Hyaluronic Acid Injections for Shoulder Arthritis

I'm also looking at acupuncture. I've always been a do it yourselfer and if I can learn how to do it, why not try it? I will say the new heated- vibration pads have helped my shoulder and knees.

Hey Katz, well said!

Getting old is not for sissies!

I'm 70 y/o now. In my 30s and 40s I ran about 25 marathons, with a handful under 3 hours. A nd yes, that was waaaaay too many. (I qualified and ran the Boston Marathon in 1994. It was fun, but logistically, a nightmare. One and done for a great race!). While the running didn't ruin my knees, it certainly didn't help that I have osteoarthritis in every joint.

In the last 3 years, I've had both knees replaced along with my right hip and most recently, my left shoulder. I'm in the gym 7x/week and for cardio, I spin 5x/week.

I've never had a gel shot but it seems the relief is there, for a while, If there is one thing I could do differently, I would have had all those joint replacement surgeries 6 months to a year earlier.

Why? Because joint replacement is a good, long-term solution to joint pain caused primarily osteoarthritis.

But that's just my opinion. I also have great ortho surgeons, and do all of the rehab work suggested. I think cortisone and gel are useful when surgery isn't convenient. Eventually though, I think a joint w/o any cartilage (bone on bone) should be replaced, given the unique circumstances of each patient.

All the best Katz!!!!!

Joe

Thanks, as always woojr, for your thoughtful comments.

I've never tried acupuncture, but have heard great things. Same for another technique called "dry needling".

I'm not a big fan of applying heat to a joint, only because in the long term it creates more inflammation. But go with what works for you. I'm an ice guy.

All the best woojr. Hope you are well!

Joe

The 4% lidocaine OTC patches work well too. ...and I love the roll on and spray, especially for feet and back. The spray goes on cold and is instant relief, for me....and the brand I use even sprays upside down, so you can get it everywhere you want!!

I've needed a right shoulder replacement for about 5 years now, and have had well over 15 cortisone injections...Sometimes as often as every 2 months. They still work, but I'll often use a small 4% patch as well, especially in the winter time.

Wow bweaver, 15 cortisone shots! That's gotta be a record. Glad they still work, at least a little. I'm a little surprised you can get them in less than 3 months - but it seems the thinking has changed by Drs and these shots are ok as long as they're working. Good for you!

There are 5% lidocaine patches as well via Rx. I also used KTape and it really helped. It takes two, ten-inch strips, and ideally someone to put them on.

One question - why haven't you had the shoulder replaced? I'm guessing because day-to-day pain is minimal. I just had an anatomical TSR on August 6th, but I was in pain everyday, not just at the gym. I'm a little over 6 weeks post-op now. The nasty pre-op pain is gone. Recovery requires a great deal of patience as the shoulder takes time to regain 1) flexibility and mobility, and 2) strength. I'm just starting on strength now with my PT.

I'm a reluctant veteran of joint replacements - both knees, right hip, and now left shoulder.

I'm 70 now and when I'm not recovering from a replacement surgery I'm in the gym 7x/week.

Anyway I wish you the best! Thanks for your comments.

Joe

I’ve had the Hyaluronic Acid injections, I think there were 3 in the series, but not certain. They were not covered by insurance. I felt absolutely no improvement. I hear they work for some. I’ve also tried acupuncture and various forms of body work. A year ago I had arthroscopic surgery to remove bone shards and who knows what. Called a “debridement”. 50% success rate. A big maybe. I’m now scheduled for a TSR next month and I’m super worried about the recovery time. I’m 65 and while I haven’t competed in a few years I still consider myself a triathlete and continue to bike and run and try to swim but it hurts. I don’t have anyone in my world that’s been through it and would love to hear some great news about an easy fast recovery. I applaud you for trying everything first. I’m at the end of that road. Good luck.

Thanks for the tip...I will ask my PM doctor if he'll prescribe the 5% patches...Especially as winter approaches here in NY, I will be using them daily.

