23 replies to this topic

[LeviM]

So I've had some shoulder issues for a while and the past several months the pain in my right shoulder has increased a lot. I went to the ortho who diagnosed me with impingement syndrome, adhesive capsulitis and ac join arthrosis. Despite having a history of a rotator cuff tear around 2000 he didn't want to do a MRI. Only after I raised a little hell did he go ahead and order it.

The MRI results are as follows.

Findings No full thickness cuff tear. Subtle undersurface partial thickness tear of the distal central cuff at the footplate. No delamination.

Bicepts-normal
Labrum-normal
Coracoacromial arch- Normal anterior arch. Curved acromium. AC Joint DJD with capsular hypertrophy
Mustles-normal
Bones-normal
other-Normal

Conclusion. No full thickness cuff tear. Subtle undersurface partial thickness tear of the distal central cuff at the footplate.

What exactly does this mean? I tried to get the doctor to explain it to me in terms I could understand but all he would say is that it wasn't anything major and then he offered me a course cortisone shots. I'm really not impressed with the doctor. I will likely seek the advice of another doctor if my shoulder issues don't ease up within the next few months. I'm back in pt/ot 4 days a week and we will be working on the shoulder issues some so hopefully that will help.

[tsh3406]

I'll assume that because you are incomplete, you are in a manual chair? The drive fast, turn left version is it's an aggitation of the area from over use. The acromiun is a small bone on top of your shouler, tissue has built up around that area. With the continuous repetive movement of wheeling, it will likely not heal on it's own. Get a second opinion.

Tim

[edlee]

Actually,, the first opinion is probably pretty close. And it's only going to get worse as you age,,,,, BUT,,,,, get the cortisone/steroid injection. They will generally allow them at intervals of no less than 6 months,, but I often go a year between,,,, and they work.

I've never talked to anyone who was happy after shoulder surgery,, but everyone I talk to who has had the shots seems pleased with the results.


AVOID THE KNIFE
ed

[LeviM]

I'll assume that because you are incomplete, you are in a manual chair? The drive fast, turn left version is it's an aggitation of the area from over use. The acromiun is a small bone on top of your shoulder, tissue has built up around that area. With the continuous repetive movement of wheeling, it will likely not heal on it's own. Get a second opinion.

Tim

I'm C7 C8 Asia B
I do spend most of my time in a manual chair because of the tight living space. Around the house I get around ok on my own but when I'm away from home I'm always being pushed. Besides the cord injury that left me with the full use of only 2 fingers on each hand and limited wrist, I also Have MS which has caused me to lose a lot of arm strength and I tend to get tired when wheeling myself very quickly.

My cord injury was in 2002 and I did opt to wheel around in a manual chair instead of a power chair for many years before my arm strength and endurance went down hill. I'm back in PT/OT to try and get back some of what I've lost from the MS hoping it will allow me to be more independent away from home in my manual chair .

I will definitely get a second opinion should the pain not improve within the next few months.

[LeviM]

Actually,, the first opinion is probably pretty close. And it's only going to get worse as you age,,,,, BUT,,,,, get the cortisone/steroid injection. They will generally allow them at intervals of no less than 6 months,, but I often go a year between,,,, and they work.

I've never talked to anyone who was happy after shoulder surgery,, but everyone I talk to who has had the shots seems pleased with the results.


AVOID THE KNIFE
ed

Hey Edlee, thanks for the info and advice on the shots. I had the shots done in my left knee before my cord injury and I remember being in a lot of pain for days following. I Guess I shied away from the shoulder injections for that reason. I can't imagine having the deal with that pain every time I need to move around or shift my weight etc. For now we decided to go with a different delivery method. I can't remember what it's called but they are going to use Dexamethosone cream on the shoulders and then use an ultrasound device to try and get it into the joint. I've been told this isn't the best way to do it so if this doesn't work I'll probably do the injections. I'm hoping it helps enough to make things more tolerable at least.

I agree with your opinion of avoiding the knife.

[Tetracyclone]

Levi,

I had a cortisone injection in the shoulder that fixed me up great. I had no pain, though i believe one needs a skilled doctor to place the injection with minimal discomfort (OK, pain). Pain from one event does not necessarily mean pain in this one.

