Subacromial impingment (shoulder pain)

[Sophocles]

I am waiting for a 'decompression operation' on my right shoulder, having seen a top UK consultant who diagnosed quite a severe form of sub-acromial impingment. However, it may take several months before I have this operation (on the NHS!) and I am suffering from much pain, discomfort and pronounced disability when using my right arm.

My question is about the safe use of Prednisolone, which I was told could help relieve the pain, if taken in short doses. Some history: I did take Prednisolone over an 18 month period to treat and contain Polymyalgia and it was a complete success without any side effects, which suggests that I have a more than decent tolerance of Prednisolone (I also took a weekly bone protection tablet). However that was a well tried long course where one starts with a high-ish dose (20 mg) and tapers down gradually to 1 mg and then nothing.

Well, I recently tried a short course of 40 mg of Prednisolone for 5 days and it again worked wonders but only provided relief for about 10 days and then the pain returned. My question is this: how often can I have these short bouts of Prednisolone while I am waiting for this operation and how long shoud the gap be between rounds? I hope I have made myself clear. (Oh, incidentally I have also had three cortisone injections in the shoulder which provided only short-term relief and I am reluctant to have any more.)

[Stillsmiling_Just]

Hello Sophocles, I'm really sorry to hear you are waiting so long for the shoulder decompression surgery. I have impingement and have waited quite a few months to be seen on the NHS too.

I'm not able to advise on the cycles of prednisolone, but I did want to say that I really empathise with you as the pain and associated mobility problems can be very challenging.

I hope you are able to get the advice you need soon. Hang on in there.

C

[marspuppy]

Hi Sophocles

I too am sorry to hear about your situation. Unfortunately I also suffer with severe pain due to back and other issues, and cannot be operated on due to autoimmune diseases I have.

I am life dependant on cortisone so take it daily. I am not sure therefore whether cycles are therefore necessary.

I hope this helps.

Best wishes!

[Sophocles in reply to marspuppy]

Thank you. May I ask what daily dose of cortisone tablets (Prednisolone?) you take - and whether you take other tablets to deal with possible side effects.

[marspuppy in reply to Sophocles]

I take 5mg Prednisone (that's the brand name in South Africa) daily. Double that when I am sick or stress dosing (one of my conditions is Addison's Disease, so stress = bad). Sometimes a Solu-Cortef injection which is I think a 100mg cortisone, followed by a saline IV drip.

I am on a ton of medications, so I can't tell you whether I have had any side effects due to cortisone, except weight gain, but I can definitively tell you, that it has saved my life on more than one occasion...

[Sophocles in reply to marspuppy]

Thanks - that's really helpful.