Insurance won't cover a cortisone injection more than every 3 months and most doctors won't give them any more often then that, and most will only do about 3 total in any joint, but my PM doctor believes with shoulders you should have the injections until they no longer work, as "they" don't have as good a success rate with shoulders as they do with, say hips and knees.
Plus, I had rotator cuff repair on the other shoulder 7 years ago, and that was a 2 years healing process, that I remember all too well, and 2, 15 year old failed hip resurfacings, I'm in no hurry for surgury....BUT I am to the point I am going to have to look for a surgeon soon. I really have to baby this dominant shoulder. No swinging a hammer, or pull start lawn mowers, etc. Usually the injection lasts 1-2 months now, so I do suffer...They use to last sometimes 6-7 months, so my days are numbered.

Hi Davey,

I had an anatomical TSR 7 weeks ago today. I'm a 70 y/o male. I ran marathons in my 30s and 40s (a few under 3 hours, so decent times) and I'm in the gym now spinning 5x/week for cardio, and working on resistance with a trainer 2x/week.

I'm only telling you all this so you hopefully feel better about your decision to have the TSR. Sounds like you are very fit, and that will help you a lot in recovery.

My rotator cuff was intact, so I had an anatomically correct TSR, not a reverse., As for the recovery:

- The first few days are painful. You'll likely be given an 18-hour nerve block before surgery and stay one night in the hospital - which I highly recommend cause your arm will still be very numb.

- The first night at home for me was hardest. This was the most uncomfortable night in recovery, so don't get discouraged, the persistent pain subsides quickly. I had a lot of swelling and later bruising as blood followed gravity down my side and arm. For the first two weeks, all I could do was simple arm dangling motions. (See "Codman" exercise.)

- At two weeks, I started on a continuous passive motion machine - 4x/day, one hour per session. Ya gotta do this as instructed. You'll increase the range each time you start a session. Have a Kindle, TV, or portable speaker handy. This is a very important phase as you rebuild flexibility. The swelling should have subsided significantly. The bruising lasts a while. Don't freak out.
- At 4 weeks I started in-person PT. I'm at week 3 now, and we've focused on isometrics and range of motion.
- I expect to be in PT another month to begin strengthening exercises. This will be the longest phase, rebuilding strength.

FWIW, I was back in the gym after 5 weeks, working on core and legs. I wore my sling so as not to do anything stupid.

Are you having an anatomical TSR or reverse? I'm guessing anatomical. If so, the subscapularis is detached during surgery, for access to the joint, and reattached to the scapula before closing. This takes the longest to heal.

Every surgery is different and there are no guarantees. I've had both knees replaced (my running days are long over!), my right hip, and now my left shoulder. That have all been very successful, and all reduced the pain I was in pre-op.

One tip - treat the first 4 or 5 weeks like a vacation from working out. That helped me a lot. Oh and you'll need to sleep on your back with your back propped up and arm on a pillow. I'm a side sleeper, but adjusted eventually.

All the best to you Davey. At 7 weeks I feel great, but it will be a few more months before my strength is built back up. If you have other questions, please let me know.

(The two most important things - 1) the skill of the surgeon and 2) the patient's absolute commitment to doing the rehab. You mentioned debridement - that's just a cleaning of loose particles in the joint, or the cleaning out of an infected joint. Sounds like yours was the former.)

You've tried everything Davey, Go into this feeling positive and committed. Hope this helps.

Joe

(One last thing - use ice, a lot!)

Hi beaver,

The 5% patches can be worn for 12 hours, and then off for 12 hours. Voltaren gel and BioFreeze Professional are also very helpful.

RC repairs seem harder to recover from than a TSR. If the RC is damaged, a reverse shoulder replacement is required.

All the best to you!

Joe

In reply to @heyjoe415 I am 82 yr old Lady who walks my dogs and kept fit. The plan a year ago was for Hyaluronic Acid Injections [knee- yes I know that's different] to relieve pain while I did PT to build muscles pre TKR. My experience with a pre and post dye shot plus 3 Hyaluronic Acid Injections for Arthritis was a NIGHT MARE. Each shot hurt worse that the last one. The final injection was unbearable!
Yes Original Medicare pays for the shots, but some how my pain was over the moon. And my exercise went to zero for maybe 4 months! I live alone, so had to save steps to do necessary survival things. Eventally I started PT. I am interviewing Knee surgeons and will soon have TKR.
Hind sight for me says that I would have paid for PRP or Stem Cells to get pain relief, strengthened the muscles pre TKR surgery.