Also, be cautious about ascribing losses of function to your MS. The trend is for doctors and patients to seek an easy explanation, but in reality unrelated problems are always cropping up. Due diligence, friend.

[LeviM]

Levi,

I had a cortisone injection in the shoulder that fixed me up great. I had no pain, though i believe one needs a skilled doctor to place the injection with minimal discomfort (OK, pain). Pain from one event does not necessarily mean pain in this one.

Also, be cautious about ascribing losses of function to your MS. The trend is for doctors and patients to seek an easy explanation, but in reality unrelated problems are always cropping up. Due diligence, friend.

Another person in favor of the cortisone shots... Guess that's a clear enough message lol..

You're right about being to quick to point the finger at MS. Myself and my doctors are pretty quick to blame every little thing on MS. I can see your point. Doing so could lead to trouble.
Thanks!

[Tetracyclone]

Levi,

I had a cortisone injection in the shoulder that fixed me up great. I had no pain, though i believe one needs a skilled doctor to place the injection with minimal discomfort (OK, pain). Pain from one event does not necessarily mean pain in this one.

Also, be cautious about ascribing losses of function to your MS. The trend is for doctors and patients to seek an easy explanation, but in reality unrelated problems are always cropping up. Due diligence, friend.

Another person in favor of the cortisone shots... Guess that's a clear enough message lol..

You're right about being to quick to point the finger at MS. Myself and my doctors are pretty quick to blame every little thing on MS. I can see your point. Doing so could lead to trouble.
Thanks!

Yes! It leads to resignation instead of looking for solutions. I find doctors tend to see me as only SCI. I am the one who has to figure out so many postural difficulties that impair movement. Things happened in my accident that impair mobility that can also be fixed- they came with the SCI, but medical people tend to see only the SCI. It took me two years to figure this out and start thinking for myself, though credit goes to my Physiatrist who, while he had no idea how to help, he dis refer me to an off-beat physio who had good ideas how to help.

Anyhow, Levi, I am glad you see my point.

[Simplicity]

Hello,

I am a T5 paraplegic that has been struggling with shoulder pain for the past five years. I have went through extensive physical therapy, cortisone shots, prolotherapy, dry needling, and a few sessions of acupuncture.

I have a minor rotator cuff tear and bone spur in my right shoulder. I am scheduled for shoulder surgery the first week in January. I was wondering if anybody can give me any feedback on the recovery process, or if it's even worth it to go through the surgery with a minor rotator cuff tear.

My left shoulder hurts about the same as my right one; however, I have not tested my left shoulder through an MRI scan. Therefore, I do not know the severity of the injury in my left shoulder.

If anybody can give me any shoulder relieving advice I will highly appreciate it.

In addition, I also struggle with carpal tunnel syndrome. I will be to receive any pain relieving advice on this topic as well.

Thank you

[nomis]

In the meantime, LeviM, talk to your OT/PT about it.

[cal1971]

Hi I'm a paraplegic t 3-4 and I woke this morning with neck pain at least I thought thats what it was but as I sat longer it went to my shoulder. By me not being familiar wiith this kind of pain can someone tell me what is wrong or happening?

[Tetracyclone]

Hi I'm a paraplegic t 3-4 and I woke this morning with neck pain at least I thought thats what it was but as I sat longer it went to my shoulder. By me not being familiar wiith this kind of pain can someone tell me what is wrong or happening?

That is the sort of thing that happens to most folks, AB or disabled, when something gets out of line during the night. I head for my chiropractor's office. Or just wait and do range of motion, gentle exercise, and it will probably clear up within the week.

[greybeard]

Having a shoulder shot this coming Friday. I'll let you know how it goes.

[LeviM]

Hey GB, good luck with your injection!! How long has it been since your last one?

[greybeard]

Hey GB, good luck with your injection!! How long has it been since your last one?

About three years I think.

[richo]

ever conciderd an electric chair even till sholder comes good.. but do avoid sugery..... i allso wouldent let them pump shit out of a seringe into it either...rest and phisio the path i went down,took long time but it came good....and with no nasty side effects...take care

[LeviM]

Wow GB that's a long time!

