Shoulder impingement : I have been diagnosed... - Pain Concern

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Shoulder impingement

Muddle profile image
35 Replies

I have been diagnosed with this painful condition has anyone else got this and found something that helps

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Muddle profile image
Muddle
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35 Replies
johnsmith profile image
johnsmith

How were you diagnosed? If no MRI scan done then your shoulder problem could be caused by anything. This means that it is impossible to know what the right treatment should be.

I have had the experience of having a tear in a tendon causing fluid buid up which in turn caused shoulder problems. The shoulder is a very complex joint relying on all sorts of things working in the right way.

Muddle profile image
Muddle in reply to johnsmith

I have had an exray and ultrasound have asked for MRI but was turned down

bantam12 profile image
bantam12

Agree with johnsmith, shoulder problems can be very difficult to diagnose, even when all the tests are done, over the 2 years I've had a painful and stiff shoulder I have never actually got a definite diagnosis so treatment is hit and miss.

Muddle profile image
Muddle in reply to bantam12

I have had an exray and ultrasound have repeatedly asked for MRI but was turned down have been offered physio but I think it will make it worse

bantam12 profile image
bantam12 in reply to Muddle

Was it your GP who diagnosed you ? maybe ask for a referral to an Orthopaedic specialist but with many shoulder problems there is no treatment other than painkillers, I had 3 steroid injections which did absolutely nothing, I was referred to an Orthopaedic Specialist Physio and his advice was to definitely avoid any physio as it can make things worse.

Muddle profile image
Muddle in reply to bantam12

Saw someone from MSK who did the tests and said physio

skit profile image
skit

Impingement could mean arthritis in the joint?If it is inflamed a course of anti flams . Injection could be offered. Meanwhile warm pad to ease localised pain is best idea . You should have idea what is not right and ask for consultant referral to get expert treatment if meds & injection no use. I went through the shoulder thing last year for one and 3 years ago for other!

Gentle hugs

Hi Muddle, sorry to hear about your shoulder I feel your pain. After 3 years of suffering I have had an MRI and diagnosed with acdf arthritis, sasd bursitis and partial rotator cuff tear. I was 3 days from having acdf surgery on 2 herniated discs on my neck but surgeon cancelled as thinks the pain is now all shoulder related. Due to go back to Guys in 3 weeks for treatment plan.

Hope you get some pain relief soon, ice works better for me than heat as advised by chiropractor, heat ok for instant relief but ice reduces inflammation.

Muddle profile image
Muddle in reply to

Thank you for your reply I have exray asked for MRI and was turned down

in reply to Muddle

Who turned you down? It has been a long battle for me to get diagnosis 3 years - 2 xrays and 2 mris on neck, 2 lots of emg tests and finally shoulder mri. Meanwhile not worked for the last 12 months. Push for an MRI if you're suffering

Muddle profile image
Muddle in reply to

My doctor turned me down and refused to send me to a place I could pay privately and saw someone from MSK team he would only give me a exray and ultrasound and diagnosed shoulder inpatient and would not give me an MRI have been offered physio but I am worried that it will make it worse

Muddle profile image
Muddle in reply to

I have tried ask my Gp to refer me and was willing to pay private he said no seen someone from MSK team who got me the exray and ultrasound and also turned me down

I guess you should try and if no improvement they will do further investigations maybe

kohai profile image
kohai

I can really empathize with you. But this is and can be a very serious condition if left untreated. And physio will NOT help if it is 100% impingement.

Ok, Heres what happens;

There is a fluid sac between the ball and socket of your shoulder. Its not painful if this is damaged by pulling on something the wrong way, but, over time, that fluid slowly drains away. Its supposed to act like a balloon with 1/4 fluid in it to stop the bones rubbing together, once the fluid is gone, the bones, over time will come together closing that gap and and some point you'll move your arm and think something along the lines of "holy crap!!!". Yes, it'll hurt that much

Over time, every time you move your arm it'll hurt even more. You'll end up with physio first, won't help, then steroid injections, which will help until the time the bones are so close together the doc won't be able to get the smallest of needles in. Then 1 year of pain killers. By this time you should then get the MRI. Be aware, its a long process of a lot of pain just fir something that is not high on the surgery list.

