Arthritis in shoulder

[wes4dbt]

Well I finally got an x-ray of my shoulder and they saw "acromioclavicular joint degenerative". Basically it osteoarthritis of the shoulder. Anyone else have this, if so, anyone have any success treating it or reducing the pain? I've been taking ibuprofen and naproxen, seem to help a little. Read that cox-2 inhibitors like Celebrex help, anyone tried it?

As of right now I can deal with it and I'm able to be active enough to keep my independence but if it get worse I may have to stop using my manual chair. I already use an electric when I leave the house. I'd be glad to hear from anyone with experience dealing with this type of situation.

Thanks

[SCI-Nurse]

Be very careful using NSAIDs and COX-2 inhibitors in frequent large amounts. Long term and frequent NSAID use increases the risk of peptic ulcer disease, renal failure, and stroke/myocardial infarction/heart attack. COX-2 inhibitors may increase the risk of serious, even fatal stomach and intestinal adverse reactions, such as ulcers, bleeding, and perforation of the stomach or intestines.

Discuss use of analgesic topical creams and rubs with your provider. This may include products such as prescription Flector, Pennsaid,Voltaren, and Solaraze, as well as over-the-counter products such as Bengay, Tiger Balm, Blue Ice, and Deep Blue Rub. These have much fewer systemic side effects.

Degenerative arthritis (DJA) is one area where stem cell therapy has been in use for some time. Your PCP may want to refer you to a specialist who could evaluate your candidacy for this.

Regardless, you may need to change the techniques used for some of your highly shoulder stressing activities such as transfers, and use of a manual wheelchair as you already indicated.

(KLD)

[Tetracyclone]

I have some arthritis in my shoulders. Symptoms first came on 18 months ago. They wax and wain. I have found regular moderate use of weights, 2X/day stretching , and daily use of Tiger Balm keeps the pain well controlled at this point.

Add to SCI Nurse's last of undesirable side effects for Ibuprofen: long term use (earlier) increases hearing loss in older people by about 17%. I used it a lot in earlier decades and my hearing is almost gone. The research I refer to had a large sample that followed nurses for decades. They tend to report more accurately, as a group, than pools with wider samplings.

I sympathize with your pain. I've found pain from my own arthritis, which afflicts many joints, is well controlled by thoughtful activity, focusing on posture improvement , and maintaining range of motion with gentle, slow stretching. I've learned some techniques watching Tai Chi on youtube.

[SCI-Nurse]

I have been a subject in the Harvard Nurses’ Health Study, established in 1976, since it's inception (Cohort #1). The studies are now in their third generation with Nurses’ Health Study Cohort #3, and count more than 280,000 participants. They now include men, but their research on women's health has been very important over the years, and has produced many, many journal publications. (KLD)

[wes4dbt]

Be very careful using NSAIDs and COX-2 inhibitors in frequent large amounts. Long term and frequent NSAID use increases the risk of peptic ulcer disease, renal failure, and stroke/myocardial infarction/heart attack. COX-2 inhibitors may increase the risk of serious, even fatal stomach and intestinal adverse reactions, such as ulcers, bleeding, and perforation of the stomach or intestines.

Discuss use of analgesic topical creams and rubs with your provider. This may include products such as prescription Flector, Pennsaid,Voltaren, and Solaraze, as well as over-the-counter products such as Bengay, Tiger Balm, Blue Ice, and Deep Blue Rub. These have much fewer systemic side effects.

Degenerative arthritis (DJA) is one area where stem cell therapy has been in use for some time. Your PCP may want to refer you to a specialist who could evaluate your candidacy for this.

Regardless, you may need to change the techniques used for some of your highly shoulder stressing activities such as transfers, and use of a manual wheelchair as you already indicated.

(KLD)

I've been working extremely hard on lessening the stress on my shoulder, but there is only so much you can do. I don't know what you consider high doses of NSaids. I usually take 800 mg Ibuprofen in the morning and 400 - 600 mg of Naproxon in the evening. Never tried topical meds, didn't think they would penetrate deep enough to make a difference.

I have an appointment with an Ortho Dr in a week. I worry that analgesics only mask the pain, I'd much prefer something that is a treatment for the condition, may help stop further degeneration. Maybe it doesn't exist.

Edit: You didn't mention how effective stem cell therapy has been.
Well it looks like medicare based insurance won't cover this therapy for arthritis.

[pfcs49]

I have had some kind of steroid injected into my right shoulder and later the elbow. Relief was pretty significant and lasted ~6 mos?

[wes4dbt]

I have had some kind of steroid injected into my right shoulder and later the elbow. Relief was pretty significant and lasted ~6 mos?

Yeah, I've been dealing with shoulder problems for 30yrs and have had several injections over the years. The last one was about two months ago but didn't seem to due much, that's why I decided to go back to an Ortho Dr. Last time was 2009. Back then they thought it was bursitis, maybe it was back then.

[Gearhead]

Yeah, I've been dealing with shoulder problems for 30yrs and have had several injections over the years. The last one was about two months ago but didn't seem to due much, that's why I decided to go back to an Ortho Dr. Last time was 2009. Back then they thought it was bursitis, maybe it was back then.

