[desertgirl8]

I'm 37 years old and have been using a manual chair for about 30 years. I would like to talk with anyone who has any type of shoulder problems related to overuse from their SCI. After a decade of getting my chair in and out of my car, my right arm/shoulder started to shut down and hurt like hell.

I have a van now which instantly made it possible for me to use my arm again. However, the damage seems to be permanent. Sleeping on my shoulder, exercise, everything has changed. My right shoulder just can't take the stress anymore. Sometimes it will just start to ache from my shoulder down through my arm to the palm of my hand.

The doctors don't have much in the way of information. I would just like to know if anyone out there has been in a wheelchair so long that overuse of your upper body is starting to make itself known. Anyone?

I also wish someone had told me the consequences of lifting my chair in and out of my cool little car. I would have saved my shoulder for more important things like skiing, biking, tennis, etc.

[nomis]

Hi desertgirl8
Sounds like a classic case of oesteoarthritis.
I'm 37yrs using a chair and my shoulders are so far holding up ok. Bu I have OA in my fingers and wrists.
This is a consequence of normal wear and tear on the bone joints that welcomes many into the senior section of their life.
Hurts like hell, unpredictable being worse some days than others, sometimes a background ache, sometimes a piercing jab. Right?

No solution only precautions. Learn to avoid the most hurtful activities but keep exercising (lots). Fish oil (omega3) is supposedly good in assisting healthy lubrication in the joint, and for slowing down the damage and maybe some restoration (not proven) a joint food containing Glucosamine and Chondroitin can help.

The bad news is that you'll always have the pain. The good news is that you can reduced it with good management and it gets easier to live with.

Or, I'm totally wrong and it's not osteoarthritis (but I reckon it is).

[Motor]

desertgirl8, on Feb 17 2008, 08:15 PM, said:

I'm 37 years old and have been using a manual chair for about 30 years. I would like to talk with anyone who has any type of shoulder problems related to overuse from their SCI. After a decade of getting my chair in and out of my car, my right arm/shoulder started to shut down and hurt like hell.

I have a van now which instantly made it possible for me to use my arm again. However, the damage seems to be permanent. Sleeping on my shoulder, exercise, everything has changed. My right shoulder just can't take the stress anymore. Sometimes it will just start to ache from my shoulder down through my arm to the palm of my hand.

The doctors don't have much in the way of information. I would just like to know if anyone out there has been in a wheelchair so long that overuse of your upper body is starting to make itself known. Anyone?

I also wish someone had told me the consequences of lifting my chair in and out of my cool little car. I would have saved my shoulder for more important things like skiing, biking, tennis, etc.

I have bad shoulders but thats because I tore them up in my accident and never got them fixed. Two torn rotator cuffs and a torn bicep sheath (whatever that is). If I get them fixed I'll be a quad while I heal, and I have a hard time as a para. I have used accupuncture with success and they have wheels with motors in them that assist with rolling. Just a slight push and your off. They have lifts or crane like machines that can help with loading. As for pain I use lidoderm patches at night. A massage regularly helps to!

[Yong]

I had shoulder nerve damage during my accident. The doctors did a nerve conduction study and found out my muscles were innervating.

Long story short, I had a very serious case of tendonitis on my shoulder from compensating for my damaged deltoids. But with about two months of therapy and 10 months of recovery, my shoulder is fine.

I hear tendonitis can occur from overuse. Did you check with your doctor to see if it could be tendonitis?

[longhaul]

Hi and welcome. Your story is my story too. I went to a PT and they gave me specific exercises to do to strengthen the shoulder and it helped big time. Like nomis says the Omega 3 oils are very helpful and food that has high nutritional value so the shoulder can heal. My favorite pain/repair potion is arnica tincture and arnica gel, I rub the tincture on and then the gel 3-4 times a day. Arnica relieves pain and aids repair. vitamin D is very important for repair and maintenance also.

[edlee]

Had it before injury, from my work (ironworker), and after from the chair.

If it feels better from not using them as much, it is probably treatable. I have had a great deal of help from cortisone shots directly into the bursa space.

I'm usually good for six monthes to a year, then back again for more.

