Running out of options. Shoulder pain but no orthopedic issues

try different things.- you don't know what's wrong so just try things.
1- Pineapple juice - anti - inflammatory natural
2- Yoga class - stretching - (basic class only - do only as much as you can without pain.
3- Rotator cuff exercises with rubber bands.

@hilda2020 I see Colleen gave you information about a frozen shoulder. I have had a frozen shoulder which was caused by an injection of gadolinium into the joint capsule during a diagnostic MRI. That was so painful it hurt to breathe and I had to just put my arm in a sling for a month and try not to move. After some time, I went to a physical therapist with the therapist moving my shoulder to get the range of motion back which was painful. That may be something you will need, but you should question why you have this inflammation. After menopause, inflammation increases in general which is what my doctor told me. Why have you been on Cymbalta for 15 years? That is masking the pain, but not fixing the source. Often after menopause, women do get shoulder joint issues. If you have tightness on the front of your chest, it pulls your arm forward in the joint capsule and can cause pain. I had that situation because of thoracic outlet syndrome and developed shoulder instability which is why they did the MRI that caused more trouble. It hurt just to put on a coat. This does make it hard to move the shoulder or arm backward. If you do too much computer work particularly with a forward head position and slouching posture, it sets the stage for this kind of problem.

My suggestion would be to see a functional medicine type doctor because they look for the cause of a problem instead of using drugs to treat the symptoms. I have seen this type of doctor for several years and they optimize health by addressing sources of inflammation. For me that was addressing thyroid function, hormone imbalances (and bio-identical hormone replacement), food allergies and general eating to avoid inflammation, and treating environmental allergies with allergy shots. Doing all of that reduces inflammation. Sometimes these doctors are hard to find. My food issues include gluten problems and that can cause joint paint, and also foods like tomatoes. Tomatoes have toxins that some people don't process well. Plants create these compounds as a survival mechanism to suppress competition from other plants called allelopathy. I had to give up tomatoes and the entire nightshade group of plants that also includes potatoes, eggplant and peppers as well as a lot of other foods. Doing that made a big difference in how I feel. At one time I had a lot of joint pain, but after I figured out what foods were safe and what foods were trouble, I felt much better and had no pain.

Inflammation leads to disease in the body. I know for myself, if I hadn't made the changes I did long ago, that I would have long term pain and inflammation too. There can be multiple sources for inflammation like pieces of a puzzle. I figured this out on my own back when doctors didn't believe in gluten issues and I fired the rheumatologist that just wanted to give me drugs. I didn't want to go down that road. You might be able to get off Cymbalta if you figure out the source of the problems. As Chris also mentioned, myofascial release physical therapy or MFR helps a lot by releasing the tight dehydrated fascial tissue that is restricting normal body movement and alignment. I do a lot of MFR because it is the best way to treat my TOS, and it also helped me have a better recovery from spine surgery in my neck because my muscles were more pliable which helped during surgery and helped during the rehab period after surgery. MFR also helps release tight surgical scar tissue and gets fluid circulating again and it releases the problem areas that cause pain. This may be something that leads to fibromyalgia. Doctors mentioned fibromyalgia to me years ago, but I turned everything around with the choices I made to better my health. Don't allow a diagnostic guess to influence your choices. Try to figure out what is causing the problem and see out doctors who are willing to help you do this. Physical therapy and MFR may possibly help in the future after you can get things calmed down.

Environmental medicine
Here are some links. AAEM has a physician provider search. You can find information at https://www.aaemonline.org/. On that page, you'll see something about my environmental medicine doctor who recently passed. I learned a lot of this from him. I'm awaiting a visit to a new doctor who uses the same methods for treating patients next month so I can continue treating allergies, etc. This link is a provider in Dallas, TX where a lot of the pioneering work was done in this field. https://www.ehcd.com/
https://www.mayoclinic.org/diseases-conditions/thoracic-outlet-syndrome/symptoms-causes/syc-20353988
Our Myofascial release discussion. https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/

I wish you well in your journey.

Hello, and I will add my welcome to Mayo Connect.

