Shoulder Pain
September 13, 2021 10:30 AM Subscribe
I have had shoulder pain issues for 5 yrs. it is continuously deteriorating since then. Invested a fortune in physiotherapy to no avail. All the blood tests CRP, CK, ESR levels are normal - ruling out metabolic myopathy. CT scan of Cervical Spine show no pinching of the nerves. I have consulted extensively with orthopedic surgeons, Sports Medicine doctors, physiotherapists, Physiatrist, Acupuncturists. short of Genetic Sequencing, followed all leads. Hoping someone with similar problem could help me.
Thanks
I have had shoulder pain issues for 5 yrs. it is continuously deteriorating since then. Invested a fortune in physiotherapy to no avail. All the blood tests CRP, CK, ESR levels are normal - ruling out metabolic myopathy. CT scan of Cervical Spine show no pinching of the nerves. I have consulted extensively with orthopedic surgeons, Sports Medicine doctors, physiotherapists, Physiatrist, Acupuncturists. short of Genetic Sequencing, followed all leads. Hoping someone with similar problem could help me. Thanks
I have had shoulder pain issues for 5 yrs. it is continuously deteriorating since then. Invested a fortune in physiotherapy to no avail. All the blood tests CRP, CK, ESR levels are normal - ruling out metabolic myopathy. CT scan of Cervical Spine show no pinching of the nerves. I have consulted extensively with orthopedic surgeons, Sports Medicine doctors, physiotherapists, Physiatrist, Acupuncturists. short of Genetic Sequencing, followed all leads. Hoping someone with similar problem could help me. Thanks
If you are a person with large breasts, a reduction changed my life immensely. I had a lot of pain but no understanding of the cause until I read about someone's experience online and a light went off.
posted by socky_puppy at 10:47 AM on September 13, 2021
posted by socky_puppy at 10:47 AM on September 13, 2021
Are your shoulder muscles tense? This stretch helps me, and so do massages.
posted by pinochiette at 11:04 AM on September 13, 2021 [1 favorite]
posted by pinochiette at 11:04 AM on September 13, 2021 [1 favorite]
Do you spend significant numbers of hours in a typical day working with a desktop screen, or (much much worse) with a laptop computer? If so, your shoulder pain might well be due to the interaction between screen, keyboard, mouse, chair and posture.
For starters, if your screen is horizontally off centre with respect to your seating position, fix that. Even looking ten degrees off centre, on average, for hours on end, will cause neck and shoulder pain. Screen height is important too - when you're seated upright in your chair, the top of the screen's visible area should be at eye level.
If you're using a laptop and it doesn't have a separate keyboard and/or screen attached, then either the screen will be too low or the keyboard will be too high. Either of these can cause neck and/or shoulder pain with protracted use.
posted by flabdablet at 11:30 AM on September 13, 2021 [2 favorites]
For starters, if your screen is horizontally off centre with respect to your seating position, fix that. Even looking ten degrees off centre, on average, for hours on end, will cause neck and shoulder pain. Screen height is important too - when you're seated upright in your chair, the top of the screen's visible area should be at eye level.
If you're using a laptop and it doesn't have a separate keyboard and/or screen attached, then either the screen will be too low or the keyboard will be too high. Either of these can cause neck and/or shoulder pain with protracted use.
posted by flabdablet at 11:30 AM on September 13, 2021 [2 favorites]
Best answer: flabdablet's post is sold advice. It really is unbelievable how a small change can really make a big difference when it comes to chronic musculoskeletal pain. I have vastly different experiences of (decades long) chronic shoulder and neck pain depending on where my keyboard and mouse are in relation to my body, esp. the mouse. If it's too far to the side or front, such that the muscles on the back of my upper arm or shoulder are held extended for too long, then I'm going to find myself in a world of pain, pretty quickly. When I had to travel to client sites and had to work, with a laptop, at a desk of whatever level with a chair of whatever height, the ergonomic disaster was.... well, you get it. Also, it has been pointed out to me several times by professionals that a big factor in chronic front-of-upper-torso tightness is the lack of strength in the middle of the back (rhomboids, etc.) . It didn't take a very long amount of time addressing that (stretches, exercises) to have a noticeable difference.
It also is unbelievable how often the established medical machinery can, even when fully deployed, miss some of the most obviously useful recommendations for addressing pain. Ask yourself how many of your practitioners recommended massage or other direct soft-tissue manipulation. "Well, you *say* it worked for you, but we don't have the research to demonstrate *why* it works, therefore it's not something we can proscribe." Keep in mind, the primary goal of many medical practices is *not* to be diagnosticians. Organizationally they are not incentivized to spend a lot of time isolating, beyond a doubt, the sure causes of an issue that does not present in a manner that matches their training or experience. There's a reason why House M.D. was such a popular and engaging show.
re: imaging of the cervical vertebrae. I don't know if it's the same as for the lumbar, but it is common knowledge now that imaging is next to useless in aiding most cases of chronic pain. IANAD. There are plenty of links to that, I think I even saw one on this site.
