Shoulder pain - limiting and headed towards debilitating

[seadraem]

Long, long story made short…
I injured my shoulder somehow last year - during Physical Therapy I believe, on something called a shark cage - stretched per directions (hanging by my hands from a bar and leaning away from a side bar to stretch shoulder and neck muscles) and woke up that night (3am) with my arm shaking in painful spasms - shooting pain through my shoulder in the joint.

I was in Physical therapy for two bulging discs at c4/5/6 and mild carpal tunnel, and the place immediately switched most of the therapy to my shoulder, which was now having intermittent pain spasms several times a day.

Over time they eased farther and farther between, but never really went away. I finally went to an orthopedic shoulder doc last Nov. He did an arthroscopic MRI and told me my rotator cuff was torn but not bad enough to do anything about it. He said I "could try" physical therapy - which after months of multiple types of therapy I was unwilling to try that. I had already been through stretching, cortisone shots, ice, heat, massage, stim, ultrasound, and something that zapped steroid medication into my shoulder via a small patch. Probably other stuff too - there was a lot.  Nothing really helped - some made it worse - anything that vibrated (stim, ultrasound, zap patch).

So another year down the road… shoulder hurts worse. Now there's a bad around my rt shoulder/upper arm that hurts when I do anything that stresses it - like lifting my arm - especially away from my body. Lifting things is almost impossible - limited strength. Typing is becoming a real problem and I already switched my mouseing to my left hand.

Same doc - takes one xray (this month) compares it to last year's MRI and declares there is nothing orthopedically wrong with my shoulder. Refers me to a spine doc in the same complex - to see if there's nerve impingement somewhere.

Spine doc takes more xrays - does the first torture test (don't let me move your hands - OW - did that hurt? - Yes! - how about now - OW) and declares he doesn't see anything wrong but this was just an elimination look - it could still be the shoulder.

What?? How??  Do you guys talk?

OK - so he's still sending me for more tests - an MRI of the neck and spine "just in case" and an EMG test.

Now let's be clear - I've had that one before - IT'S AWFUL - the brochure status "some minor pain may be felt" - LIE! It hurt like he**! So I'm scared - that one is next Friday. I really hate that test.

Then he says - if everything comes back negative, we can try putting in a spinal non-steroidal shot and bathe C4/5 with it and if the pain goes away - that was what was wrong!

OK - I know it's "practicing medicine" but come On! I know I'm ranting here - but am I unreasonably frustrated? I'm in constant pain - I'm depressed - not clinically yet because I couldn't get an appt for two months and that's not til Dec 5th - and I bet half my depression stems from frustration and pain.

What else can I do? Any recommendations?

[seadraem]

OK - I've now had the second EMG (at elast as bad as last time) to a "no carpal tunnel, no nerve impingement" result. I then went so far as to set up a second opinion appt with an orthopedic surgeon shoulder specialist at the Mayo Clinic, and got the SAME treatment and diagnosis as the other doctor. Took only an Xray, compared it to my Nov 2007 Arthrogram MRI and said there was nothing he could see. When I (again) asked if an MRI might show something different, he said "unless you've had a serious trauma to the area since, there should be little or no difference".

My pain says otherwise. The smallest actions can cause the biggest pains. Flipping a dog bone accross the room to one of the dogs had me down on the ground almost throwing up from the pain. Pulling my emergency brake on my car is either painful or impossible, depending on how the day went. Sleeping is difficult as I'm a side sleeper - shoulder kind of gets in the way there.

I don't know what to do. I feel I might have gotten a more thorough answer from the Mayo doc if I had lied and said I've had no tests and seen no doctors and had him start it all over, but I screwed that up.

I said to the doc, I really feel if the pain increases at the rate it has been, I'll be crippled within 6 monthes. He said "we could try the AZ Pain Management Center". I don't want to manage the pain - I want the problem fixed, and I just need a doctor to look close at it. How do I do that??!!

[seadraem]

Thanks Weesy68! Funny about the looking for MS thing. The original Neuro guy I saw before the shoulder was injured found a spot in my brain that he said "could be indicative of MS or a number of other things" - nice and specific... Recommended a spinal tap but I'm WAY too chicken for that one. And of course, when I started looking into a second opinion I tried the premier neurological hospital but they weren't taking any more MS patients... Did I say I have MS?!?? Again - DOCTORS! :-) (Sorry doctornee)

As for posture - I thought it was that and have actually improved my posture quite a bit this year to no avail - more pain if anything. I can't get muscle relaxants (which I can't stand - they make my mouth dry) because I can't get anyone to say anything is wrong.

Oh well - second opinion time I think.

[seadraem]

Thank you very much for your information. I have to say I read that web info and it looks like it was written about my shoulder. I was very frustrated when the doc compared a new Xray to a year old MRI so I think I'll request a new MRI - and maybe I'll do it via another doctor. I still have the EMG to "look forward to", so I'll finish those tests first.

I can't use the arm much less - I am right handed. I already mouse with my left hand and recently bought an automatic because shifting was a problem, but I still have to type for my job. The above sums up how much I can type before it starts to hurt :-P

I'll let you know if they ever find something treatable... Skeptical but hopeful...

[Weesy68]

I also had a similar pain after doing a gymnastic maneuver I shouldn't have been doing at 35, ha ha.  Five years down the road my shoulder started getting worse and I could hold a blow dryer or type on the computer (the most disturbing part for me of course).  If I'm not on my computer, you may as well consider I have a serious illness.  I admit that addiction wholeheartedly.  Anyway, I also had several EMG studies, which showed only bilateral progressive carpal in both hands.  No biggie, I've had and dealt with that for years. Had an MRI of the thoracic spine and brain looking for possible MS since I had a burning sensation behind my left scapula which can be a sign in MS, as well as the weakness starting on one side of the body.  That was all negative.  I was hoping the carpal tunnel was so bad that it was causing the pain to radiate, but the pain was always behind the left scapula and down the back of the left arm.  I started wondering if I wasn't compensating for my pain behind the scapula by lifting my shoulders and actually making it worse because I did notice I was hunching often.  I have tried to be more aware of that and did take two muscle relaxants given by my doctor.  I had a whole bottle but I hate muscle relaxants.  I don't like to be tired.  They did help.  I think that the initial pain caused me to start hunching those muscles in my shoulder and in turn caused me more pain because the muscles were just tightening even more and the muscle relaxant kind of told it to chill out.  I still have a bit of that pain but nowhere near the same as it was, so I can only assume that becoming aware of what I was doing with tensing my muscles must have helped.

[Dr. Kokil Mathur]

Hi

Thanks for the post! How are you now?
  I know you are frustrated and rightly so. However, your doctors are following the right direction to diagnosis. Shoulder area is a tricky area with so much activity, many muscles, nerves, blood vessels and bones around. At times despite best tests available a clinical judgment is difficult to get.

Please decrease the use of your arm. Maybe a shoulder sling should help. I am giving you a link, you can read to understand what you have and that there is a stepwise approach to diagnosis. Refer: http://orthoinfo.aaos.org/topic.cfm?topic=A00064

Is it possible for you to take a second opinion? At times that helps. It is difficult to comment beyond this without examining. Please let me know if there is any thing else and do keep me posted. Take care!