Shoulder pain and replacement

[hlh]

Going to see the orthopedic surgeon tomorrow. Really reluctant to do the shoulder replacement thing. Too many things can go wrong, not including the ever looming autonomic disreflexia. The Physician's Assistant that has been doing my cortisone shots said that the surgeon might be able to go in orthoscopically and "clean up" and perhaps give me some relief that way. And I would only be laid up for a couple of days. Leaning that way.

By the way, the arthritis has gotten into my muscles now. Almost all the muscles/tendons/ligaments seem to ache now. Has anyone had this issue too?

I have increased my pt, but it seems that it makes it worse at times.

It seems that you need to figure out which exercises work best to strengthen and stabilize the shoulder without increasing pain too much. I think it is hard to find a balance. Hopefully your PT will know. My Dad seemed to get good advice working with an OT as well.

My Dad has also had aching in the surrounding muscles of his upper arm/upper back at times. Usually that's if he wakes up at night with his arm in the "wrong" position so his shoulder is bad, or if he is having a particularly bad bout of pain.

Let us know how your visit with the orthepedist goes. Curious - has he ever suggested doing any injections other than steroids?

[Tetracyclone]

I have some similar problems with arthritis, especially in the right shoulder. No surprise there- back when I was AB I overworked that shoulder a lot doing building restoration. Surprising to me, after my doctor recommended that I get off caffeine (and energy drinks) the muscle aches largely disappeared. I have had this arthritis for years and never had symptoms until I started using a lot of caffeine.

I still get them mildly occasionally but find that using either Biofreeze cream or SoreNoMore gel after a physically stressful day lets me wake up without pain. SoreNoMore is a muscle rub sold on veterinary sites and generally sued with horses. It is inexpensive and wonderful.

Finally, stretching the shoulder muscles gently 3 times a day is useful.

[Tetracyclone]

I have some similar problems with arthritis, especially in the right shoulder. No surprise there- back when I was AB I overworked that shoulder a lot doing building restoration. Surprising to me, after my doctor recommended that I get off caffeine (and energy drinks) the muscle aches largely disappeared. I have had this arthritis for years and never had symptoms until I started using a lot of caffeine.

I still get them mildly occasionally but find that using either Biofreeze cream or SoreNoMore gel after a physically stressful day lets me wake up without pain. SoreNoMore is a muscle rub sold on veterinary sites and generally sued with horses. It is inexpensive and wonderful.

Finally, stretching the shoulder muscles gently 3 times a day is useful.

[MikeRobison]

Ok. I saw the orthopedic surgeon. He said, surprisingly, that shoulder replacement should be viewed as a last hope. I got the feeling, though, that he didn't really want to do anything with me because I'm in a wheelchair and would complicate things. Anyone else ever get this feeling from your doctors? It seems to happen a lot.

I'm not sure that they don't care, but that's the feeling I get some times.

Anyway, I asked him about Lipogem injections and he said that I should try anything that might work, but they don't do it there.

He did say that something called Synvisc might help. It's some kind of lubricant. Anyone hear about this? He said that it has been approved for arthritis in knees but not in shoulders - yet. He said that he would inject it if I purchased it. Kind of weird. Anyone know where I could buy it?

[Patrick Madsen]

My surgeon said the same thing. We rely on our shoulders to do the brunt of the work with the possibility of tearing out all his good work in an instant falling over in the early months or putting too much stress too early. I know of only one person its work for after three years post surgery. All the others, athletes and non athletes have had issues again later on. Once you're cut there's no going back and any damage done usually can't be brought back to where it was before.

Last I saw my surgeon was ten years ago with the first visit 22 years ago; post injury 47 years.. The shoulder has gotten wose but is still very viable. I have been going to a masseuse, chiropractor and and working with a trainer in the gym for most of those years. I gave myself 6 months to try to improve the shoulder before making the decision for surgery. That was 22 years ago. I have biceps torn off the longhead, full tears in the spinatus and osteo by now I'm sure.

I still see the three of them but only go once a week rather than the two a week I did for years. The covid halted the gym. They wanted to see how far we could go delaying surgery so each gave me a good monthly rate and communicated with each other to maximize my potential. Seems to have worked so far. The trainer I have thinks outside the box for exercises and really concentrates on form and function. Revive A Back is his office in Bellingham, Wa. He does Skype sessions if needed.

Injections have really improved thru the years. Part of my issues with the shoulder was too many cortisone shots while competing at the Nation level. I'm contemplating contacting the surgeon again just to see what changed for injections.

One thing I think that's really helped is, I am more conscious on transfers, though they are getting tougher. Also I still ride my handcyclesand added power assist, work out with lighter weights in the gym and use the stretchy bands religiously at home. I have a few hanging from the ceiling above my stander for light overhead stretching; they stretch the whole upper body where it's tough to do sitting down. I'm also looking at the skierg for an additional piece of equipment at home along with my shoulder press and Vitaglide. Main thing is to stay active and stretch the shoulders. There are days where the pain is pretty severe; If so, I'll take an oxychodon. The shoulder stretches usually precludes the need for them.

I agree with your doc., do anything before going for surgery. Don't baby the shoulder yet don't overdo it either. I feel not doing anything to maximize it's potential for recovery is the worst thing people do.

[nevada]

Has anyone done the Lipogem injections? I am really thinking hard about giving it a try. Cost is not covered by insurance near as I can tell but I am willing to roll the dice even if it only would give me half a normal shoulder back.

[SCI-Nurse]

Just to clarify a few points above:

• Arthritis does not involve soft tissues. It is a disease of the joint space and the articulating surfaces of the bone.
• Arthritis is not the same thing as tears or strains of ligaments, tendons, or muscles surrounding a joint. Painful inflammation in tendons is called tendonitis.
• Injections into the joint space of stem cells, lipids, or other slick "lubricant" materials may help with true arthritis, either degenerative (most common in those with SCI/D) or rheumatoid. It does not help with tendon, ligament or muscle tears or inflammation.
• Steroids and numbing agents may be injected into painful tendons with tendonitis, but these injections should not be done repeatedly or they increase your risks for tendon tears down the road. Such injections also do not repair tears of ligaments or tendons.

(KLD)

[wes4dbt]

I'm a little confused. I believe in therapy, spent many years doing mass amounts. But my shoulder just plain hurts no matter what the movement is. The only thing that seems to help is reducing the amount I do and NSAIDS. Cortisone not helping much or for long now a days, plus that's only allowed once every 4 months. So how is exercising my shoulder going to help? Basically the more I do the more severe the pain. 43+ yrs has just taken it's toll.

[SCI-Nurse]

Therapy will help to strengthen the muscles that help the shoulder to move. It will help to decrease the pain. Depending on what is causing the pain, it may help.
If activity is aggravating the pain, then I am not sure that it will help to have therapy. That being said,I am not a therapist or physician so before chucking it out the window, I would talk with them.
ckf

[wes4dbt]

Therapy will help to strengthen the muscles that help the shoulder to move. It will help to decrease the pain. Depending on what is causing the pain, it may help.
If activity is aggravating the pain, then I am not sure that it will help to have therapy. That being said,I am not a therapist or physician so before chucking it out the window, I would talk with them.
ckf

I have been thinking about seeing an Ortho again, it's been @ 10yrs. Been seeing a pain management doc the last 5 or 6 yrs, mainly for my back. But I've got my back in pretty good shape right now. Got an appt. with my pcp next talk, I'll talk to him, it'll take probably 3month to get an Ortho appt.