Prednisone and 2 Torn Rotator Cuffs

[A77bruin]

So, strange question. I was diagnosed with polymyalgia rheumatica in July. I have been on Prednisone since then and at the present time I am down to 17.5 mg. Have any of you ever experienced what I am going through right now? I now have 2 torn rotator cuffs. I tore my left one about 4 months ago. Surgery was scheduled for about a month ago until my orthopedic surgeon either discovered or realized that I was on Prednisone and canceled my surgery because Prednisone inhibits healing and he would not operate unless I was at 5 or below. Fast forward a couple months and now my right rotator cuff has torn. I am trying to find a correlation between this and Prednisone. Any ideas or suggestions? Ever hear of this? HELP!

[Ozark]

I have been on prednisone for about two and a half to three years now, and within that time I've experienced, just like you, a rotator cuff injury to my left arm and I'm currently slowly, very slowly, recovering from injury to my right arm. In neither case has this been so severe to require surgery, but my left arm took, perhaps, 6 to 8 months to heal, and my right arm is only very slowly improving. So can this just be coincidence, perhaps, but I'm inclined to think not. My supposition would be that in some way the administration of prednisone weakens the connective tissues in the shoulder. I have no advice what to do about this other than to confirm what you are reporting as it pertains to my particular situation. My best to you, and I hope you recover soon.

[A77bruin in reply to Ozark]

Thanks so much. My left side had the tendon completely tear away from the numerous head and definitely requires surgery. I’m hopefully going to have an MRI on my right side this week. Even though surgery is out for now, I still want to know. I am in pain….both sides……but basically between a rock and a hard place …..

[Ozark in reply to A77bruin]

I'm so sorry you are in pain, and a nasty pain it is. I still can't figure out what caused my shoulder situation. Especially with the right arm, to the best of my knowledge, I did not lift anything especially heavy, it just seemed to happen out of nowhere.

[DorsetLady PMRGCAuk volunteer]

Not sure there is a direct correlation with Pred, would say rotator cuffs were already weakened, but being on steroids probably hasn’t helped.

I do sympathise, I had a shoulder replacement and minor repairs to RC almost 2 years ago and well remember the pain prior - do hope you can get some relief asap. (Note not on Pred at the time).

According to Mayo clinic -

The following factors may increase your risk of having a rotator cuff injury:

Age. As you get older, your risk of a rotator cuff injury increases. Rotator cuff tears are most common in people older than 60.

Construction jobs. Occupations such as carpentry or house painting require repetitive arm motions, often overhead, that can damage the rotator cuff over time.

Family history. There may be a genetic component involved with rotator cuff injuries as they appear to occur more commonly in certain families.

Many on here have had successful operations (usually hip or knee replacements) on higher doses than 5mg, so maybe you should discuss again with surgeon, perhaps he could be persuaded to increase the limit to a slightly higher dose.

Have you been given specific exercises to help both or either injury.

[A77bruin in reply to DorsetLady]

Thank you DorsetLady!

[PMRpro Ambassador]

I agree with DL - so soon after starting pred I think it would be a bit of a stretch to blame it but there is no getting away from the fact that over time pred does make muscles and tendons more delicate. But so can PMR since it inflames the soft tissues around certain joints, especially shoulders.

Rotator Cuff Tendon Ruptures and Degeneration as the

First Manifestation of Polymyalgia Rheumatica Disease -

A Case Report

is a case study where the doctors felt the patient's rotator caff damage was actually the presenting problem of her underlying PMR and that this may be more common than currently thought, I'd give a link but it is a download of a pdf which you get direct from google.

Suggestion: shop around for a shoulder specialist. We have people on the forum who have had successful shoulder surgery while on more than 5mg pred - hips have been replaced while on higher doses but that is a simpler operation. It doesn't stop some surgeons refusing until the patient is off pred altogether while another surgeon says fine, and just gets on with itl But there are conservative approaches to rotator cuff injury - I assume that has been initiated?

mayoclinic.org/diseases-con...

[A77bruin in reply to PMRpro]

Thank you PMRpro. My orthopedic surgeon is the best one in the county where I live. In addition, my rheumatologist agrees surgery while on prednisone is not a good idea due to the healing process.

[Josephinem]

My left rotar cuff is torn. I was told by the specialist , he could not repair it. Firstly he didn't think an operation would work and secondly at at the time I was on 5mg prednisolone. I have been on prednisolone for 13 years. Unfortunately they are causing my body some issues. Hope all goes well for you 🙏

[A77bruin in reply to Josephinem]

Thank you so much Josephinem!