My wife has a similar problem with her knee that has been helped with a series of shots of a product called HYALGEN. It is also injected into a space that normally contains liquid ( under her knee cap).

They have knee replacement and hip replacement,, I don't think they have shoulder replacement. There are times I think I would risk it if they did.
ed

[ItCanBeDone]

desertgirl8, on Feb 18 2008, 01:15 AM, said:

I'm 37 years old and have been using a manual chair for about 30 years. I would like to talk with anyone who has any type of shoulder problems related to overuse from their SCI. After a decade of getting my chair in and out of my car, my right arm/shoulder started to shut down and hurt like hell.

I have a van now which instantly made it possible for me to use my arm again. However, the damage seems to be permanent. Sleeping on my shoulder, exercise, everything has changed. My right shoulder just can't take the stress anymore. Sometimes it will just start to ache from my shoulder down through my arm to the palm of my hand.

The doctors don't have much in the way of information. I would just like to know if anyone out there has been in a wheelchair so long that overuse of your upper body is starting to make itself known. Anyone?

I also wish someone had told me the consequences of lifting my chair in and out of my cool little car. I would have saved my shoulder for more important things like skiing, biking, tennis, etc.

Desert (you go!) girl,

active lifestyle- good, persistent cumbersome shoulder/arm pain- bad. sorry, hon. i am a 35 y/o primarilly right-handed quad who uses the heck out of my shoulders, bicepts and forearms (preferential to my right arm). i presented my doc with intense symptoms of pain and occasional feelings of...well...overuse! a subsequent CAT and bone density scan gave me a discernable, very plausible answer; bursitis. "burrs" of bone that may develop as a result of overuse and a lack of necessary nutrients. my arms get overworked and underpaid, per ce. might be something to check out.

[kewlcatkez]

edlee, on Feb 19 2008, 12:45 AM, said:

Had it before injury, from my work (ironworker), and after from the chair.

If it feels better from not using them as much, it is probably treatable. I have had a great deal of help from cortisone shots directly into the bursa space.

I'm usually good for six monthes to a year, then back again for more.

My wife has a similar problem with her knee that has been helped with a series of shots of a product called HYALGEN. It is also injected into a space that normally contains liquid ( under her knee cap).

They have knee replacement and hip replacement,, I don't think they have shoulder replacement. There are times I think I would risk it if they did.
ed

Hello,

I haven't replied til now as I have been a chair user for almost 3 years, so hardly qualify for the "been in a chair forever". However, I have severe dislocating EDS as well as my paralysis. This is due to faulty connective tissue genetically. Basically I have always dislocated, but it has worsened so that now I am dislocating multiple times, multiple joints a day...This has led to Bursitis and Tendonitis at my major joints, with some tendon and nerve damage in my upper body too..due to the repeated micro and macro traumas..

Sooo

To cut a long story short, this is how my shoulders are screwed..

I have multiple dislocations just pushing my chair, not to mention taking it apart and transferring..The pain which you mention may be due to impingement of the nerves in the shoulder and also the inflammation of the Bursa/tendons at the joint. Some damage could be due to Rotator cuff tears..

It may be worth ( if you haven't already) looking into the rotator cuff tears. Sometimes a small tear can be found using fibre-optic probe, and the debris removed and tear repaired. That can lead to improvement to your pain and function. Although the time after surgery where you won;t be able to use your arm much to allow healing, will be a factor also..

People who had Glenoid fractures in the past are also at risk of shoulder arthritis.. Osteoarthritis is also a factor, due to the overuse and bone mineral loss ( in tetras/quads or where peripheral nerve damage). Myofascial pain is also a main culprit, due to overstretching and poor posture (due to chair and neck craning) it is normally an aching or burning pain. You can usually feel a hard knot in the muscle that is very sore to touch.

As Edlee mentions, people have Steroid injections (Methylprednisolone, Triamcinolone Acetonide, Betamethasone) into the joint spaces. I have had several to my DeQuervains Tenosynovitis ( wrist/thumbs) and it didn't make that much difference for me and then of course worsened again afterwards. However some do get relief from that. Do note that These injections are only recommended a handful of times a year, due to the side effects ( risk of tendon rupture, and some say increase joint cartilage problems -others say this is not true..) Indeed, if a first injection is ineffective, a second can be given a month or so after, and is shown to have some success in trials. If it doesn't work after two injections, it probably won't at all...

