Tendon and muscle pain

Posted by Jim @wrig1jam, Mar 20 10:40am

My symptoms include severe tendon pain in my right wrist, pain in my neck and right shoulder muscles with some muscles atrophied. I am taking 500 mg ibuprofen twice a day, but not sure if it is having any impact. I also have a 3M Futuro elastic brace on my right wrist.

Some history; I had the the flu first of January which lasted a week and then I was weak until the first of February. I started some light weight lifting in early February and strained my left and right shoulder muscles. About 2 weeks later I developed a severe burning in my left shoulder area and a mild burning in my right shoulder. Pain was so severe I couldn’t sleep on my sides. I took Celebrex every night and after a week the pain lessened. I was finally able to get a doctors appointment. He took a blood test (CK) for muscle damage which came back negative. He prescribed 500 mg twice a day for the pain. After the doctors appoinment my right wrist tendon pain became severe. I am in the process of scheduling another doctors appointment

Looking for any one with similar experience and recommendations. I hope my message wasn’t too long. Thanks for any insights. Jim

Interested in more discussions like this? Go to the Bones, Joints & Muscles Support Group.

Your situation sounds similar to mine…Have you been evaluated by a PT or physiatrist (physical medicine and rehab doctor) yet?

A few years ago, I got a very, very bad cold (must have been some kind of virus). I was sick for 2 weeks, then about a month later, I started having mysterious symptoms. It started with numbness and tingling in my legs, then a few months later I got diagnosed with runner’s knee (patellafemoral pain syndrome), and got sent to PT.

In PT, I developed tendon injuries in rapid succession: patellar tendinopathy in both knees, insertional Achilles tendinopathy in both heels, adductor strain, calf tear, IT band syndrome, quadriceps tendinopathy. This all happened within the span of 3 months.

I was seeing a physiatrist—they’re a good option because they look at things holistically and are trained in internal medicine and physical medicine (like with PT), and she realized in that amount of time, I should be seeing some improvement with PT, so she referred me to a rheumatologist.

Long story short: I got diagnosed with seronegative spondyloarthropathy. Seronegative = No elevated inflammatory markers in my blood tests—there are autoimmune conditions like this. It causes inflammation in the insertion points where tendons go into the bones causing joint and tendon pain.

Because it’s seronegative, one of the ways they diagnosis it is they prescribe high doses of NSAIDs (like Celebrex) to see if the pain significantly improves. And in general inflammatory (so autoimmune) arthritis gets worse at rest or in the morning but better with movement—that’s another clue if you think you may have what they call “morning stiffness.”

It’s often mistaken especially in active people as the usual overused tendinitis, only it doesn’t get better with the usual interventions.

I’m not saying that’s what you have, but you had asked if anyone had a similar experience, and I did… My care team suspects the virus triggered an autoimmune response, much like Long COVID does for some people. Even before the pandemic, it was well-known this could happen to people.

I’m not sure if you’ve tried PT yet or seem a physiatrist, but that may be a good place to start. They may be able to give insight in if you’ve had a cascade of injuries because of the original biomechanical issue/injury, central sensitization (nervous system gets hypersensitive to pain after injury) or may need to see a rheumatologist.

I don’t want to scare you off…but looking back at the years it took me to be diagnosed, I wish that someone would have told me so I’d at least know my options, because I knew intuitively something felt off but didn’t know who to go to or what to look for.

If it’s something you might suspect, you could also check out the Autoimmune group on Connect.

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Thank you very much for your detailed response. I plan on taking your experience to my physician

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@wrig1jam

Thank you very much for your detailed response. I plan on taking your experience to my physician

Jump to this post

You’re welcome. Feel free to send any questions or just vent. Happy to help if I can.

If you and/or your doctor think you may have an autoimmune condition, a rheumatologist is usually best positioned to weigh in—they see this stuff a lot, and it can be hard to diagnose. If you feel strongly that something’s up—whether it’s this or something else altogether, keep asking questions or advocating for yourself. I ended up seeing 3 rheumatologists, including one through an evaluation at Mayo, and they all missed it. I wish the lines weren’t so fuzzy.

I hope you feel better soon.

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@emo

Your situation sounds similar to mine…Have you been evaluated by a PT or physiatrist (physical medicine and rehab doctor) yet?

A few years ago, I got a very, very bad cold (must have been some kind of virus). I was sick for 2 weeks, then about a month later, I started having mysterious symptoms. It started with numbness and tingling in my legs, then a few months later I got diagnosed with runner’s knee (patellafemoral pain syndrome), and got sent to PT.

In PT, I developed tendon injuries in rapid succession: patellar tendinopathy in both knees, insertional Achilles tendinopathy in both heels, adductor strain, calf tear, IT band syndrome, quadriceps tendinopathy. This all happened within the span of 3 months.

I was seeing a physiatrist—they’re a good option because they look at things holistically and are trained in internal medicine and physical medicine (like with PT), and she realized in that amount of time, I should be seeing some improvement with PT, so she referred me to a rheumatologist.

