Running out of options. Shoulder pain but no orthopedic issues

Posted by hilda2020 @hilda2020, Oct 23 2:32pm

Hi, I hope someone can help. I am 53 years old, post-menopausal for 3 years. I have always lifted weights and I am also an avid runner. Healthy, 5’2″ 120lb. All good until a year ago when gradually my left shoulder started to feel week and sore. It is now 12 months and both of my shoulders are in pain, the left shoulder more so than the right. Limited motion when reaching the back, or if I suddenly need to move my arm. Have been to three orthos, had cortisone shots, Xray, Ultrasound, MRIs, and all they see is inflammation of my muscle and tendons, and fluid but no reason as to why is there. Pain stretches to under my arm and biceps. I have been taking Cymbalta for 15 years but when I tried to titrate down I developed horrible hip pain on my right side. Once I started to take the Cymbalta again, the pain went away. I was told by my primary that it was probably fibromyalgia pains. At this point I don’t know what else to do, where to go, or who do I talk to. The pain is so bad at night or when working. Please help!

Hi @hilda2020, welcome to Mayo Connect. I moved your message to the Bones, Joints & Muscles group because it is more closely related to your question. Your situation sounds very similar to the discussion @nenahurts @sandytoes14 @cipaul were having a while back. See it here:

– Frozen shoulder (adhesive capsulitis) but is it something else? https://connect.mayoclinic.org/discussion/frozen-shoulder-adhesive-capsulitis-but-is-it-something-else

Like you, I'm in my 50s and I work out regularly doing high intensity training and weight lifting (not overly heavy). A year ago my dominant arm started growing weaker and then I lost significant range of motion and was in pain (for months). It's been a long year of physiotherapy, massage and rehabilitation. Only now after 12 months am I able to get most of my range of motion back. I'm almost pain free and am slowly building up strength again. That's my story, which may not be yours. I don't have fibromyalgia.

Does this interview with Dr. Christopher Camp, an orthopedic surgeon at Mayo Clinic, describe your shoulder issue?

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I would go see a rheumatologist.

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It could be frozen shoulder, I had a similar problem like that. I first had it in my right shoulder. I have to go to MY and also hydRocortisone shots. It took about a year to heal. A couple years later I started getting it in my left shoulder, wasn't to bad. I started the exercises that I learn in PT. After awhile it healed

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I too have had a very similar situation and your description of the upper arm pain sounds exactly like mine. I am in your age range, have fibromyalgia and had stopped taking Cymbalta for a period of time. I was referred to a physiotherapist who determined it was a bilateral strain of the biceps and possibly the deltoid/rotator cuff muscles (the latter likely due to compensations). I did the prescribed exercises and massaging of the area for a few weeks. It started to feel better and after a while I abandoned the physio. But it has not disappeared completely yet. I still have some range of motion stiffness when reaching backwards. I'm finding that time is easing the situation but it has felt like a long time. I will be going back on Cymbalta at some point soon so perhaps that might help a bit. In any case, I thought perhaps my physiotherapist's identification of the ailment might shed some light on your situation.

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Did you get an MRI on your shoulder and neck? could be referred pain from your cervical spine.

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Research SIRVA (Shoulder Injury Resulting from Vaccine Administration). I’ve been diagnosed with SIRVA , been in physical therapy for almost two years for two separate instances. The vaccine was given incorrectly by giving it too high on my arm and dispersing vaccine into my bursa. This caused great pain and inflammation within my shoulder.

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I could only raise my left arm to 4 o'clock when about your age. A good physical therapist would warm the shoulder with a pad for about 20 minutes, then move it gently. After a few treatments, I was floating in shallow warm water and was able to get it up to 3 o'clock . It rose faster after that. After 12 treatments it was normal.

Liked by migizii

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Good morning @katherineanne and welcome to Connect. I see that this is your first post. You have had a little time to get acquainted.

First. I think your use of the clock to measure flexibility in your arm is great. I am not very good with all the degrees and angles.

Secondly, I now remember those warm moist pads that begin the treatment session. And then the PT comes and gently moves the shoulder more freely.

How long did it take you to complete 12 treatments. Did you have them weekly with at home follow up?

I am currently evaluating the benefit of twice a week MFR therapy treatments. That may be a better way for me. If I have less pain for fewer days maybe I won’t nap all afternoon because I need relief from pain. Do you have pain under control?

Would you share with me your shoulder treatments? Have you had surgery or because it is your shoulder, maybe you have had more than one.

What are those options that have worn out their welcome? Are you in pain of unknown origin right now? We are not medical practitioners or providers. What we have is our own shared experiences…..we've been there.

May you be content and at peace.
Chris

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hilda2020, look into a thiamine deficiency as a possible answer.Thiamine requires magnesium to activate it.and magnesium malate may also aid the condition while activating thiamine. Then research glutathione, the master antioxident in the body. Here are some links to refer to. Always consult with your heath care professional before using any supplement.
http://www.hormonesmatter.com/thiamine-fibromyalgia-chronic-fatigue/
https://www.krispin.com/magnes.html

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Many symptoms with our body can be traced back to what we eat. I know a person that had their thyroid gland removed, only to find out later that their symptoms were caused by "Gluten-Intolerance." I suggest that you cut meat from your diet (especially pork, which can cause joint pain) for a period of three months. See at that time if your symptoms get better. Other than that, have you ever been to a foreign country where mosquitoe-born illnesses are prevalent? My father had shoulder pain, and no-one could figure out what was wrong. After much testing, it was discovered he had "Filarisis," which he contracted while serving in the military overseas during World War II. Of course, it is doubtful this is what you have, but you have gone through the gamut of tests, and this does cause joint pain.

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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.

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@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.

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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

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@sueinmn

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

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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/

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@sueinmn

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

Jump to this post

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.

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