Rotator cuff tear and RA

[debssky]

Hi I'm debs ,I'm 51 had RA for 9 years now I'm new to your site was wondering if anyone has had this problem I had a bad fall in November last year , I've now been told off my rheumatologist I have a frozen shoulder too I'm in a lot of pain , waiting for a scan before he can do anything as my GP sent me to physio and made things worse

[JacquiThomas999]

I have had a rotator cuff problem for a year now. Was diagnosed with RA in December. Have had months of physio but the only thing that stops it hurting is an injection. Seeing my Rheummy nurse on Thursday, if she doesn't do anything, it is back to the Dr. I hope you get better soon.

[debssky in reply to JacquiThomas999]

I hope they can do something for you I'm waiting for a scan app , I now have a frozen shoulder too things are getting worse pain to I hope your app goes well good luck

[earthwitch]

Yes, I've had rotator cuff problems, but with me its enthesitis from ankylosing spondylitis rather than RA. I did get help from physio, but it wasn't actually an NHS physio, it was someone who had a lot more hands on sports injury experience. I had very very gentle mobilisation done with it, and it really helped. I now have to make sure I do gentle stretching exercises every day to stop it freezing up again.

One thing I'd seriously warn against is getting steroid injected into it - steroid is fine if it goes right inside the joint, and the other kinds of non-steroid injections (I think hyaluronic acid, etc) are OK into the tendon, but there is now increasing evidence that steroid injected into tendons contributes to tendon ruptures (even though it may initially make it a whole lot better).

[debssky in reply to earthwitch]

Thanks for your reply my rheumatologist wanted to give me injections of that sort I said no I would hold off I'm glad I did after what you have told me ,I'm just waiting for some scans to see what's going to happen next

[Someonesmother]

I had a rotator cuff repair a couple of months ago after injuring mine in a fall a couple of years ago. I would wait to get steroid injections until you see an orthopedic surgeon in case you need surgery, as steroids can make the problem worse if you need surgery. I am now 3 1/2 months post surgery and it is going along better each day.

[Barrister in reply to Someonesmother]

Hi Someonesmother, just seen your rely and wanted to ask you a question. I had arthroscopic rotator cuff repair and removal of a huge bone spur 4 weeks ago. I'm doing my exercises faithfully but the pain doesn't seem to be getting a lot better yet. Is this what happened with you? The surgeon said that I have a large area of raw bone where the spur was removed and so that will be painful, but I was hoping that it would be feeling better by now. To be fair, I can at least now do up my bra at the back ( but that hurts). Clemmie

[Someonesmother in reply to Barrister]

Don't go too hard on the exercises. Do them but don't overdo them or it will damage the repair. It takes a long time for us to heal, and I still get pain if I overdo it, like I did last week. Look after it do everything they say, like wearing the sling as ling as they say to and do it religiously. Because of our disease and the meds we take it may be a slower process to heal, I took tramadol (it is the only pain relief I can tolerate) for weeks afterwards and only just started being able to sleep lying down about a month ago. I found icing it was the best relief for pain too. BTW I wore front opening post surgery bras for ages as I couldn't stand the under wire ones and the pressure they gave me on my shoulder. The other tip is to put it on around your waist and swing it around until the boob bits are at the front. Always put your injured arm in first too when dressing. The other thing I bought was a boomerang pillow which gave much more flexibility in getting comfy in bed.

[Barrister in reply to Someonesmother]

Thanks so much, at least I know that it's going to take longer now. I haven't worn the sling for 2 weeks now. Using pillows to prop my shoulder in bed. My husband has been doing my bra up for me as I've not been able to manoeuvre the bra round my body. It hurts terribly to cross my arm over my body. I was only given 3 physio sessions ( had my surgery in Saudi Arabia, where my husband works) but back in uk now. I'm just taking Brufen & paracetamol for pain. I was thinking of getting an appointment to see my rheumatologist and asking for a steroid injection to tide me over. Clemmie

[Someonesmother in reply to Barrister]

I was told to religiously wear the sling for 6 weeks to give the repair a chance to heal no wonder you are in so much pain. Get icing and get your sling back on. Do not under any circumstances get a steroid injection it will interfere with the healing process. You need to go see a physio as you shouldn't be doing any of the things you are talking about only very gent;e exercises that do not lift your arm away from your body. it should have been immobilized in a sling for at least 6 weeks. Wow you have had no correct info given on how to look after it. You may need to see someone to see if you have damaged the repair. Are you seeing anyone in UK?

[Barrister in reply to Someonesmother]

No i only got back at the weekend. The tear was very tiny and the surgeon said it would be fine so long as I didn't lift my arm higher than my shoulder for 3 weeks. I wasn't impressed with the physio who told me to lift it higher in the first week! I told the surgeon and he said I mustn't and he would write in the notes but the next physio appointment, she said to do it again. I said no and she said okay don't! My main problem is where the bone spur was removed- it has left a large area of raw bone and I don't know how long it will take to heal.

