you do heal it, the next time you feel even a TWINGE rest and don't use the arm.

I was (under the care of a doctor) taking ibuprofen round-the-clock for over a year before I had any issues with it, but of course, YMMV.
posted by fiercecupcake at 8:18 AM on April 9, 2019 [1 favorite]

If your insurance covers physical therapy with an affordable co-pay -- or if you can save up for a month or two to pay for one session on your own -- try that before you look for another doctor. but do a lot of pre-research to find a good and reputable and above all, experienced PT (plenty of new PTs are just fine at the hands-on stuff as long as it's something straight out of a textbook and they don't have to figure out the problem, but the middle-aged ones who are really good at their job will just look at you standing there and know secrets about your ligaments or whatever.)

(research first because if you call a PT practice and ask to see someone with special expertise in shoulder/arm problems, chances are they'll just say that all their PTs are experts in everything.)

you may have the kind of problem that can only be helped by a cortisone shot or surgery, and a PT can't help you there. but good ones are really excellent at diagnosing problems that are impossible to describe but easy to see on the body for someone who's seen it before. don't blindly trust them and don't do exercises that hurt in a dangerous way. but listen to them. it's not likely to fix you but it can help you figure out the right condition to research and eventually ask another doctor about. PTs I have seen have been a lot more curious and sincerely interested in working out what the problem is than doctors, especially orthopedists.

my experience with doctors for problems like this is that they have one big signature Thing they like to do -- surgery, injections, referrals to PT -- and if you don't seem like an ideal candidate for their one Thing, they have no further interest in you. doesn't mean your problem can't be solved.
posted by queenofbithynia at 8:24 AM on April 9, 2019

Physical therapy was great for me. I could not throw a ball without pain nor reach sideways across my body. Now all that is fine. I am in my 40’s. I never would have figured it out on my own because the real problem was not my arm, it was the shoulder blade.
posted by kerf at 8:26 AM on April 9, 2019 [2 favorites]

I had similar pain and it turned out to be in my neck, and my physical therapist fixed it (or showed me how to fix it). Maybe your crappy doctor can get you a referral. "Welcome to your forties" is not a reasonable answer to this kind of thing.
posted by The corpse in the library at 8:48 AM on April 9, 2019 [6 favorites]

Just do granny pushups. Get on your knees, in hands and knees position, do twenty with flat palms, twenty on your fists, twenty with your arms open wide and palms flat facing out to the sides, twenty on your elbows where you straighten your arms, and twenty with palms flat, out in front of your head with arms at a 60 degree angle. Start with tens if you need to. Within a couple of weeks you will have no arm pain. Weight bearing exercise works to build bone in the arms like walking does for the legs and feet. With the bone enhanced it will hold on to the muscles, tendons and ligaments better. Don't forget to exhale on the exertion. Just start, and don't wimp out. When I don't do these for a week, my left arm starts to hurt, and nothing ever happened to my left arm, it is my right shoulder with the 11 Polyethylene terephthalate screws. If I don't exercise I get sore. I have found that a well rounded routine where you develop bilateral symmetry in all of your muscle tissue, mitigates repetitive injury, and sudden injury from unexpected exertion. That doc telling you are old at 40, is full of crap. I am older at 68, yes I am, but as Lady MacBeth said, "You have to kick against the pricks!"
posted by Oyéah at 9:19 AM on April 9, 2019 [4 favorites]

Agree with having your neck checked.

I know that chiropractors are not popular here, but I swear by mine. She's helped me through a few injuries that had me out on disability, including an injury do to a car crash, and a couple of sports related injuries.

She does her continuing education with The Carrick Institute; you might look them up and see if you can find someone affiliated in your area.

Alternating heat and ice might help. Short term use of a sling or a brace might help if you are continually reinjuring the site.

Fwiw, long-term ibuprofen use is associated with an increased risk of stroke. Short term use is likely okay, but don't allow yourself to get into a pattern where you just take ibuprofen every day and otherwise try to ignore the pain.

"Welcome to your 40's" is not a medical diagnosis, JFC. Once you're feeling better please review the hell out of this dismissive idiot.
posted by vignettist at 9:43 AM on April 9, 2019

I am not your doctor, or a doctor, but I have been through this a lot.

First, find a different orthopedic.

Second, if you can go to physical therapy without a referral, as others have said - do that.

If you can't, find a different orthopedic that will give you a script/referral to go to PT (physical therapy).

Yes, you are old. But if you are lifting on your own, or with a trainer who is not a therapist, you likely have incurred a repetitive stress injury, which PT can and will help you with.

A *good* orthopedic will send you to PT, and re-evaluate you in about 6 weeks. If you are still suffering and NOT improving at all, they will likely then order an MRI to check for something more insidious.

But, my experience with my wife, myself and my sons - all different ages, but similar issues, this has been a highly successful path.

Important thing is to learn from the PT on how to not re-injure yourself, or to recognize the symptoms and to initiate the exercises (and icing/heat routines) they teach you.

