Shoulder Pain/Stiffness

[Chockyuk]

Morning all 👋

Just a little question.

I have sero positive RA, on Mthx 10mg for 2 and a half years now. Although it’s not as controlled as I’d like, have intermittent flares, my Consultant can’t really increase the dose as my ALT shoots up to over 100. Last year she introduced Hydroxychloraquine, but it gave me severe stomach problems and I ended up in A&E. Now she’s procrastinating about adding anything else in, saying I’m obviously sensitive to medications 🤷‍♀️

Anyway, since going back to work after lockdown my left shoulder has started to stiffen, and I’ve had trouble doing my bra up etc, I’m sure you’ve all been there 😉

Having tried and failed numerous times to get in touch with the nurse helpline and Consultant I finally phoned my GP last week who gave me Prednisone (such a sweet relief). After the first two day I felt great, all pain and stiffness gone, as would be expected with steroids, but yesterday and especially this morning the stiffness is back. Not as bad, but still there. I can only tolerate 10mgs as I get severe indigestion otherwise, even with the gastro coated ones (plus I am on Lansaprozal), I’m wondering if maybe it’s the dose is not high enough or it’s actually something else happening there like maybe osteoarthritis? If so, how do they differentiate or diagnose between the two 🤷‍♀️

[oldtimer]

You really need a diagnosis of what is wrong with the shoulder. It is possible it is not the Rheumatoid Disease (we tend to put everything down to that, as do our medical team). On the other hand, if it responded to steroids that suggests that it was inflammatory in origin. 10mg steroid is not a big dose - perhaps a steroid injection might be indicated? But not without a diagnosis which can only be got if you keep trying to get into contact with the rheumy team at the hospital.

[Poppyesterhazy]

I too have a painful shoulder and would be worried about having steroids given to me by a GP without further investigation to the cause of your pain. I was sure my pain was not RA related and saw an orthopaedic consultant I first had a steroid injection into the shoulder joint and I was pain free for about five weeks . This was then followed by an X-ray which showed no bony problems and then an ultrasound of shoulder. (Was going to be an MRI but couldn’t have that as I have a pacemaker) The ultrasound showed a tear in one of my rotator cuff tendons and I am now awaiting surgery. I would suggest you go back to your GP and ask for further investigation. The problem of course is that the NHS is on its knees and you might have a long wait. If I wait for surgery on the NHS it won’t be for at least a year but you may get an x-ray quicker to establish whether there is any bony involvement . Good luck🤞

[Chockyuk in reply to Poppyesterhazy]

Hi 👋 Thanks for your advice. I actually had a face to face appointment with my Rheumatologist to review my meds and while we were at it she examined what is now a very painful, sore shoulder. She said, like you, rotator cuff and has requested an ultrasound.

Meanwhile I’m struggling to do anything that involves lifting, hoovering, driving (changing gears is so painful) and what I think actually caused it, mowing the bloody lawn.

I just wondered how you manage your soreness and pain? I’m not into taking very strong pain killers, codeine really bungs me up 😳. I’ve been thinking physio, but without knowing how severe it actually is, I don’t want to make it worse before the ultrasound. 🤷‍♀️

[Pythagorus in reply to Chockyuk]

I am not sure what started my shoulder problem but must have had the problem for about five months now. I did see a physio initially and persevered with exercises but that was before the ultrasound established it was a tear. Its not painful all the time but some movement are restricted and painful. Some nights particularly so and then take paracetamol.I am seeing the shoulder consultant next week and I know he is keen to operate. I am ok with that but would have to stop my Benepali two weeks before op and not resume until I am healed. I am on Methotrexate also and can continue with that but feel anxious about stopping the Benepali .My RA is very well controlled with this drug combination and don't want to upset my condition if I discard Benepali for a few weeks.

Your ultra sound will help with a diagnosis. Good luck and let me know how you get on 🤞😊

[Chockyuk in reply to Pythagorus]

Thank you, I have my ultrasound next week 👍I’d definitely do surgery if it was offered. While my son is at Uni I live on my own, it’s so painful I’m finding everything from hoovering, cleaning, even doing the washing is hurting like hell. 😖

I can understand you not wanting to be off your meds, as that opens up a whole other can of worms.

😔

[Thingybob]

I had shoulder pain and stiffness. It improved when i increased the mtx dose .

[Joanneforbes]

I was in same position with meds but I added sulfasalazine it was rough start with but now I’m fine on full dose ... I was really apprehensive too as have a hiatus hernia ibs but these are for chronic stomach issues so are ok 👍🏻 coated of course good luck My shoulder improved too !