[Someonesmother in reply to Barrister]

wow they have very different ideas over there. In Oz they are cautious otherwise it was pointless having it done if you over exercise or don't look after it. I guess it will take a while for the bone to heal but remember you also have the repair to heal regardless of the size and that takes months and months. I was told 8 to 12 months until it is completely healed and the ligaments, nerves and tendons are better.

[PFKAAde]

Hi debs

Another unfortunate soul to welcome aboard the good ship HMS Agony 😱😳

I seem to have woken up in a silly mood today.

Anyway, I have had a torn rotator cuff and (I wish I could remember) other something or other damage to the cuff in my shoulder for 10 years or so.

I have RA, you would assume this is the cause. It was excruciating at first. It would seize up and take 30 minutes of extremely gentle stretching before it would click and the acute pain would subside.

I have seen an orthopaedic who advised me that the only surgical option was a total shoulder replacement - but that this was contraindicated due to the torn cuff and damaged collar. Said there was a risk of chronic pain that would be untreatable, but he'd do it if I insisted.

I had physio to loosen it up which helped immensely, didn't sound very nice though.

These days other things have taken priority and if that was the only pain I'd be ecstatic.

All I can really tell you is to try and keep it mobile. Gentle stretching and loosening are very important, you might want to get professional advice on that though so you don't do the wrong things. My mum had a frozen shoulder and this went off over a few months with gentle exercise etc.

I have quite limited movement in my shoulder but have noticed that over the past year it has eased off a little pain-wise. Firstly I was on crutches for some time and lately sticks, so have been using my upper-body quite a bit. More recently I have been going to the gym quite a lot, mainly because of back problems (hence the crutches) but I see a Personal Trainer and therefore she makes me do a mix of things with some upper body stuff as well. Although it can hurt afterwards (and even for a day or two), overall it is definitely helping with strength, mobility and pain.

Finally I agree with what others have said about steroid injections, as effective as they can be there is quite good eveidence they do soft-tissue damage which won't help long-term. I'm sure one wouldn't be the end of the world, but repeatedly injecting steroids can be counter productive, from what I understand anyway.

Good luck getting some relief from the pain / stiffness.

Regards

Ade

[debssky in reply to PFKAAde]

Thanks for the welcome Ade and thanks for the reply and all the info I'm in a lot of pain not a lot of movement at all waiting for a scan just seen my rheumatologist you seem to have gone through a lot ,me too and thanks again most appreciated and good luck

[PFKAAde in reply to debssky]

No problem. Yes, it's been a rather painful 16 years on and off. 🤕

I have to say though, when it 'went' the shoulder was about as painful as it gets, truly agonising. Not as constant as disc / spine problems but agony all the same.

If I was you I would keep doing really gentle mobility things to stop it from freezing completely. It might well hurt but it will keep it mobile. Just things like swinging your arms at your side a little, slowly increasing the range of movement. Really slowly.

Take whatever pain relief you have, regularly as it works best if used all the time not every now and again.

Drink lots of water, try to get good sleep (i know it isn't easy, believe me I know), and wait for the scan.

Then you will hopefully know what your options are.

Oh yes - the physio I had was very painful at the time and sounded awful, lots of cracking and grinding noises 😱 but, it really helped long term.

Good luck.

Ade

[debssky in reply to PFKAAde]

Thank you I get more feedback from you lovely people than from my own GP , and may I add I've only just joined this is my second day I've learned so many new and different things and I will take them all on board 😊

[PFKAAde in reply to debssky]

Ha - your GP (probably) hasn't felt the pain / been there got the t-shirt 👕

Also we probably have more time than them to be fair. I think GPs (and doctors / medical staff in general) tend to forget that when we first present to them with our symptoms we know nothing about it. They tend to assume that we know what they are talking about and that we already know things (like which OTC pain meds work and how / when to take them).

They are time pressured and see similar symptoms over and over again, it's human nature to think other people know the same things as us, so they forget to tell us the basics sometimes because they think it's obvious.

Also they learn to not get too involved with every patient, they can't as they don't have time or the emotional capacity to deal with everyone they see like that.

Which ultimately means that they rush through (some) appointments and once we are out of the door forget about us. I'm not saying they are all bad people or not good at their jobs, but they are people after all and, human nature.

I've learned that the folk that get most from the NHS are the ones that are most assertive, don't take no for an answer and don't shout / get angry with them. In general.

If you aren't happy with a doctor's response to something it is tempting and easy to leave and worry / wait for it to get much worse before going back. Sometimes it takes 2 - 3 visits about the same problem before they will even consider it 'serious' enough to progress to the next stage.