When you finally have surgery, its a day surgery, the op takes 1 hour and you go home the same day. 2 weeks later you start physio on it, but try getting it moving very slowly bit by bit after 48 hours. Very gently.

Warning - the reason I said how serious this is is because if past 3 yrs nothing is done (surgery wise) the bones grinding against eachother will cause bone spurs. These break off as you try moving your arm. The spurs can start to shred the chest bicep. No ortho surgeon will allow a shoulder and bicep MRI, it costs too much, but a good surgeon will find it during surgery. It can take them over 5 hours just to sew the bicep up before even shaving the bones causing the impingement.

I'm being as honest as I can because if this is what you have, the pain will get worse

If you don't get your front and back shoulder muscles built back up during physio, you're shoulder will keep rising too high and you will always get impingement twinges

Arthritis does not always come with impingement, you may be lucky

I've had/still have impingement in both shoulders

I injured both within months of eachother

Only the left bicep was shredded thankfully, and I only have arthritis in one, but I have very little muscle left in my shoulders from being left almost 5 yrs waiting for surgery so I've been through this myself, twice!

I do sincerely wish you the very best of luck with your condition.

One more thing to remember, physio, even senior ones can be wrong! My surgeon was looking at the MRI and was telling me its shoulder impingement but the senior physio, who had never seen my MRI kept telling me it was a potato cuff tear. The physio was adamant she was right and oddly enough she was the one my lawyer found guilty of malpractice. Just something to think on

Sorry, gotta go, due at the hospital soon and not even dressed yet.

Very best of luck xx

Muddle profile image
Muddle in reply to kohai

Thank you very much for your reply every time I even try the physio it hurts like hell if I full asleep on it shooting pain up my arm my hand goes numb

kohai profile image
kohai

It takes time to condition yourself not to lay on that side. What I tried first was just one pillow under my shoulder, to stop me rolling onto it, but during the night the pillow would slip away. I ended up propping my painful shoulder on a mountain of pillows forcing me to roll onto my less painful side. It may help you or may not be practical, but even disability aids stores or places like ebay sell foam pieces especially designed to prevent you rolling onto the painful side.

Muddle profile image
Muddle in reply to kohai

Thank you for the information

kohai profile image
kohai

As a small FYI on my posts, my Android phone dictionary sucks, has a mind of its own at times (like insisting on changing the words rotater cuff tear to "potato" cuff tear.. I swear it changes what I enter just as I hit the send button)

also it has a small keyboard where the o and i are next to each other, so I try to write the word 'for' and it comes out as 'fir'.

Hope my post info was of some help, and apologies for the daft typos my phone likes to enter.

Muddle profile image
Muddle in reply to kohai

Have kept photos of answers for next time I see the physio I have dyslexia so takes me ages to post something as trying to find a word I can spell having a iPhone helps me you don’t need to apologise your answer did help always feel free to keep in touch

kohai profile image
kohai

Ok. so you know in advance, the physio doesn't need to see this one, it isn't relevant 😉 Its just me rambling because I can't get up yet and I'm both bored and in pain. I ramble on to distract myself - so feel free to ignore the below post 😁

I'm not brilliant at keeping in touch. I start off ok, then can take ages to reply, it all depends on my pain level and if I have fatigue again. I'm not lucky enough to get flare ups like some, I'm in pain almost all day every day. I'm trying new meds at the moment to stop the severe spinal spasms but if I'm up late, then oversleep, it means I'm late taking my meds and the pain kicks in as soon as I try sitting up in bed. I know if and when I take them on time they do work as the last few days have been the first time since 2011 where I've had three pain free days in a row and it was amazing. I almost felt like my old self again. The only problem is I don't get my short term memory loss fixed and my words come out backwards, that and the loss of balance, so I have to continue using my chair whether I like it or not. Last time I was on meds that caused loss of balance, I fell flat on my face and broke my nose.

(To avoid confusion, I recently moved house so have an old doc and new one). Neither the old or new doc has offered these injections for my spine, my old doc only ever did it in my shoulders, for shoulder pain.