[A trophy guy]

Speaking as someone who has had about 20-25 cortisone injections in my shoulders over the years, I can say that they are miraculously helpful in the beginning. Or in other words, if you don't let the total relief you feel from the shot (and you do feel total relief) let you think you can do whatever you want again and you are careful with your shoulder, they work great.

[greybeard]

Wow GB that's a long time!

Well, I'm not a full-time w/chair user (but seem to be heading that way), and I don't have a rotator cuff tear. A recent MRI has discovered I have several patches of calcification which are now causing sleep-disturbing pain at night.

[LeviM]

Wow GB that's a long time!

Well, I'm not a full-time w/chair user (but seem to be heading that way), and I don't have a rotator cuff tear. A recent MRI has discovered I have several patches of calcification which are now causing sleep-disturbing pain at night.

Hey GB, I've read some posts where you were talking about the issues you're having. I can imagine it's a pretty frustrating and sad decline. I can somewhat relate to that frustration and despair as I too am on a steady decline in health and as the months and years go by, I lose more and more function due to MS. I really hope in your situation they are able to get a grip on things to stop the decline. Calcification in a joint must be excruciatingly painful. How do they even go about repairing that? I too have the issues with pain when trying to sleep and often get woke up after a short time with pain. It's frustrating to say the least.

Hopefully the cortisone injection eases things for ya pretty good for a while.

[greybeard]

Calcification in a joint must be excruciatingly painful. How do they even go about repairing that?

If it's all in one place, they squeeze it out like toothpaste out of a tube. There are some interesting clips of it on YouTube. I had this operation on my other shoulder 20 odd years ago. Bloody painful recovery, but reasonably trouble free since. The current calcification is inoperable because it is too wide spread for easy extraction.

Thanks for the good wishes.

Edited by greybeard, 01 March 2012 - 12:22 PM.

[McTavish]

I don,t suffer from shoulder pain but sometimes if I have been wheeling around a lot I may start to get little twinges in my shoulders, if that happens I try to take it easy for a day or two and just give them a rest. I often think of getting an electric wheelchair to save my shoulders, in the house as I do a lot of going around. When you stop and think of the work they do pushing us around every day it seems inevitable that eventually they are going to cause some pain.

[greybeard]

Having a shoulder shot this coming Friday. I'll let you know how it goes.

It didn't happen.

Advice for the squeamish - go read something else now.

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The doc read the report from the ultra-sound scan then decided he should try to suck out some of the calcification before giving me the cortisone shot.

He prep'd the shoulder - - "X" marks the spot and all that, and then started hunting in his tool kit for a suitable needle. He brought out one about two inches long, squinted at it and muttered something about "not big enough". Then started scrabbling through cupboards and drawers before telling me that the only needle he had wasn't anywhere near big enough! Nice. I almost offered to go fetch my bicycle pump for him, but contained my enthusiasm to assist in this farce.

I foolishly mentioned I had seen calcification surgery (which I'd had on the other shoulder) on YouTube and he promptly fired up his browser and started to look for similar clips. By then I was seriously beginning to wonder if he really knew what he was doing. He assured me that he just needed to find out exactly what had to be injected to help push the calcification out, which I actually found to be no assurance at all.

He did manage to put my mind at rest a bit about the "big needle" thing, though. He didn't mean longer, just a bigger bore - not that I fancy something the thickness of a drinking straw being shoved into my shoulder joint while I'm awake but perhaps he didn't quite mean that big.

Anyway, eventually he re-scheduled the event for two week's time. Hopefully by then he'll have done his homework and perhaps practised his needle technique on a potato or two. I think I'll double up on the pain killers that morning - just in case.

Do you think I'll be awarded an "I've been brave" badge?

[LeviM]

Oh GB!!, I would have been flipping lol.. I think you're right in assuming he doesn't have a clue what he's doing. That would make me nervous enough to stop the whole ordeal!!
Yes I most definitely think that earns you the bravery patch. I would have been out of there so fast he wouldn't know what happened! I hope for your sake he has educated himself before he starts poking on you in 2 weeks!