Arm/Shoulder pain

[mystic_shrimp]

Hi all.

MF and Jak2 positive ET here.

My shoulder got wrenched in January whilst playing ball games with my dog.

It had started to get better but then my wife and I went to Barcelona for a week. I did lots of walking, plus had a camera and bag across my back/neck. This has aggravated even more!

I've seen the Dr and been sent for physio but that doesn't seem to be helping much.

Paracetamol doesn't really touch it, and I can't take Ibruprofen as on Aspirin.

The pain is like a shooting/burning pain in my shoulder and back, as well as down my left arm.

This morning, it is agony to move and trying to sit myself up in bed was torture.

I have a pretty good range of movement, but it's the pain that getting to me more.

My question is this... does my MF and ET mean that such injuries will take longer to heal?

Any advice welcomed!

[hunter5582]

I have been there and done that with shoulder injuries. I have torn 1 labrum and both rotator cuffs. Having a MPN does not make it take longer to heal. MPNs do increase the inflammatory environment however. In addition, this kind of injury can cause reactive thrombocytosis.

The shoulder is a complex joint. It can take a long time to heal when you sustain an injury like a rotator cuff tear. To make matters worse, it is common to develop adhesions, where the array of muscles no longer slide past each other properly. This can be very painful. The pain can also be referenced to other locations (e.g., down the arm). This kind of injury will not get better on its own.

What has worked for me with shoulder injuries is a combination of extensive physical therapy and massage therapy. I have had to have adhesions broken free. It was quite painful but worth it to get my shoulder to heal. You have to be very committed to the process to achieve real healing. Surgery is a last resort if nothing else works, but is something best avoided.

Note that orthopedists will sometimes sub-specialize. It helps to see a "shoulder-doc." It also helps to be sure to see a really good physical therapist and not a PT Assistant to develop your treatment plan. It also helps to see a massage therapist who is skilled in therapeutic massage. Note that this is a specific form of treatment and not the generic massage for relaxation you get at many spas.

Wishing you all the best and success at healing.

[BlastedKnees]

I know how frustrating that can be - I have a few back issues and when it gets inflamed, it’s a vicious cycle of inflammation causing pain causing more inflammation ever increasing. NSAIDs used to be my go-to to break the cycle until MPN diagnosis and starting daily aspirin.

One thing that that works for my muscle/joint/nerve inflammation is Salonpas patches. They are topical and comes in two types - either lidocaine, or the type I use has methyl salicylate which is an NSAID, but localized. I checked with my MPN doc and the oncology pharmacist and both approved, providing used in moderation. I use one or two patches occasionally when I have serious pains and they help to break the inflammation cycle.

Note that I am considered low risk for thrombosis. Like all internet advice, be sure to check with your doctor(s) first before using any medication.

[EPguy]

Shooting and burning sound to me like neuro problems esp since your range of motion is ok. Paracetamol not helping is another indication of a neuro source. If so Ibruprofen probably wouldn't help much either.

I know of these from my Parsonage Turner syndrome(PTS) from the flu vax. This is a type shoulder nerve injury that also goes down the arm and elsewhere. From my experience, physical therapy can help, but mostly limited to any 2ndary motion problems that the nerve injury can cause.

A medicine you should ask your Dr about is Gabapentin. It's the go-to for nerve pain where Paracetamol doesn't work. It worked for my acute phase. I couldn't tolerate it for long, but it did the job while I needed it. Most pts seem to do ok on it and it's cheap.

You may want to discuss a referral to a neurologist if your Dr agrees. The fix for most peripheral nerve issues other than a pinched one is natural healing from what I've learned. It can take a long time. My PTS is largely healed (I'm PV) but arm etc issues remain.