The musculo skeletal ?? team (think I spelled that right) at the hospital intervened on every referral my old doc sent in asking for new spine, shoulders and knees X-rays, those are my worst pain areas. The skeletal team just kept using an old x-ray from 2012 to tell me I have disc degeneration (they even relied on that same 2012 x-ray to tell me the same in 2016 when I last saw them. I now haven't been able to lay flat for 4 years so have to sleep in a hospital bed. If I do lay flat, even for a few seconds on my back, I'm screaming in pain, so you can imagine what my MRI was like early this year (old doc had me tested for MS). New doc did ask for new X-rays and I finally got them from a different hospital. Weird, I remember a time when I was stood against a freezing cold plate in a room that looked like something from a Frankenstein film last time I had X-rays, now its all modern, warm, smaller room, but unfortunately I was made to lie down.... this is the part where I get to apologize to hospital staff present, in advance for all the swearing I do when they make me lay flat on my back. (I have a hoodie I wear to the hospitals with

"Voluntary Tourrettes" on the front.

(Basically it means if you physically hurt me, I will swear".

Its actually funny when the more knowledgeable hospital staff, like surgeons get the wording, but its even funnier watching the look on a med students face, its like you can see their brain ticking in overtime going over all the things they'd been taught while they think "I don't remember learning about voluntary Tourrettes, did I miss that class? was I late" it actually can last a while unless I put them out of their misery and explain what it really means. Ha! shows how long I've been in and out if hospitals when I start wearing clothing with wording to tease the staff for my own amusement.

(I was also a nurse for 18 years before a career change, so it gives me the added advantage of knowing who will get the joke and who won't).

When I visit hospitals and I'm really grouchy from lack of sleep and severe pain, I'll wear my t-shirt that says 'Normal people scare me".

Ok, I'm officially rambling now, I need to get back on topic. (and go get coffee. I've only been awake 10 minutes but took my meds late so can't physically get up yet. Hence the rambling mode. I'm bored staring at unpacked boxes and the god-awful blinds in this disability adapted bedroom, so I'm rambling waiting till I can get up).

melodie profile image
melodie in reply to kohai

You’re an Angel for warning us with your experience. Very upsetting to read what happened to you, and you were a Nurse for 18 years. Hope you get a bit more respect for all your hard work when you have hospital appointments these days.

I want to know how to deal with frozen shoulder - terribly painful. Hope you have someone to take care of you. Constant pain is so draining.

kohai profile image
kohai in reply to melodie

Hi melodies, one thing I know of to help frozen shoulder is swimming. Gently at first, as in first few weeks if going or at least first 7 times, as it eases a little, try a bit more, but very gradually, don't force it or it'll hurt even more later.

Also, a good tip to remember for most painful shoulders is to keep it warm, so as soon as you get out of the pool, get a towel over your shoulders before the cool air can dry the water on you. It'll drop your body temp. As you get changed, get your top half dried and dressed first, then you can sort out the bottom half after. Its to stop the cold getting into your shoulder. A frozen shoulder is usually caused when you hurt it then keep it immobile too long. It basically freezes the shoulder in the position you've kept it in. People with arthritic shoulders, rotator cuff tears, shoulder impingement etc anything that causes pain so you naturally want to keep it still, as moving it hurts, its a natural response we all want to do, but sadly its the worst thing we can do for the joint.

Any form of very minor repetitive movement you can do without causing too much pain will help. Also be gentle with yourself! It will take time to get back to normal, but while physio's can advise on exercise, they'll never know or understand the pain the exercises they give will/may cause unless they themselves have gone through it themselves.

I remember my mum falling against a wall unit. She was never one for doctors so just kept her arm still thinking it'd heal itself. She ended up with a frozen shoulder. I went swimming with her every time. If I remember correctly she was also advised to try doing press ups against a wall. (this way you only put your upper body weight against the shoulder instead of having your whole body weight on your shoulders/arms and feet.

She started with about 5 press ups a day, gradually increasing them as her shoulder pain allowed, and went swimming twice a week.. She didn't swim much for the first month, she just lent against the poolside, bend her knees so her shoulders were under the water and stood still moving her arms in the 'breast stoke' swimming movement. It took her quite some time to build her confidence enough to swim where she didn't feel she'd hurt her shoulder mid length of the pool, so I swam along side her, talking to her to keep her mind off her shoulder.

That may work for you if you know someone who you can take with you.