I have been having similar issues, and like Colleen therapy is helping to resolve it, but it is very slow going. I was having chronic pain & spinal immobility due to arthritis, stenosis, bone spurs and 2 years of a different illness, which limited my ability to be active...Then I needed to stop anti-inflammatory meds I was taking, Covid hit and took away all my outlets for socializing and I was miserable - everything hurt.

My primary doc referred me to a pain management specialist whose skill is helping get you over the pain through multiple, non-opioid strategies. I was diagnosed with overreactive pain sensory nerves that needed to be calmed as well as the arthritic pain. I am taking (temporarily I hope) a medication to calm the nerve response, and specialized PT by a person trained in traditional PT and osteopathic therapy. He first designed series of stretches and exercises to mobilize my neck and spine as well as performing specific manipulations meant to do the same. After about two months, we began targeting individual parts of the body, depending on which were the most painful at any given week. For five weeks we have been targeting my painful shoulders, and I am beginning to feel some relief, though I still cannot sleep on my right side.

In addition to the therapy appointments, I have a series of exercises to perform each day. The shoulder pain seems to be related to my neck, so those exercises are performed in a specific order to work best. I also continue to walk for exercise, practice mindfulness to keep positive, eat a very healthy diet and strictly limit caffeine and alcohol use.

My recommendation to you is to locate a pain management specialist who works to find and correct the root cause. It has changed my life.
Sue

Sue, I encourage you to research individually vitamin K2 MK4, which was first named Activator-X by Dr. Weston Price, for arthritis, stenosis and bone spurs along with boron, also in the form of calcium fructoborate and magnesium. Together they offer the body calcium management, co-factors and balance needed to address a staggering number of conditions. Always consult with your heath care professional before using any supplement.
https://www.westonaprice.org/health-topics/in-defense-of-vitamin-k2-mk-4-dr-prices-activator-x/
https://www.krispin.com/magnes.html
https://juniperpublishers.com/jojcs/pdf/JOJCS.MS.ID.555582.pdf
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4712861/

I can relate to your problem completely but my orthopedic and a rheumatologist say it is osteoarthritis. I know I will need my knee replaced in the future and wonder if that is not exasperating my hip, shoulder and back issues. I appreciate your suggesting pain management doctor and your results. My PA said she wouldn’t go to one, but then she is not experiencing the pain and discomfort. That may be my next step. I keep telling myself, that I will find something that will help. I am 65 and have lots I want to do. I am doing various PT exercise to keep me moving.

"The shoulder, which is the most mobile of joints, is affected by any physical or organic malfunction!" Robin McKenzie.

@suz55 You said "I know I will need my knee replaced in the future and wonder if that is not exasperating my hip, shoulder and back issues." I will answer from experience - Absolutely! I had bilateral hip replacements at 55 and revisions 6 years later. The change in my overall pain level was amazing after I stopped limping. For two reasons - first, pain in a joint causes you to change gait, the way you hold your body, and the amount you move. Second, pain activates the pain receptors in your brain, which then become highly sensitized, causing more pain (in my family we call them "pain buddies.")

If your PA is only familiar with what I call "old-style" pain management specialists, whose primary tools were injections and opioids, that may color her opinion. What you need is a new-style one, whose goal is to find and interrupt the signals, and if possible treat the underlying cause. Ask your ortho or rheumatologist to refer you to a doc whose goal is improved function in spite of issues.

Good luck!
Sue

Thanks for the recommendation. I will be doing some more reading before I jump in, but looking at the tables in the NIH report, I estimate we are already getting the 6mg daily through our heavy consumption of fruits, vegetables & beans. Sue

Thank you for the encouraging words. I hate to think I will be in this condition the rest of my life. You have given me hope and I will look into your recommendations from your experience.

I find this interesting. I had my 2 Shingrix vaccination shots this year, both in my left arm. (I am right handed.) Following the 2nd one in August, I have experienced reduced range of motion reaching my left arm up behind my back, plus some weakness and general soreness in that arm that I could not account for. I suspected that it might be related to the vaccination based on when the symptoms appeared, but had not found mention of the this when reviewing adverse reactions on the Shingrix web site.