[Chockyuk in reply to Joanneforbes]

I have IBS as well, after not getting on with Hydroxychloraquine, I would imagine Sulfasalazine would be the next point of call. Glad it’s worked for you 😊

[Chockyuk]

Thank you all for your thoughts. I’m definitely unsure as to whether it’s something to do with my RA. I’m not due to speak to my Rheumatologist until July, so I’ll see if I can get an x-ray via my GP. Could just be a frozen shoulder or something like that, but better have it investigated first. 👍

[LoneEra in reply to Chockyuk]

Yes, I think a scan would be great. And you could see if there’s an expert physio available who could tell you if it is muscle related (they won’t manipulate it if they think it’s inflammatory). My physio makes me stand in my underwear across the other side of the room from her but she can precisely pinpoint every muscle that’s hurting me with this exercise - and every area of inflammation. It’s quite incredible. She then works out the best approach for sorting stuff out, without hurting me or causing any damage. Sometimes it’s acupuncture, sometimes massage, sometimes ultrasound or other times she sends a letter to the GP and/or consultant telling them off for leaving me in such a state 😂

[Chockyuk in reply to LoneEra]

That’s interesting, I have a great physio locally who really helped me after I had broken my arm. 👍Thanks 😊

[Moomin8 in reply to LoneEra]

I'm interested which excerise this is! I too have a shocking left shoulder. Never had it looked at as an individual joint because I have so many flaring. My RA first reared it's ugly head in my left shoulder October 2015...it has never gone away.

[LoneEra in reply to Moomin8]

Just me standing there more or less naked 😂 She has a specialism in pain physio and can identify all my problem areas without me even telling her. She’s like a physio magician!

If you can find a physio who knows a lot about RA and pain, they could well be able to help the shoulder with non-invasive treatments that will assist, not aggravate x

[Moomin8 in reply to LoneEra]

Wow!

[Kalimera57]

Shoulder pain is very debilitating. 18 months ago both my shoulders were troubling me a lot. I was given a 3 week dose of prednisone and it helped. However since then I’ve had 2 steroid shots in both knees ( I had relief for 24 hours only ) 2 steroid infusions in Dec which didn’t do much and another 3 week course which gave me relief for 24 hours again. It seems to be very hit and miss. I hope things improve for you soon.

[LoneEra in reply to Kalimera57]

What permanent meds are you on? X

[Kalimera57 in reply to LoneEra]

Methotrexate and Sulphasalazine. Injections for the first med. The consultant wants me on a biologic now. My RA was pretty good until I had my first flu jab March 2020 and then it was all down hill after that.

[Meldr]

I’ve been on Prednisone for at least 4 years with Arava (leflunomide 20mg) I take the Prednisone with a stomach protector (Omeprazole 20mg). I have got the Prednisone dose down to 2.5mg. But when I have a flare I have to start with 15mg for 1 week, then 10mg for 2 weeks, 7.5mg for 2 weeks and so on down until I am stable again. It is essential to reduce the dose very slowly. As far as I can tell it will not be effective for long without the Arava. I had a bad reaction to Mthx so can’t take that. As for your shoulder it could really be a strained tendon/frozen/rotator cuff problem etc. So establish that first.

[Chockyuk in reply to Meldr]

Thanks for that 😊 an appointment came through to see my Consultant on 10/6, so hopefully that’ll shed some light on it. Although after a few more days on a slightly higher dose of Pred, the shoulder pain has eased (so far 🤞).

[Moomin8]

Hi, how did your appointment go on the 10th?

[Chockyuk in reply to Moomin8]

Hi 👋 She diagnosed rotator cuff injury and I’m having an ultrasound next week to confirm. It’s a bugger as I’m struggling to drive to work as changing gears is making the pain worse, having trouble with sleeping cos it’s having a knock on effect on my neck and back. My friend at work has the same thing, hers is her right shoulder, mine my left, so between us we can help with things like taking our coats off etc! Geez it’s like when I was first diagnosed with RA, but this time with no relief 😖

[Moomin8 in reply to Chockyuk]

I'm glad you have a diagnosis - hopefully, you'll get somewhere soon with it 🤞I had a cortisone injection in my shoulder this week...boyoboy did that hurt! 😭I think it's feeling a little easier atm. I love the idea of you teaming up with your friend 😆

[Jackie1947]

Hi. I also have shoulder pain going down the upper arm muscles. Dr just prescribed steroids as she's thinking it's Polymyalgia. If I respond to the Steroids that will give her a stronger diagnosis. I also have RA, OA and Fibromyalgia

[Chockyuk in reply to Jackie1947]

I’m sorry to hear that. I have two friends with PMR, that’s the last thing you need as well as your other conditions. It does respond well to steroids though.I hope you’ll be ok, sending you virtual positive vibes 💕