Keep on at them, nicely, and don't give up if you aren't happy with something. Painkillers are not the long-term answer. As much as we'd all like them to be.

Regards

Ade

[debssky in reply to PFKAAde]

I'm laughing sometimes I wish my GP did feel my pain maybe then I would get the response I needed ,but I understand what ur saying and totally agree ,I know there's no quick fix it will take time and pains been a part of my life for a lot of years now as it has for most people here if not all but we all just get on with our day the best we can thanks for all your kind words take care debs

[rogerj]

I thought I had a rotator cuff damage but its actually a impingement of the tendons, feels like a knife being pushed in and rotated for good measure. had a steroid injection and it did nothing, I was on 6-8 tramadol a day but since the first session of physio with acupuncture felt great more movement and tramadol free for nearly 2 weeks till I moved suddenly and it came back but not as severe now had a 2nd session and fine again just got to see if it works instead of a operation.

give it a try, you've got nothing to lose.

[debssky in reply to rogerj]

Thanks for ur reply roger , unfortunately I can't take tramadol,I have a bad reaction to them , I've tried physio had to stop pain was too bad , now waiting for scan and further app with rheumatologist to see what can be done ,glad things are getting better for you hope it continues good luck

[JanWellcome]

Hi skyranger, sorry to hear your in this situation but take hope from my situation it can and will get better but it does take a lot of work.

I had a bad fall about 2 years ago now, I tore my labrum (this is the part that holds your shoulder into the joint) from 1200 to 0600, the MRI scan is definitely what is needed otherwise it very difficult to get the right diagnose.

I know it is increadable painful, but the physio in this situation is really necessary you have to keep moving the arm, don't be tempted to put in a sling, as that will make the frozen shoulder worse, I ended up needing 2 operations, the problem with having RA With this type of injury is that the inflamation starts to flare up, my first operation was to do the repair by keyhole, but because of the RA my shoulder froze because of the inflamation.

Now this is where the physio is important because you will feel like its not helping and not working, but if you preserver, if you require a repair or release operation, it will make the recovery easier and hopefully having the best use of your arm after.

I have about 95% use back, it's a long hard road, but with determination and hard work you will almost full use back.

I wish you a speedy recovery, if there is anything else you would like to know from my experience please let me know, I'm more than happy to share my experience

Jan😘

[debssky in reply to JanWellcome]

Hi Jan , thank you for all your information it's a great help to me , I'm trying my best to keep moving it the pains getting worse day by day , I've got severe pains down my arm which radiates into my hand this is constant , just waiting for scan my rheumatologist is sorting it then he will take the next step ,glad your improving and things are getting there it's great to think there's light at the end of the tunnel thanks again debs

[JanWellcome]

Before my operation, I had a spell were I was the same and it felt like every movement was continuing to tear my shoulder and Im sure that is why my tear was so extensive. So be careful keep it moving but try not to overuse.

Have you tried icing and heat alternating, although I felt ice was more helpful.

I wore a shoulder brace for some time before my operation which helped give some support also used anti inflamitory gel not sure it does anything, (i got the brace off amazon) I think someone else mentioned but don't be tempted to get a steroid jab until you know if they are going to operate, otherwise they cannot operated I think it's something like 3 to 6 months.

Great your rheum is involved, my GP was useless, and I looked like I gone 10 rounds with Tyson and only was told to go home and rest for a week!!😝😝😝 my physio who I went to myself sorted my referral for orthopaedics, I don't think the GPs realise that with RA your in a whole world of trouble if its not sorted, and we all have enough problems.

Good luck I hope you get your scan really quickly, and speedy recovery.

Jan. Xoxo

[debssky in reply to JanWellcome]

Hi Jan Yeh ice helps a little ,ur right my GP wasn't interested just kept telling me to rest it ,then I seen my rheumatologist he was great only seen him this week gone and he's ordered my scan and told me not to go back to GP he will sort everything out he's already said it's froze and that's just the start but you have really helped I have some gel so will try that along with ice and gentle exercises thank u and I hope ur well debs

[CloudTreeDrive13]

I had a frozen shoulder some years ago and stupidly carried on working for 3 months. Eventually after injections didn't work i had keyhole surgery for a subacromial decompression. They shaved a bit of bone off the top of my shoulder. Magic - so much better. Good luck with the scan xxxx

[debssky in reply to CloudTreeDrive13]

Hi so are u pain free now and have u full movement , thanks for ur post X

[CloudTreeDrive13]

Yes have been pain since having it done and you only get 2 little marks.I have been up the hospital most of the day having my ritux infusion. Blood pressure dropped slightly but then came back to normal. It has been 7 months since my last one so a bit of a shock to the system. Second half of infusion in 10 days time.

[Hidden]

Sorry to hear of your probs; please be aware that your "frozen shoulder" could be a neck injury, with referred pain to your shoulder, get both scanned, best of luck.