As for my getting more help being a nurse that long .... July of this year I had what's called a TIA (Trans Ischaemic Attack), like a small stroke. It happened while I was asleep. I don't know what other symptoms I had, as those had dissipated by the time I woke up, but it left me with a long term completely paralysed right hand (I'm right handed) so wasn't even able to write my own name, let alone do much else with my left hand.

I got literally no help what so ever, not even a physical therapist, O.T or physio..I was just told it'd take 18 months to see a neurologist!

I had to buy a bunch of kids toys just to play with with my right hand to try and get my hand moving. The longer it was left paralysed, the longer it would take to correct, and there was no way I was going to let my life get any worse than it was, by being useless with one hand.

If I hadn't taken my own care into my own hands (no pun intended), I'd still have a paralysed right hand. It took me constant daily practice and exercises with all of my fingers and hand, it took every waking moment for 3 whole months to finally get the use of my hand back.

But for every day I missed, my hand would stiffen up again, so I knew I had no choice.

Sadly nowadays with the visible and invisible illnesses, we're pretty much left to our own devices where our care and well being is concerned.

I hope you find something that works for you, hopefully swimming, if there is a pool nearby, may loosen it up enough to enjoy Christmas.

kohai profile image
kohai

Sorry about that Muddle, am more awake and "with it" now I've had coffee and my meds have kicked in.

As far as the physio goes,I've just gone over all of your previous comments on this post and something concerns me.

You mention you had had physio, the pain down your shoulder and arm where your hand goes numb,

Q1. did that start before or after the physio?

Q2. When exactly did it start? And have either the MSK Team or physio been told about this?

I want to make a comment about this, but need the answers to the above 2 questions before I can.

And while it IS 100% your choice, I would definitely not let the physio touch your shoulder again. Nothing she does will be of any help and will only increase the pain. The MSK were basically frigging idiots in their field to even suggest physio if they have already diagnosed impingement because if you re-read my description a few posts up describing what happens to cause shoulder impingement and how it progresses, those idiots should have known that any form of physio would cause intense pain.

Their only achievement here may possibly be strengthening the front and back shoulder muscles pre-surgery, in order to keep the shoulder ball from rising too high and grinding again against the top of the socket (so even post surgery, if those muscles aren't strong enough, you'll continue to have impingement, although a lot less painful - for example when you do things like raise your shoulders so they are under your ears (like when you cross your arms and lean on a desk to look closely at the computer monitor, or lean on your elbows so your shoulders raise higher).

Hope that makes sense, but please re-read my long post above where I explain about impingement and what causes the pain. It kinda explains itself their why physio won't help and will only really cause more pain. If you do see the MSK Team again, please ask them what they hoped to achieve by sending you for physio, more so when the only thing that will fix it now is shaving back the bones that are now grinding together.

Their answer will be interesting, because I'm betting they'll try and change the subject or say it was someone else on the team who suggested it so they can't answer why (all excuses if you see a different person as I did on my visits to them).

I really don't understand their method if thinking here Muddle, I don't understand why they would send you for physio and the physio would even attempt to do physio on you if they all knew what causes impingement. It doesn't make sense.

Muddle profile image
Muddle in reply to kohai

Have not have physio yet get very frustrated with the shoulder at night and keep moving it which means can pick up a cup of tea the next day been and had a injection in it by the GP can have another one in a month start physio this month

Muddle profile image
Muddle

When I saw the MSK he ask for an exray and ultrasound I keeps asking for mri he shows me exercises to do and refer me to physio in one exercise I had to use left arm to help move right arm another hert so much I would refuse to do it in pain a lot at night with shoulder I have osteoarthritis in most of my body and told him too much exercise will cause a flare up which feels bad I have made an appointment to see my Gp for the injections but at the end of the day the only thing that will help is an operation I think the man said he is going to try and strengthen the arm used to be an elderly carer so heavy lifting

Simbistaffy profile image
Simbistaffy

I was diag same till new GP went and had me reassessed then turned out more ring me will guide you

Muddle profile image
Muddle in reply to Simbistaffy

I am sorry I do not ring people I do not know

kohai profile image
kohai

muddle, the MSK team consists of various people. You can ask to be seen by someone else on the team. I've seen them 5 times now and each time was with a different person.

