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Avatar universal

Shoulder pain spreads over time

Hello,ive been having shoulder pain for over a six months now.Been to my gp,who sent me to a physio which gave me a few excercises which didnt help at all.Then i got sent for ultrasound scan,they said theres a small,tiny point of inflamation,but thats nothing to worry about and thats it.The pain that im having starts in my right shoulder, while doing something with my right arm and it grows with time,even walking for about an hour.It doesnt hurt at all if im not doing anything or not doing anything more active with my right arm.While working or doing something active,After 2-3 hours pain spreads to my neck,elbow,hand,chest.Recently it started spreading to my other shoulder and arm.At that point it hurts too much,cant raise either of my arms without having incredible pain,all other movements are limited,basically half of my body feels like struck by a train,it feels hot,inflamed in places where its spread.Painkillers simply dont help,they dont even reduce the pain.Dont know what else can be done,please help.
11 Responses
Avatar universal
Hi there. Have u had neck  xray  or mri  if you have disc issues  in neck can cause what u are describing. Just a thought
Avatar universal
No,I havent,but my pain in the neck starts after working for a few hours,when its usually alreadu spread up to elbow.But the main pain source is the shoulder itself,so never gave it a thought,neither did doctors.But ill ask about it during my next appointment,thanks.Any other suggestions?
547368 tn?1440541785
Hello Arvydas,

Welcome to the Pain Management Community. I'm sorry to hear about your pain - but glad that you found us and took the time to post.

I just went through something very similar to your pain. I diagnosed myself with Acute Brachial Plexus Neuritis. I've had MRIs of my Cervical Spine (neck) and of my Thoracic (upper) Spine.  I've also had x-rays of my shoulder and chest. Enough about me -  I just want you to know that I understand how horrific that pain can be. I agree that you should have some diagnostic testing too. An ultrasound is a good diagnostic tool but it has many limitations. They could not have seen the structure of the shoulder, including the rotator cuff - which in my opinion is what you need.  

My right shoulder began hurting several days ago. I attribute that to the fact I favor my left and use my right shoulder most all the time. Could that be true in your case too? It often is.

It's probably not an arthritic type of condition as usually you note more pain in the morning that decreases (to some degree) with use.

The fact that the pain travels may mean that there is some nerve involvement, possibly nerve entrapment. There are so many possibilities as the shoulder is so complex. Shoulder tendonitis or rotator cuff tendonitis are just different ways of saying there is inflammation causing a common set of symptoms. The proper terminology for these symptoms is 'Impingement Syndrome.'  This occurs when there is inflammation of the rotator cuff tendons and the bursa that surrounds these tendons.

Actual Nerve Entrapment is less likely but mot impossible. Usually an injury is involved, arthritis or other conditions. I'm far from an expert but I'd guess your pain is probably due to Impingement Syndrome.  

If your PCP is not willing to do the proper diagnostic testing then I'd consult another. Six months is a long time to be miserable - too long.

I hope you'll keep in touch and let us know how you are doing. We'll look forward to hearing from you again soon.

Take Care,
~Tuck


547368 tn?1440541785
I'm sorry I forgot to add that your pain could also be related to a cervical spine problem - as luvdolphins suggested. I certainly didn't mean to dismiss her comment or that possibility.

It's obvious you need a better diagnostic work up than what you've had.

Again Take Care,
~Tuck
4851940 tn?1515694593
Pain in the shoulder can sometimes be referred pain from problems in the cervical area.  

Many years ago I experienced pain in one of my shoulders radiating down my arm.  The physiotherapist pressed on areas of my upper spine a couple of times over a few weeks and that sorted it.

If you have not had xrays or MRI scan done of your cervical, shoulder and thoracic area, that may be something to suggest to your GP to refer you to have done.  Ultrasound scans do not show up bone damage and you still could have calcification in the shoulder bones or other arthritic changes.

It may even be a good idea for you to ask your doctor to refer you to a rheumatologist.  I did that last October, and have received more help by way of physio, hydro, acupuncture, referral to a pain management consultant and different treatments being tried.  My doctor had been ignoring my concerns so asked for xrays to be done and a referral.  

