Mild wear and tear

Hi Meril,

I noticed your reply to Sarah and you say you have shoulder pain. I have had shoulder pain for 6 months now. I have been to pysio several times and after having done my exercises i haven't improved. I have to go to GP now and have it investigated. I was wondering if you have any advice on how you cope with it. I understand that there could be many reasons for shoulder pain. How long have you had it, have exercises helped and what is the prognosis?

Elizabeth

Hi Elizabeth

I started having aches and discomfort in my right shoulder just over a year ago. I couldn't lift a cup of tea even. Came overnight. I too had physio for months but it didn't do anything for me. As I was not responding to physio my physiotherapist sent me for a shoulder x ray and there was no osteoarthritis found. She said it was tendonitis and referred me to another physiotherapist who was qualified to give steroid injections. I had this done 7 months ago, I had some side effects but the pain went after 4/5 days. Now it's come back but I have been overdoing things.

I won't have another injection and I am not going to do my past physio exercises, there's no point. I shall just rest it, take painkillers when I have to and do gentle pendulum exercises.

Hope it all works out for you,

Best wishes

Might be worth asking for an ultrasound to be done - my shoulder pain which without scan of any kind my doctor said was probably wear and tear arthritis turned out to be after having a couple of ultrasound scans done to be a major tear in the rotator cuff and also ruptured bicep tendons - probably also due to wear and tear. Treatment is very different to that recommended for my pre existing OA.

hi i also have a tear on my shoulder and arthritis i have had m r i to confrim this

this has been going on for a year i see my surgeon in a couple of weeks what next step is

Hi Loxie

Thanks for replying. After I had the steroid injection in my shoulder the pain went away, I just had a few niggles now and again. Would a steroid injection disguise a rotator cuff tear? I had an xray on it but it showed no osteoarthritis, both physiotherapists I saw said tendonitis. 😏

Hi Meril. I have a torn rotator cuff on one side but the other side is also painful so I asked what was causing that and my consultant said I had tendonosis on the other side but they didnt detect a tear, ie it was just inflamed. Tendonosis is the chronic (ie persistent and recurring) version of tendonitis, the latter tends to be short lived flare up caused by, for example, injury.

Hi Loxie

How was your tendonosis side diagnosed if you don't mind me asking? My pain is at the top of my shoulder and goes up to my neck along the clavicle. If I had tendonosis, I read that a steroid injection could be harmful. I think if I go back to my doctor I'll ask to be referred to a rhuematologist again.

I had several ultrasounds, on both shoulders and upper arms. It showed I had a ruptured bicep tendon and torn rotator cuff on the right arm. On the left it showed tendonosis in the left arm, affecting the rotator cuff and the tendons but at that point no actual tears. At my last six monthly review the consultant did mention an injection but previous ones havent helped much so I declined. Not sure if he meant just the right side or both. The physio said I need to strengthen the muscles to increase flexibility and lower pain. I've been doing strengthening exercises at home which have helped tremendously with the pain but my range of movement - especially moving my arm behind me is still very restricted, makes getting dressed a major drama 😃

Thanks Loxie,

What causes those tears and ruptures, is it something physical or general wear and tear?

I don't over exert myself, just housework. I do have poor posture. I too find if difficult putting my arm to the back of me and lifting.

I asked my doctor at the outset if I could have fibromyalgia and he said possibly but my rheumi said no. She tested my fibro points but said there wasn't enough, I don't think they rely on that anymore. She applied the lightest pressure I hardly felt if, if she had applied more pressure I'm sure I would have. I ache from head to toe, headaches, neck and shoulder, elbows, chest, back, knees, feet.

I'm also with drawing from citalopram so that too could be causing some of my symptoms.

I will have to go back to doctor but if if is withdrawal I perhaps should wait a little longer.

Thanks for listening, husband just doesn't get it. Hope you find the pain relief you need. Best wishes.