Like you, I have osteoarthritis in every major joint. The MSK team, even Jan of this year were still referring back to a spinal x-ray taken in 2012, so the first time I saw them I was able to get free ambulance transport and went in to see the team using a walking stick. The second visit I was on crutches but the last three visits I was in a wheelchair. They still refused to do another x-ray and just kept repeating that I have 'mild' spinal disc degeneration in the lumbar area.

I recently got a disability adapted house in a different area so had to change doctors. She sent me for an urgent lumbar and cervical spine x-ray (top and bottom of the spine).

I was agony but no where near as Mir's are for me as I can't lay flat.

The X-rays showed severe disc degeneration in L1 to L2, L2 to L3, L5 and S1 to L5. It also showed extremely bad disc degeneration below, over and above the top of my spine (the cervical area). If that wasn't bad enough, she then told me the report showed I now don't just have osteoarthritis in my main joints and hands, but I now have it throughout my entire spine too. Then, me thinking 'oh crap", it got worse. she then told me that while as a doctor (as a general practitioner) she wasn't qualified or experienced enough to treat the severity of my condition or prescribe the types of medication used and needed to control this type of pain, only the pain management team can. So now I have to wait until ??? whenever for them to contact me.

As I explained to my new doctor, the last MSK person I saw tried the same thing, and the pain management turned them and me down.

This is all because around Jan 2016 when I was on 580mg Oxycontin a day, the pain management told me they couldn't prescribe anything due to the extremely high dose of Oxy I was already on. I had been getting frequent bouts of Fatigue around this time so made sure no appointments were made for me or to come see me before noon. But pain management said they wanted me to attend a 12 week pain management course, every Monday at 9.30am.

Remembering I was suffering fatigue and the high dose of meds I was on was making me slur my words. I could have sworn she said 1.30 as I knew I had fatigue and theres no way I could be up, dressed and out the door by 9am. I'd have to have gotten up 6.30-7am every Monday.

When the letter turned up, I opened it but didn't read it. It arrived about two months before the January course.

So Saturday before the course began i looked at the letter so I could check on the map where I had to go. It was only then I saw it said 9.30am!.

I phoned them several times throughout each day every day for five days, no-one ever answered, not even an answerphone.

Since then, which will be 3 years this coming January ( little over 2 months time) it'll be 3 years they've refused to see me.

My doctor said they can't just refuse to see a patient, but they have been. She told me I could file a complaint, I would if the stupid complaints page recognized my area code! It just throws up errors. My doctor read part of her letter she was writing to them, she said she was basically pleading with them to see me now since my meds have changed and my condition has drastically deteriorated. She said if they sat no to her, she'd file a complaint against them herself.

WWasher hoping the pain management are blocking my name as registered with my last doctor, so may agree this time not realizing its still me, but via a different location' that's on a big assumption they don't cross reference with details like date of birth, nhs number, I can just imagine them having the word

'Blocked' written across my record! 😯 More so as I'd prefer to start with a clean slate with them and not them showing animosity toward me.

I'll update IF I hear from them.

Muddle profile image
Muddle in reply to kohai

Thank you going to ask to see someone else

041051 profile image
041051

I have been diagnosed with an impingement in my right shoulder. The surgeon said he was happy to operate but there was only a 50% chance of success. I struggle to walk because it causes pain in the shoulder but I do also have arthritis in my neck and the facet joints in my shoulder area. My previous consultant at the pain clinic was going to look in to the shoulder area next but he retired and I now have to travel to a hospital that is too far for me to get to. I have an appointment at another hospital in January. I have discovered that since I have started taking a list of all my health issues to appointments, I get told that the person I am seeing can't help me and I am being passed from department to department. Good luck.

Muddle profile image
Muddle in reply to 041051

I have osteoarthritis nearly everywhere exercise helps the worst is the neck pain causes headaches sickness eye pain have to rest my neck and take painkillers when it hits

Muddle profile image
Muddle in reply to 041051

Sorry that they are not helping you

041051 profile image
041051

I have osteoarthritis in other places too. I'm going to see my G.P. because my hands/fingers are getting worse and I want to see if there is anything that can help prevent the "clawing".

Muddle profile image
Muddle in reply to 041051

I used to wear a hand support when I was diagnosed with carpal tunnel then had the operation it’s a lot better now

Muddle profile image
Muddle in reply to Muddle

Hope they can offer you something

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