It needs to be done in radiology so it gets injected in exactly the right location. I had 2 done in radiology and it was great pain relief. My 3rd shot, the doctor did it in his room. That shot had very little effect. Spring time I want another so I can work in yard.

I just completed therapy for my left shoulder. A little hand bike and rubber band work, then passive motion and stretch, finishing with Tens and heat. It really helped as it doesn't wake me at night but I can tell that my range of motion will never be the same. I have to take care with >any< lifting..

[SCI-Nurse]

Steroid and "caine" injections into joints are for treatment of tendon and ligament inflammation and pain (such as tendonitis or rotator cuff tears) and do nothing for the joint surface which is what is damaged in degenerative arthritis (DJA). In addition, repeated steroid injections can predispose you to ligament and tendon tears or rupture.

(KLD)

[wes4dbt]

That's true, steroid shots and NSAIDS are for treating inflammation but arthritis causes a lot of inflammation. So it's m y understanding these are very common treatments.

I don't know of any medication that actually treats the joint surfaces, was hoping some one had. My daughter swears by glucosamine and chondroitin sulfate, anyone else tried it?

Also read that they sometimes do orthoscopic surgery to clean and make minor repairs to the area. Does anyone have experience with this?

[SCI-Nurse]

Don't confuse rheumatoid arthritis (RA, which has a large autoimmune and inflammatory component) with degenerative arthritis (DJA).

Many people report improvement with glucosamine and chondroitin sulfate, although there are not good large sample clinical research studies done for people with SCI. (KLD)

[Tetracyclone]

I've been working extremely hard on lessening the stress on my shoulder, but there is only so much you can do. I don't know what you consider high doses of NSaids. I usually take 800 mg Ibuprofen in the morning and 400 - 600 mg of Naproxon in the evening. Never tried topical meds, didn't think they would penetrate deep enough to make a difference.

I have an appointment with an Ortho Dr in a week. I worry that analgesics only mask the pain, I'd much prefer something that is a treatment for the condition, may help stop further degeneration. Maybe it doesn't exist.

Edit: You didn't mention how effective stem cell therapy has been.
Well it looks like medicare based insurance won't cover this therapy for arthritis.

The topical products work in a different way. Through cold or heat effects they stimulate circulation in the entire area, which tends to reduce inflammation. It can be surprisingly effective.

[wes4dbt]

It needs to be done in radiology so it gets injected in exactly the right location. I had 2 done in radiology and it was great pain relief. My 3rd shot, the doctor did it in his room. That shot had very little effect. Spring time I want another so I can work in yard.

I just completed therapy for my left shoulder. A little hand bike and rubber band work, then passive motion and stretch, finishing with Tens and heat. It really helped as it doesn't wake me at night but I can tell that my range of motion will never be the same. I have to take care with >any< lifting..

Yeah, saw my ortho on the 10th. Gave me a shot but said if it didn't work they would try the radiology method in the ball joint. He wasn't if the procedure could be done while I was in my chair. Anyone ever had this procedure???? Got any info on how it's done????

[MikeRobison]

As if I/we need more issues, I got rapid onset osteoarthritis and in about six months, am left with bone-on-bone in both shoulders. I can barely brush my teeth anymore. I've got OT in to help with maintaining flexibility in the shoulders. I tried cortisone shots and they had some effect at first, but that diminished over time.

I tried plasma rich platlet injections, but neither helped. As a last gasp measure, I'm going to get radiofrequency ablation in both shoulders this coming January. If that doesn't work, it looks like I'll have to get shoulder replacement.

Up until this summer, I was driving and fairly mobile, including transferring by board into and out of my bed. No longer. I have to get hoyer lifted into and out of bed. And the inability to do pressure reliefs has lead to the formation of three pressure sores. Two of them are being managed by a wound vac.

[wes4dbt]

Yeah that sucks. It's a shame when these things start to snowball. Take good care of the wounds, shoulder pain is one thing but pressure sores are much more dangerous.

Good luck, Wes

[Tetracyclone]

As if I/we need more issues, I got rapid onset osteoarthritis and in about six months, am left with bone-on-bone in both shoulders. I can barely brush my teeth anymore. I've got OT in to help with maintaining flexibility in the shoulders. I tried cortisone shots and they had some effect at first, but that diminished over time.

I tried plasma rich platlet injections, but neither helped. As a last gasp measure, I'm going to get radiofrequency ablation in both shoulders this coming January. If that doesn't work, it looks like I'll have to get shoulder replacement.

Up until this summer, I was driving and fairly mobile, including transferring by board into and out of my bed. No longer. I have to get hoyer lifted into and out of bed. And the inability to do pressure reliefs has lead to the formation of three pressure sores. Two of them are being managed by a wound vac.

Yours is a terrible story, Mike. I've had rapidly worsening osteoarthritis in my right shoulder and left knee for the past 18 months. It is threatening my independence, which until now has been great. The emotional adjustment is challenging.

You have my sympathy and encouragement. We cope as best we may.

[SCI-Nurse]

If I can add a personal note, I had a shoulder replacement the end of Sept and although I do not have a spinal cord injury, I was having significant pain and disruption in daily activities. It has been the best thing I have done. While I am not totally pain free or able to do everything in my daily activities, I am significantly better and see only continued recovery. While my journey is different than yours will be - I encourage you to explore it if you feel it is the next step.
ckf