You know something Meril, you sound just like me - I asked those same questions. At first my GP thought it might be fibro and I too got referred to a rheumatologist - she was to put it bluntly, an evil woman. She dismissed everything I said, stated I didnt have fibro but if I persisted in saying I was in pain (like it was a fairy story!) the only thing to help would be to prescribe some really rather nasty meds. When I told her I was concerned about the side effects of such strong drugs, she got angry with me and told me she was a 'pill pusher' (her words!) I left there in tears. After lots of doctors appointments and finally a referral to an orthopaedic consultant, who referred me for an MRI. The MRI showed mild OA in the upper spine but not sufficient to be causing the amount of shoulder and arm pain. So he then referred me for the ultrasound. I'm in the UK where waiting lists are long, all of the above took several years by the way. Three months after the ultrasound I saw another consultant who said they needed a further ultrasound because he said they didnt do the left side (i remember quite clearly they did the ultrasound on both sides but he wouldnt believe me) so a further wait then another ultrasound, then another wait for a review appointment. I too asked what would have caused such severe tears in both rotator cuff and bicep tendons. A lot of shrugging later, a few umms and errs and basically no idea. "probably" just wear and tear/age (I was in my 50's at the time). I hadnt had any injuries neither had I done any extreme sports etc.Five years later and I finally managed to persuade the doctor at six monthly review meeting that I could benefit from physio. I've had three appointments, 6 - 8 weeks part. No actual hands on therapy but a quick discussion each time about exercises I can do at home and the gift of one of their ubiquitous rubber resistance bands . Oh I forgot to add, way back near the beginning of all this I did see one osteo who gave me a steroid injection in the right shoulder but it didnt really have much effect.

OMG Loxie, what a horrible experience you had with your rheumatologist. It's such a worry about getting the right diagnosis, the last thing you want is an unsympathetic health professional.

What pain killers do you take? My rheumi said paracetamol but I can't take them, they make me nauseous and almost every other otc painkiller. I take anadin extra but I'm beginning to wonder about those lately. They help with pain and I know they contain paracetamol but the aspirin and caffeine combination are more tolerable to me. I don't feel great after them though and I've been looking into salicylate overuse lately. I have the symptoms but the problem is, so many illnesses have similar symptoms.

I had the rubber resistance bands too but I was getting too much pain after a while so I stopped using them. When my physio started floor exercises I had to stop there because lying down flat makes me dizzy.

I've been to ENT about dizziness and tinnitus but they couldn't find anything, my epley manouvre was normal. They said it was my neck, damaged nerves.

It's a minefield out there for sure.

I'm in the UK too and the weather isn't helping. I'll be glad for the spring weather to come to go out in the sunshine and get some vit d.

Just to add, a family member of mine was getting shoulder pain, she bypassed the doctor and went straight to a chiropractor who told her that her top rib/s were out of alignment, probably had been for years. Anyway, he started treating her, I think she had about four sessions with him and was given exercises to do and now she has no problems. I wish I had done that.

All the best Loxie😊

Aspirin and indeed all nsaids iinterfere with cartilage regeneration.

Yes Anhaga, I've heard that but I don't know what else to do. I seem to be sensitive to other meds, I even had horrible side effects after my steroid injection. I'm trying to cut back on anadin but I need something for the headaches in particular. My doctor told me to take one paracetamol two hourly but I tried it and they make me feel unwell. Maybe I should try a half tablet every hour. I use a wheat bag sometimes and get some relief from that, I use a support pillow around my neck and sometimes I wear a neck collar. I've wasted a small fortune on various support pillows but I've gone back to ordinary ones.

I do take aspirin for headache. I don't take anything for osteoarthritis. So I'm only taking aspirin occasionally.

Do you have headaches all the time? What might be causing them? There are so many possible causes. Sodium deficiency gave me morning headaches - took a long time to find out and that was by accident from a chance comment to an acquaintance. Not my only headaches, I get migraines still, despite advancing years, usually caused by changes in air pressure (annoyingly come on when weather is improving). I react to some foods, and artificial scents. Dehydration. Some illnesses cause headaches.

Hi Anhaga

I get migraines, have done for 20 years, definitely brought on by certain foods with me. These days they are not too frequent I avoid triggers. I mostly get tension headaches because I am withdrawing from citalopram. I have early neck and spine osteoarthritis so that is another reason, at least that is what my doctor and rheumatologist told me. I've tried paracetamol, co-codamol as suggested by my doctor and ibuprofen but I can't take them. I now have shoulder pain and neck stiffness, comes and goes, I take anadin extra (aspirin, paracetamol and caffeine combo) before I go to bed. I don't take any prescribed pain killers. Citalopram has an analgesic effect so the reduction in dose could be having an affect on my increased pain, that combined with withdrawal effects which in itself causes body pains. Also, citalopram and aspirin should not be taken together, one of the reasons I'm coming off it.

I am going to try gently introducing paracetamol to see if I dan tolerate lower more frequent doses.😊

I have suffered with migrains for 40 yrs im 52, but like you they have lessened over the yrs so only get occasionally now, I only take ibuprofen for the occasional migrain so the thought of having to take them or stronger ones if it gets worse is not good 😳 arnt the stronger ones addictive?

Hi Sarah

I didn't think ibuprofen were addictive but I don't know for sure. I can't take them, they make me ill, nauseous, light headed. My neighbour faints if she takes them. My husband has no problem with them.

BTW, how's your hip and how is the ice treatment going?