You are perhaps not going to want to hear this, but there is a growing body of solid work around the role of the mind and emotions in pain. You may want to check out the Curable app. There's a lot of good content, unfortunately it's wrapped up in a presentation layer that is less than clinical to say the least, but it's worth sorting through it.
Also, this.
Last: good onya for reaching out. Asking for ideas, opinions, experiences of others is going to pay big dividends. It is sooooo important to not suffer in silence. The chance of finding out something life-changing from a friend, peer, or random stranger is higher than you might suspect. memail me if you want to hear my story for saying this.
posted by armoir from antproof case at 12:19 PM on September 13, 2021 [4 favorites]
It also is unbelievable how often the established medical machinery can, even when fully deployed, miss some of the most obviously useful recommendations for addressing pain. Ask yourself how many of your practitioners recommended massage or other direct soft-tissue manipulation. "Well, you *say* it worked for you, but we don't have the research to demonstrate *why* it works, therefore it's not something we can proscribe." Keep in mind, the primary goal of many medical practices is *not* to be diagnosticians. Organizationally they are not incentivized to spend a lot of time isolating, beyond a doubt, the sure causes of an issue that does not present in a manner that matches their training or experience. There's a reason why House M.D. was such a popular and engaging show.
re: imaging of the cervical vertebrae. I don't know if it's the same as for the lumbar, but it is common knowledge now that imaging is next to useless in aiding most cases of chronic pain. IANAD. There are plenty of links to that, I think I even saw one on this site.
You are perhaps not going to want to hear this, but there is a growing body of solid work around the role of the mind and emotions in pain. You may want to check out the Curable app. There's a lot of good content, unfortunately it's wrapped up in a presentation layer that is less than clinical to say the least, but it's worth sorting through it.
Also, this.
Last: good onya for reaching out. Asking for ideas, opinions, experiences of others is going to pay big dividends. It is sooooo important to not suffer in silence. The chance of finding out something life-changing from a friend, peer, or random stranger is higher than you might suspect. memail me if you want to hear my story for saying this.
posted by armoir from antproof case at 12:19 PM on September 13, 2021 [4 favorites]
If you wear a bra, make sure it's the correct size and style. (Schedule with a fit specialist at Nordstrom, or at a high-end lingerie shop -- not a Victoria's Secret.)
posted by Iris Gambol at 1:40 PM on September 13, 2021 [1 favorite]
posted by Iris Gambol at 1:40 PM on September 13, 2021 [1 favorite]
How's your mattress? I experienced a lot of shoulder pain when I had my old mattress. It went away when I got a better one.
posted by WalkerWestridge at 2:52 PM on September 13, 2021 [1 favorite]
posted by WalkerWestridge at 2:52 PM on September 13, 2021 [1 favorite]
Depending on what kind of shoulder pain I can tell you about adhesive capsulitis. I was diagnosed with it in the spring.
It felt a lot like a rotator cuff injury, which I was diagnosed with 4 years previously, on the same shoulder. VERY similar, with the exception that there was no injury and no change in my behaviors (computers, work, etc.) this spring. It was treated with a horribly uncomfortable set of cortisone shots into my shoulder and anti-inflammatory pills, and then physical therapy to rebuild the muscles around it, regain flexibility and range of motion, and improve my posture--it had actually worsened my posture so that my neck and head were held forwards and down a bit.
My symptoms were too complicated to explain, but essentially it hurt to sleep on that side, it hurt to reach out and grab or lift things, and sometimes it just hurt. Good luck!
posted by Snowishberlin at 4:21 PM on September 13, 2021 [1 favorite]
It felt a lot like a rotator cuff injury, which I was diagnosed with 4 years previously, on the same shoulder. VERY similar, with the exception that there was no injury and no change in my behaviors (computers, work, etc.) this spring. It was treated with a horribly uncomfortable set of cortisone shots into my shoulder and anti-inflammatory pills, and then physical therapy to rebuild the muscles around it, regain flexibility and range of motion, and improve my posture--it had actually worsened my posture so that my neck and head were held forwards and down a bit.
