Shoulder pain

[Feta]

This is my first post...I am 66 years old, have had OA for many years but was diagnosed 18 months ago with Sero negative RA and am now on a good cocktail of mtx, folic acid, naproxen. Paracetamol, Enbrel, Bu Trans patches and Hydroxychloroquine. The RA is now quite well controlled although I do need occasional steroid injections and am about to have injections into both shoulders. I do Pilates and aqua fit classes as often as possible but now I can't raise my arms higher than chest level and the pain is pretty bad, keeping me awake most nights. My concern is what next if these injections don't work? It seems joint replacement could be the next step so I am wondering whether anyone else has had to go down this path and how bad their shoulders were before the decision was made....and how successful the operation was. I'm seeing my Rheumy next month for a review but also this month for the injections. I have to say I think I am so lucky and must have the best, most supportive RA team in the world so I am not complaining, just getting a bit fed up with still being in constant pain despite all the meds. However, up to the point of diagnosis I could hardly walk, so upwards and onwards eh? Thank you....this site has been so useful and supportive.

[PB1950]

Hi i havnt been on this site for a while and my first visit for several months I see your post, I to have RA I was diagnosed in 2006 I'm on Metho. Folic acid, Declofenic, and Infliximab, the RA is now under control as like yourself. My shoulders were where I suffered the most pain, I was having steroids injected into both shoulders every three months sometimes only 6 weeks between injections then I lost considerable movement in my right shoulder, only able to lift it 15 degrees from my body after several X-rays it was found the the joint was impinging thus causing the pain and restricted movement.

In 2012 surgery was done Hemiarthroplasty of the right shoulder after 8 months of Physio the pain reduced, now 2 years on I am relatively pain free still have some restricted movement I can now lift my arm above my shoulder which is great.

One of the things that was discussed with my RA clinical nurse at the time when she was giving me the steroid injections was the steroids can have an effect on the cartilage and bone around the joint in as much it can cause long turn damage, but quote she knows a good Orthopedic Surgeon which is what I believe accelerated the joint damage, I hope this helps.

[nomoreheels]

Hiya Feta. I'm in a similar position to you & remember another post as we both have RD & OA. My RD is considered controlled by my meds but recently my OA has been really affecting me. My GP performed a pain med review for my OA since my last reply & she prescribed BuTrans patches, starting at 5mcg/h & now on 10mcg/h at present but being reviewed on Monday & feel it may be increased to 15mcg/h. She touched on steroid injections but as I've been taking them orally for some time now she's concerned about further reducing my bone density as I am borderline for osteoporosis it was decided they weren't an option.

I have cervical spondylosis from which I have transferred pain to my shoulders & upper arms & I had problems just as you describe. Has your Rheumy ever questioned CS may be the problem, or have you had confirmation that it's OA damage that you have steroid injections in your shoulder joint/s for? I was prescribed 10mg amitriptyline as I've had it before for whiplash & take it before I go to bed. It has helped, but again feel the dose will increased. I know you've tried ami but you didn't mention why it was prescribed so a bit in the dark there. Alternatively maybe an increase of your BuTrans dose could be considered helpful to cover the pain, although this of course wouldn't solve the stiffness. If it's stiffening of the shoulder muscles & in turn your reach is becoming prohibitive perhaps a muscle relaxant of the same class of ami could help. I know the more pain I have the more I stiffen up & not using the muscles can caused them to contract, making them painful as well as losing movement.

I do know if any of this helps but I do hope your pain problem is solved as I can be so wearing & the less good sleep you have the harder it is to cope I find.