Also - they'll help you understand what medication is best for the type of injury you have, if you actually need medication.
posted by rich at 10:03 AM on April 9, 2019 [1 favorite]

I would not go back to an orthopod. Their clinical decision-making tends to be along the lines of "surgery, yea or nay?" And if it's not amenable to surgery, they tend to lose interest real fast, or and usually don't have the training to work up other causes.

If you want another physician, a sports medicine doc might be a better way to go. If it's a sharp burning type of pain, as opposed to dull and achy, maybe a neurologist. But I suspect a physical therapist would be best of all. Even just one session + good home exercises may get you back on track.
posted by basalganglia at 1:36 PM on April 9, 2019 [2 favorites]

I second the recommendation for a sports medicine doctor and nth the recommendation for a physical therapist. I've seen both, successfully, for various kinds of back pain that my GP thought was just inevitable arthritis.
posted by brianogilvie at 2:49 PM on April 9, 2019

I would do a bunch of gentle sustained stretches, particularly of my neck and shoulders. If I found tension in the neck or noticed my posture was not good I would work on those. The gentle stretches held for several seconds may give you an idea which ones of your muscles might be contributing to the problem, if it is something a PT can help you with.

If you hear cellophane crackling type noises when you roll your head around it means that you are having joint problems of an arthritic nature in your neck and that could be causing bad posture to pinch a nerve. And if you hear any faint crunchy crackling noises in your arm or elbow that could mean there is an arthritic problem there.

I would start with really light weights - two pound weights and start my exercise routine at very few reps and see what happens. If nothing bad happens I would increase it and start working it up.

I would try applying hot compresses to the painful area and see what happens. If it hurts I would stop. I would try icing it and seeing if that makes it better or worse, or no change. I would cut back on dietary items that cause inflammation - that means sugar, mostly, so try to go on a negligible sugar in the diet regimen. I would also try eating hot spicy foods, like turmeric as that can reduce inflammation.

And once I had tried all those diagnostic and repair routines if I had not figured it out and coaxed it to get better, I would consider seeing a PT.
posted by Jane the Brown at 8:04 PM on April 9, 2019

Strongly recommend rest and ice, then seeing a PT or sports medicine doctor if possible: they care about getting you able to do what you want to do, and don't get caught up in whether they can diagnose a specific named injury. Based on your description (can't pick up laundry) I'd put ice where it hurts and rest it as much as possible for a week or two, and then try some stretches and lighter weights to get back in to it.

The procedure for ice does require some care. Make sure to have a layer between your skin and the ice and stop if the ice becomes painful - you can do nerve damage with too much cold. But 15 minutes on (with a bag of frozen peas on the injury), 15 minutes off (with the peas back in the freezer), 15 minutes on again is what my PTs have recommended and it's worked really well for me. It promotes healing / reduces swelling as well as reducing pain.
posted by Lady Li at 12:08 AM on April 10, 2019

Sounds like it could be the rotator cuff (shoulder migrating down to bicep). I had a rotator cuff injury that has recovered, but left me with a sore/tight bicep due to whatever soft tissue impingement that caused the rotator cuff issue in the first place.

One thing I read on the PainScience blog (written by an evidence-based massage therapist) that was really smart in trying to sort out my own minor aches and pains is this: MDs and medical research are really not good at all in dealing with minor or even chronic muscular pains. Major pains and major interventions, sure. But "my bicep is naggingly sore in my 40s" -- not so much.

My recommendation, therefore, would be to not listen to your MD about weight lifting, and instead seek out a physical therapist and then a very talented physical trainer (or small group exercise instructors). Shop around for trainers, and find one that has a deep background. Of the two best trainers I've worked with, one had a masters in dance, and the other had his BS in kineseology. Look for online profiles of trainers who specifically discuss having had experience in rehabbing post-injury clients, and working with older clients. A good trainer should be able to immediately describe to you in words what to do with your body.
posted by schwinggg! at 10:24 AM on April 10, 2019

I am ridiculously prone to random, long-lasting pain in various joints such as shoulders, hips and elbows. One thing I have found that helps if I take it regularly is fish oil. I currently take four packets of Coromega daily and found that within weeks of starting, the shoulder and hip pain I'd been bothered by for months cleared up like magic. (It's a citrus-flavored gel with no fishy taste or burps, you can throw it in a smoothy and not even notice it or suck it straight out of the packet.)

The exercises in this book I found very helpful for an (again random) pain in my elbow: End Your Carpal Tunnel Pain Without Surgery. My elbow pain was definitely not carpal tunnel, but the exercises did something to either "free up" or align the muscles and nerves in my arm and the pain went away.

If your doctor didn't find anything wrong and you are on your own, these things may be worth a try.
posted by Serene Empress Dork at 11:16 AM on April 10, 2019

If you have persistent pain that doesn't respond to physiotherapy, you might consider acupuncture.
posted by HiroProtagonist at 9:59 PM on April 10, 2019

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