Other things to do are to limit force to the joint ( lightest chair, more efficient chairs, beds and other furniture at a better height for transfers, sliding boards etc) and PT. Occupational therapy can also be utilised to help find new ways of doing things which help to decrease strain and pressure and improve posture..

I am still finding ways myself. In my case the constant several times every day shoulder dislocations make it seem unlikely to be fixed anytime soon..
goodness help me in 20 years..LOL


I hope this helps,

Take care,

K

[Avocado Baby]

Yep...same here! I wasn't sure where the pain was coming from but the stabbing pain in my palm sounds very familiar!!

[handi2]

I had to get Cortisone injections in my shoulders from racing and lifting weights. I have been pain free for 15 years now after the injections AND I stopped doing sports. The steriod injection may be the thing for you also.

[longhaul]

If you use a mouse on the arm with the sore shoulder it will make it worse.................

[Ahlam]

desertgirl8, on Feb 18 2008, 01:15 AM, said:

I'm 37 years old and have been using a manual chair for about 30 years. I would like to talk with anyone who has any type of shoulder problems related to overuse from their SCI. After a decade of getting my chair in and out of my car, my right arm/shoulder started to shut down and hurt like hell.

I have a van now which instantly made it possible for me to use my arm again. However, the damage seems to be permanent. Sleeping on my shoulder, exercise, everything has changed. My right shoulder just can't take the stress anymore. Sometimes it will just start to ache from my shoulder down through my arm to the palm of my hand.

The doctors don't have much in the way of information. I would just like to know if anyone out there has been in a wheelchair so long that overuse of your upper body is starting to make itself known. Anyone?

I also wish someone had told me the consequences of lifting my chair in and out of my cool little car. I would have saved my shoulder for more important things like skiing, biking, tennis, etc.

Hello,
Aha, I believe the problem is from an orthopedic point of view, Ur over working Ur muscles so to know the right diagnosis I can help u with the following:

To assess shoulder pain first ask ur self:
1- Is pain present with FREE ACTIVE movements? (Move arm in all directions)

If pain is percent in ACTIVE movements >> shoulder problem
If pain is NOT present >>Back or Cervical problem

So if the problem is in the back or cervical contact the doctor for an X-Ray

2- Ok, so it's a shoulder problem then it's one of the following:

Assess pain in ACTIVE & PASSIVE range of motion:
- Pain in PASSIVE (I mean relax Ur arm and let someone move it for u) >>> capsule problem
- Pain in ACTIVE movement >> tendon problem

*IMPROTANT:
If pain is present in both ACTIVE & PASSIVE movements >>> capsule + long head of biceps problem

3- PASSIVE movement and pain:
Capsular pain (frozen shoulder) to make sure that the diagnosis is correct:
Flex Ur arm to 90 degree, if pain is present >> supinate Ur arm (palm of hand to the
Ceiling) >> continue to the end of range 180 degree >>> PAIN FREE

* IMPROTANT: movement is passive not active!

in capsular pain (frozen shoulder) u must let is live its course, pain will be present in the beginning and it is different for each person, after that stage u will have immobile stage where u can't move ur arm in any direction, after that stage u will enter the healing stage, this may take weeks, months or even years!

Contact the doctor for pain medications and be referred to a physio, he will give you techniques for relaxation and simple Exercises for keeping Ur range of motion not to lose it when recovery stage comes.

4- ACTIVE movement pain:
Tendon, how do we know which is involved?
- Pain in flexion >>> long head of biceps
- Pain in external rotation>>> infra spinatus
- Pain in internal rotation >> subscapularis
- Pain in abduction>> supraspinatus

When it's a tendon problem, u should have an X-ray, to see if its (rupture, inflammation ....etc) then the treatment will follow!

Hope I helped u figure out what the problem is, and u need to make sure by visiting Ur doctor ok!

Ahlam