Long story short: I got diagnosed with seronegative spondyloarthropathy. Seronegative = No elevated inflammatory markers in my blood tests—there are autoimmune conditions like this. It causes inflammation in the insertion points where tendons go into the bones causing joint and tendon pain.

Because it’s seronegative, one of the ways they diagnosis it is they prescribe high doses of NSAIDs (like Celebrex) to see if the pain significantly improves. And in general inflammatory (so autoimmune) arthritis gets worse at rest or in the morning but better with movement—that’s another clue if you think you may have what they call “morning stiffness.”

It’s often mistaken especially in active people as the usual overused tendinitis, only it doesn’t get better with the usual interventions.

I’m not saying that’s what you have, but you had asked if anyone had a similar experience, and I did… My care team suspects the virus triggered an autoimmune response, much like Long COVID does for some people. Even before the pandemic, it was well-known this could happen to people.

I’m not sure if you’ve tried PT yet or seem a physiatrist, but that may be a good place to start. They may be able to give insight in if you’ve had a cascade of injuries because of the original biomechanical issue/injury, central sensitization (nervous system gets hypersensitive to pain after injury) or may need to see a rheumatologist.

I don’t want to scare you off…but looking back at the years it took me to be diagnosed, I wish that someone would have told me so I’d at least know my options, because I knew intuitively something felt off but didn’t know who to go to or what to look for.

If it’s something you might suspect, you could also check out the Autoimmune group on Connect.

Jump to this post

You confirmed my suspicions with my painful right rotator cuff and both gluteus Maximus muscle under my butt. Just got over a month long cold along with very painful muscle pain. My orthopedic physician isn't putting the butt pain and shoulder pain and cold virus together.
I am physically active and had started using the rowing machine at the gym. I wasn't sore from over doing the rowing but the virus seemed to attack muscles that had been stressed. After a month long cold and painful muscles your diagnosis really sounds similar to my problem. Muscles should have recovered by now.
Thank you. I will take your experience to my orthopedic and rheumatologist.

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Ibuprofen is a good first move. Now that your symptoms continue more blood test to look for inflammation and
autoimmune rheumatic antibodies are indicated.
If the diagnosis is not clear you may need referral to
a rheumatologist.

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I have something similar that started after covid. I have a rheumatologist appointment in August for Sjogrens evaluation, (Earliest available.)

This info sounds so familiar. My concern with NSAIDS is kidney health. I also have type 1 diabetes.

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@vgen

You confirmed my suspicions with my painful right rotator cuff and both gluteus Maximus muscle under my butt. Just got over a month long cold along with very painful muscle pain. My orthopedic physician isn't putting the butt pain and shoulder pain and cold virus together.
I am physically active and had started using the rowing machine at the gym. I wasn't sore from over doing the rowing but the virus seemed to attack muscles that had been stressed. After a month long cold and painful muscles your diagnosis really sounds similar to my problem. Muscles should have recovered by now.
Thank you. I will take your experience to my orthopedic and rheumatologist.

Jump to this post

magnesium has helped me. one pill a day

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I have been on magnesium morning and night. Doesn’t help me. This started Feb 20 and i am still hurting today March 23,2024. Monday i am getting a steroid shot in my right rotator cuff. Orthopedic doctor told me a rotator cuff tear will present in bicep.
Now I feel symptoms starting in left bicep. I think the virus is still causing inflammation. Rheumatology my next option. Maybe they will consider all my smptoms

REPLY
@vgen

You confirmed my suspicions with my painful right rotator cuff and both gluteus Maximus muscle under my butt. Just got over a month long cold along with very painful muscle pain. My orthopedic physician isn't putting the butt pain and shoulder pain and cold virus together.
I am physically active and had started using the rowing machine at the gym. I wasn't sore from over doing the rowing but the virus seemed to attack muscles that had been stressed. After a month long cold and painful muscles your diagnosis really sounds similar to my problem. Muscles should have recovered by now.
Thank you. I will take your experience to my orthopedic and rheumatologist.

Jump to this post

I guess I should say it is possible it could still be a tendon/tendinopathy issue… This is why I was referred to rheumatology after I’d already tried a few months of good PT with no change. It’s hard to tell the difference between that and an underlying condition.

Because if it is, those do take notoriously long to heal and to a few people’s points, doctors will usually prescribe rest, ice, and NSAIDs and then usually call it a day. But I learned from my PT that tendon injuries can cause lingering pain because the tendon fibers don’t get always get aligned neatly as before, which can cause pain. So there’s specific exercises to help. It was just that we learned those didn’t help me because there was an inflammatory/autoimmune component to my pain!

I hope you’re able to find answers and relief.

REPLY
@vgen

I have been on magnesium morning and night. Doesn’t help me. This started Feb 20 and i am still hurting today March 23,2024. Monday i am getting a steroid shot in my right rotator cuff. Orthopedic doctor told me a rotator cuff tear will present in bicep.
Now I feel symptoms starting in left bicep. I think the virus is still causing inflammation. Rheumatology my next option. Maybe they will consider all my smptoms

Jump to this post

Did they find evidence of a rotator cuff tear?

A rheumatologist or possibly a physiatrist could be a good idea. You’re right they may be more likely to consider the whole picture.

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