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Shoulder impingement...cortisone shot?

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    Shoulder impingement...cortisone shot?

    I've been experiencing pain in my right shoulder since last fall. A lot of popping and cracking. I went to go see a specialist to make sure nothing major was wrong. Took an x-ray, nothing as I expected. Did an MRI and he says my shoulder blade is pressing downward slightly, causing pain during movement, especially above the head.

    No risk of a tear or anything serious but it isn't really getting better. He suggested a cortisone shot and see what happens, might work and might not. Anybody had one before? How did it go?
    -------7-23-04----------
    C5/6- Workin' on Recovery
    www.darrentempleton.com
    www.pushtowalknj.org

    #2
    I did..really did not help me any. It made it hurt worse for a bit (while the shot was working into the joint) but after that...if I had any relief it was minor. That is just me though.
    "Unless someone like you cares a whole awful lot nothing's going to get better. It's not." - Dr. Seuss

    Comment


      #3
      During the past few years I have had cortisone shots in both shoulders. I got good pain relief with them. If the physician is well experienced giving the shots, your chances of it working are improved. Most physicians will not do more than two a year in one shoulder because there is some evidence that too many will weaken tendons. Read the manual at the SOS link below. There are a number of things you can do to preserve shoulder function.
      You will find a guide to preserving shoulder function @
      http://www.rstce.pitt.edu/RSTCE_Reso...imb_Injury.pdf

      See my personal webpage @
      http://cccforum55.freehostia.com/

      Comment


        #4
        I agree with Sci55. I have both shoulders done every three months. They feel like a million dollars. after the shots I rest for two days and ice them. I then can go back to bench pressing and lifting weights with no problem or pain. They do start to wear off after about eight to ten weeks for me. I would give it a try. It can't hurt. Best of luck

        Comment


          #5
          Responses here, as typical, are anecdotal and may or may not bear on your sitch. Years ago I had a very small but very painful rotator cuff tear. I had a great response to a single cortisone (actually, Kenalog) injection. But there's likely an infinite source of clinical presentations that result in shoulder pain, some of which may respond to injection, others not. The risk of further harm from an injection or two is pretty remote, so it's probably a reasonable approach. But Joe's every-three-month routine goes against every caution I've ever heard. Cortisone DOES weaken tendons and repeated injections are pretty much guaranteed to result in a worsening of your condition.
          Last edited by stephen212; 11 Jun 2015, 12:39 PM. Reason: readability
          stephen@bike-on.com

          Comment


            #6
            Totally agree with the above post. Did your X-ry show any arthritic changes? That would not be surprising if it did. That would more likely respond to cortisone than some of the other issues.
            ckf
            The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

            Comment


              #7
              I had good results from a targeted cortisone injection performed by the shoulder clinic at the Palo Alto VA. By targeted, they used ultrasound to identify where to inject. This outcome was very good and much improved from the first experience. My diagnosis is osteoarthritis and cortisone reduced the pain level. Hope you have good results.
              In the dime stores and bus stations, people talk of situations, read books, repeat quotations, draw conclusions on the wall. ......Bob Dylan

              Comment


                #8
                Re: "Did an MRI and he says my shoulder blade is pressing downward slightly, causing pain during movement, especially above the head."

                The part of your shoulder blade pressing on the rotator cuff is called the acromion. Figure 2 in the article link illustrates how different types of of curved acromions can increase your risk for rotator cuff impingement. If this is what you have, the cause of the impingement is structural and cortisone injection effects will be temporary.

                http://www.aafp.org/afp/1998/0215/p667.html
                Last edited by 2drwhofans; 9 Jun 2015, 8:58 PM.

                Comment


                  #9
                  Originally posted by 2drwhofans View Post
                  Re: "Did an MRI and he says my shoulder blade is pressing downward slightly, causing pain during movement, especially above the head."

                  The part of your shoulder blade pressing on the rotator cuff is called the acromion. Figure 2 in the article link illustrates how different types of of curved acromions can increase your risk for rotator cuff impingement. If this is what you have, the cause of the impingement is structural and cortisone injection effects will be temporary.

                  http://www.aafp.org/afp/1998/0215/p667.html

                  This is likely correct. If that is the case pushups while in the wheelchair and transfer activities cause of and/or aggravate the problem. Pushing downward forces the head of the humerus upward along with the ligaments under the acrimion. As a result the pinched ligaments become inflamed.
                  You will find a guide to preserving shoulder function @
                  http://www.rstce.pitt.edu/RSTCE_Reso...imb_Injury.pdf

                  See my personal webpage @
                  http://cccforum55.freehostia.com/

                  Comment


                    #10
                    Let us know how the cortisone works, if you decide to do it. And seriously work on saving your shoulders by limiting the number of transfers, if you can and other activities that cause you to work them harder. You may want to consider seeing a PT to learn other techniques of doing some of your mobility activities.
                    ckf
                    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

                    Comment


                      #11
                      I really appreciate all your responses. I had an appt scheduled for next week but the office actually called and he was able to fit me in today, so I went. I will see how it feels over the next few days. He said what most of you have been saying, 1 and maybe 2 a year is ok if effective, but anything past that not recommended.

                      It's difficult to imagine how I could reduce the number of transfers I do daily without a big lifestyle change. I'll definitely be mindful though. I do use e-motion power assist wheels so that really reduces the daily strain on my shoulders. However I probably do at least 12-15 transfers a day. Sometimes more.

                      Also, he didn't mention anything about arthritic changes in my x-ray. Would he need something to compare it to?
                      -------7-23-04----------
                      C5/6- Workin' on Recovery
                      www.darrentempleton.com
                      www.pushtowalknj.org

                      Comment


                        #12
                        Try kenesio tape first. You can get it a walmart where the tennis stuff is. $10 a roll. I chased a bad shoulder for 10 years. Since the tape no problem. If it doesn't work its still pretty and its not a chemical stuffed into your body.

                        Comment


                          #13
                          Originally posted by baldfatdad View Post
                          Try kenesio tape first. You can get it a walmart where the tennis stuff is. $10 a roll. I chased a bad shoulder for 10 years. Since the tape no problem. If it doesn't work its still pretty and its not a chemical stuffed into your body.
                          Does it work for ED?
                          stephen@bike-on.com

                          Comment


                            #14
                            To use the kinesiology tape, you need to see a PT or OT who knows the correct technique in applying it. They can teach you how to apply it correctly. It is difficult to tape your shoulder yourself, so you may need someone to help you with it.

                            it may assist in reducing your pain and is certainly a good option to consider. That being said, the cortisone should also assist in reducing the inflammation significantly. Add the tape to that and you may not need as many injections.

                            ckf
                            The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

                            Comment


                              #15
                              Ok so I'm about 5 days past when I had the cortisone. It was quite sore for a few days. The next day I could barely transfer and could feel some soreness all the way up until yesterday. So now I can kind of feel if it has had any effects.

                              It still clicks and pops a little, I wasn't really expecting that to change right away or at all, but I think there is a bit of improvement. The easiest thing to tell is that I'd sometimes get pain while pressing downward while in bed on my stomach, to either roll over or change positions. I'm not really getting that pain right now. I've been a bit cautious but it does feel better. I'll give another update in a few days or a week.
                              -------7-23-04----------
                              C5/6- Workin' on Recovery
                              www.darrentempleton.com
                              www.pushtowalknj.org

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