PMR or rotator cuff damage?

[Bonbows]

Diagnosed August 2019 with PMR. Starting dose 15 mg. pred then tapered to 8 mg By April 2020 but had severe pain in right shoulder and bicep. Upped pred by 1 mg increments until pain gone (17mg). Now back to 10mg but shoulder/bicep very painful with restrictive movement but only on right side. Is this PMR or something else, ie damaged rotator cuff?

[DorsetLady PMRGCAuk volunteer]

As it’s only one side would plump for rotator cuff, maybe arthritis or myofascial pain syndrome.

Higher doses would have masked pain.

You need to get it checked.

[Bonbows in reply to DorsetLady]

Thank you for replying so promptly. I have messaged my GP requesting an examination - not holding out much hope for an early appointment though ☹️

[DorsetLady PMRGCAuk volunteer in reply to Bonbows]

No.. don’t do that!

[PMRpro Ambassador]

When a symptom is restricted to one side it is probably a good idea to regard it as not PMR until all other possibilities have been ruled out. There are other options besides rotator cuff but either a physical examination or imaging should rule most in or out.

[Bonbows in reply to PMRpro]

Thank you I’m now waiting for the doctor to contact me.

[Hidden]

It might be R/C but you will have had to do something to injure yourself? I have got PMR and previously damaged a R/C the pain and limited use of the arm is more intense with a rotater cuff. This of course is only my experience good luck

[_multistrada]

I have exactly the the same problem, I don’t want understand it either press hide a lot of problems and Male life easier, probably also a result of hard work? I have had intense massage which has helped a lot.

[Daffodilia]

Is it frozen shoulder?

[Burroughs123]

I am recovering from a trapped cervical spine nerve (C7). The pain was/is only on the right side and extends from the back of shoulder down and under my arm into my forearm and then as a sore tingle into my index finger. But I had full movement and no stiffness - just extreme nagging pain. This led my GPs to diagnose a nerve impingement diagnosis rather than a PMR flare. Initially, I also upped my pred dose from 10 to 15mg thinking it was PMR but after diagnosis dropped back down to 12.5. Now that the pain is more than manageable (thanks to 4 weeks of strong painkillers and amitrypteline!) I can consider a possible small pred taper. I am also slowly tapering off the painkillers. Regarding painkillers: Ibruprofen should only be mixed with steroids If you are taking something to protect your tummy (omeprosole in my case). I am also on cocodamol and have dropped that from max dose to just one or two per day. I am getting there and so will you. I hope you’ll get some answers from your Rheumy or GP as it is worth a call to them. Be really specific when describing where your pain is as this will help them to provide a correct diagnosis. Good luck x

[Bonbows in reply to Burroughs123]

Thanks for replying. Spoke to a doctor - a new one to our surgery - who seemed clueless. After suggesting I stop the Pred and take anti inflammatories (I said NO!) he said he’d consult with the other GP’s and get back to me - Monday if I’m lucky😡

[PMRpro Ambassador in reply to Bonbows]

Clueless seems fairly kind ...

[Bonbows in reply to PMRpro]

Could have expressed myself in much stronger terms but I’m a lady😂

[PMRpro Ambassador in reply to Bonbows]

[anutycrixp]

I was fobbed off with "frozen shoulder/rotator cuff injury" yet I have no history of any injury.Get yourself examined and X-ray or even better c.t scan.Unfortunatly things got worse for me and after m.r.i and orthopaedic consultant exam diagnosed avascular necrosis of humeral head.Now waiting total shoulder replacement.Unfortunatly needing steroids for 2 years may have caused or exacerbated this condition,however this is rare.So do not neglect this and try and get a proper diagnosis at least an X-ray to check condition of bone.Best wishes!

[PMRpro Ambassador in reply to anutycrixp]

Doesn't have to be trauma. The Mayo site says "Rotator cuff disease may be the result of either a substantial injury to the shoulder or to progressive degeneration or wear and tear of the tendon tissue. Repetitive overhead activity or heavy lifting over a prolonged period of time may irritate or damage the tendon"

[anutycrixp in reply to PMRpro]

interesting.I was referred to practice physio back when shoulder really started playing up.I had already seen a private physio before that who treated me for rotator cuff injury ..with no effect at all .Anyway the n.h.s man specifically asked what the injury was,I replied that there was no incident or accident.He checked me out and described my shoulder as "very grumpy" and would not treat as such only gentle mobility exercises and advised not to abuse it ,heavy lifting etc overhead work etc and to further investigate if it doesn't settle or improve at all.He said it was not a rotator cuff problem,how right he was.!I assumed he meant because of no history of specific injury.Thinking back he implied it was probably a bony arthritic thing.The g.p however blithely carried on with"frozen shoulder".It is now unbearably painful and disabling..dressing even washing myself.I anticipate impending surgery with longing, fear and dread .Oh dear sorry to go on so ,but thank you for your reply.

[PMRpro Ambassador in reply to anutycrixp]

I don't mind GPs sticking to their opinion - IF they have done the appropriate investigation. And yours very obviously hadn't.

[Bonbows in reply to anutycrixp]

So sorry to hear of all your troubles re your health. I eventually spoke to a doctor (see reply to Burroughs) so will have to wait until next week. I will be quite firm when I do but sometimes you still feel as if you’re being fobbed off ☹️

[jobyway]

Hullo Bonbows, I have a Rotator Cuff injury as well, have been wondering if happened while steroid masked the pain of an action. I'd say definitely don't increase steroids, but get a scan and, for myself, am aiming to get some physio and/or osteopathy and massage. Good luck.

[Bonbows in reply to jobyway]

Thanks jobway. Getting a scan is easier said than done especially with Covid raging! Will see what the doctor says when he decides to ring me - honestly I think I could get an interview with God quicker than with this shower at my surgery!

[Burroughs123 in reply to Bonbows]

Same at our surgery! I have been refused a scan/x-ray twice since this recent issue. They are totally convinced it is a trapped nerve and, to be fair, it is improving with painkiller help and rest. And the physio agrees it is probably the correct diagnosis. They all also agree that it is a separate issue to PMR (I was hoping they would say that it has been a trapped nerve all along and that I didn’t have PMR. They didn’t!). Just keep pushing. Hope it goes well on Monday. Could you ask for a private scan/X-ray? Keep us informed.

[Bonbows in reply to Burroughs123]

Will do x

[pegpowell]

I had a knot under my right shoulder blade which eventually developed into a torn ligament and led to seeing an orthopedic surgeon who gave me a steroid shot and it healed nicely. This happened around the same time that I was diagnosed with PMR. It sometimes reminds me that it could tear again if I reach too high.

[Bonbows in reply to pegpowell]

Thanks for replying. My doctor is ringing back tomorrow and I’m pushing for an MRI or at the very least a physical examination. However, what I want and what I get are two different things. Just keeping my fingers crossed.