My symptoms were too complicated to explain, but essentially it hurt to sleep on that side, it hurt to reach out and grab or lift things, and sometimes it just hurt. Good luck!
posted by Snowishberlin at 4:21 PM on September 13, 2021 [1 favorite]
I started getting shoulder pain when I got my new mattress. My doctor was able to make a first guess at bursitis based on my symptoms and on being able to feel the swollen bursa on palpation. I have not yet been to my usual arthritis doctor appointment where I get the steroid injections for this sort of thing, so can't yet report on whether that helped (though it really helped the bursitis in my hip a couple years ago). In the meantime, I've been reading up and experimenting with sleep positions and pillow arrangements, and, more long-term, what kind of mattress I should get next time.
posted by Orlop at 4:35 PM on September 13, 2021
posted by Orlop at 4:35 PM on September 13, 2021
You said you had a CT of the C-Spine, but have you had an MRI of the C-Spine or your shoulder?
posted by radioamy at 4:41 PM on September 13, 2021 [1 favorite]
posted by radioamy at 4:41 PM on September 13, 2021 [1 favorite]
Even just one orthopedic surgeon should have ruled out a rotator cuff tear via MRI, but it worries me a little that you didn't mention that. If they didn't, they should have.
I just recently had a shoulder arthrogram (a hideous experience) which is when they put a big needle full of dye right up in the shoulder joint before the MRI. this makes some things easier to see & other things more difficult. In my case it was done because I already had incompetent rotator cuff surgery a few years ago, but I am not sure the small labrum tear they found along with the re-torn rotator cuff would have been visible without the dye. you may want to ask about the possible utility of an arthrogram, if you haven't already had one.
I also have calcific tendonitis, which is when part of your tendon turns into (?) a big lump of calcium. I did not know this condition existed until I read my own report & I do not know if it is possible for a calcium deposit to be big enough to cause pain but small enough to escape the notice of a radiologist. I have read that it shows up on X rays as well as MRIs, so you would presumably know already if you did have that. but if you are having pain that feels like a kidney stone, but in your shoulder, radiating out in all directions until you fall down on the floor nauseated & weeping, this is perhaps the problem. They say the more painful it gets, the closer it is to spontaneously resolving itself, but it can take years, so that is small comfort.
finally, there is the super scary possibility of referred pain to the shoulder from terrible things happening elsewhere in one organ or another. but after 5 years I would think that either you would be experiencing other urgent symptoms or something would have shown up in your bloodwork, if that was it.
posted by queenofbithynia at 4:56 PM on September 13, 2021
I just recently had a shoulder arthrogram (a hideous experience) which is when they put a big needle full of dye right up in the shoulder joint before the MRI. this makes some things easier to see & other things more difficult. In my case it was done because I already had incompetent rotator cuff surgery a few years ago, but I am not sure the small labrum tear they found along with the re-torn rotator cuff would have been visible without the dye. you may want to ask about the possible utility of an arthrogram, if you haven't already had one.
I also have calcific tendonitis, which is when part of your tendon turns into (?) a big lump of calcium. I did not know this condition existed until I read my own report & I do not know if it is possible for a calcium deposit to be big enough to cause pain but small enough to escape the notice of a radiologist. I have read that it shows up on X rays as well as MRIs, so you would presumably know already if you did have that. but if you are having pain that feels like a kidney stone, but in your shoulder, radiating out in all directions until you fall down on the floor nauseated & weeping, this is perhaps the problem. They say the more painful it gets, the closer it is to spontaneously resolving itself, but it can take years, so that is small comfort.
finally, there is the super scary possibility of referred pain to the shoulder from terrible things happening elsewhere in one organ or another. but after 5 years I would think that either you would be experiencing other urgent symptoms or something would have shown up in your bloodwork, if that was it.
posted by queenofbithynia at 4:56 PM on September 13, 2021
Best answer: This links to an infographic and study on whether to have surgery or not for subacromial shoulder pain, if this is relevant for you. The latter is defined in the infographic.
posted by lulu68 at 6:04 PM on September 13, 2021
posted by lulu68 at 6:04 PM on September 13, 2021
Response by poster: I am very sorry I was not able to check these insightful responses from all of you. Thanks to you all.
Yes, I do have a small degenerative labral tear and a 4 mm tear in Supraspinatus. But I am told no surgery needed as most people live with these.
I appreciate the straight forward thoughts, observations and comments.
posted by page123 at 8:49 AM on October 21, 2021
Yes, I do have a small degenerative labral tear and a 4 mm tear in Supraspinatus. But I am told no surgery needed as most people live with these.
I appreciate the straight forward thoughts, observations and comments.
posted by page123 at 8:49 AM on October 21, 2021
This thread is closed to new comments.
posted by DarlingBri at 10:40 AM on September 13, 2021 [5 favorites]