Do you do any repetitive work?  Or do any physical sports where you have fallen or had any impact into to your shoulders?  Soft tissue injury can take a very long time to heal.  I damaged a tendon in my leg by using the treadmill some years ago,  I could not walk on that leg without sever pain for 9 months.  The type of work that you do may have something to do with your problem.  

Have you tried applying hot or a cold compress to see if that will give you any relief?   My doctor prescribed Algesal to apply to my severely jarred shoulder when I fell and severely whilst on holiday.  It helps a little, but I know that it will take many months before I am able to use my move my arm.  I was provided with a sling by the hospital.

Do your gentle exercises as advised by your physio, what you don't want is to get a frozen shoulder.  Avoid doing things that aggravate your condition.
If you do lifting and manual work or any other type of repetitive work, if you are still going to work, ask for your duties to be changes or ask for a doctors sick note.  If the condition is due to muscle, tendon (soft tissue) damage, be aware that these take a very long time to heal.

Steriod injections may be considered, but if you have diabetes, it can spike up your sugar levels.

Avatar universal
Thanks for all replies,that should really help to get the most of my next appointment,will ask for mri scan and will suggest some ideas to doctor that i read here.

The day i realised i cant take more than a 3-4 hours of work was on christmas eve as I was working that day.Im working in a factory and basically I do packings,which means lots and lots of movements with arms as well as my back as im a tall guy and most of the time have have to bow to reach something from the line.And its 12h a day.At the time I was working alot maybe 4-5 days a week.So yes the work is probably the cause of my problem.

When I first went to doctor she gave me sick for light duties.She said she cant give me normal sick note as im able to do full range of movement with my arm.My factory has no light duties,so I worked half shifts - 6h for few days a week.But the note was oly for a few weeks.Now I have a new GP,but I didnt ask for a sick note.I was happy when he said hes sending me to do ultrasound,finally maybe teyll find out whats wrong with my shoulder I thought.

But it was few hours travel for literally 5 minutes,the guy said it was nothing,didnt even let me explain that pain starts with time and spreads,he just left out the door saying "take care".So I had to leave hospital without any further advices on what I should do next.Thats when I decided to seek help on the internet.
547368 tn?1440541785
Now that you've added additional info telling us of the repetitive physical work you do it sheds some light on the more obvious conditions you may be enduring.

I didn't hear you mention diabetes as Jemma suggested so if you require steroid injections that won't be a concern.

I wasn't real clear (a typo) when I talked about arthritis. Normally arthritic conditions become better as you move and exercise - and not worse as you report your symptoms (sx) to be.

The most important thing here is for you to locate a medical provider that will be concerned with your sx and well being. Only diagnostic tests will provide you with the answers - none of us here can diagnosis you.

I see that you and Jemma are from the United Kingdom - where your medical delivery system may work differently that it does in the USA. However I'm certain you still have kind and competent physicians.

Once again I'll ask that you keep us informed and wish you the best.

Peace,
~Tuck


4851940 tn?1515694593
Sorry to hear that you have had no support from your doctor and no proper consultation with the last consultant.

I suggest you do the following:-

1.  Make an urgent appointment to see your doctor and explain to him the position you are in, the type of work that you do, the lifting and the bending, that there is no light duties available for you at the work place and ask for a sick note.

2.  Make an entry in the works Accident and Report Book and write down the date when your symptoms first appeared (this will be before the 26 December) and the symptoms that you are having.  The shoulder problems with the fact that you have explained the type of work you do, is a work related injury.

Do not let anyone tell you that you cannot do this.  If you do not know where the accident report book is, information should be on notice boards, or ask your manager or an officer in the personnel department.  You must enter your injury into the book.  Don't let anyone try and bully you to not do this - By law you have to report any work related injuries.

3.  When you get your sick note, fill in the details and keep a copy for yourself and send a copy to your employer.  

4.  Before the sick note date ends, book in advance an appointment to make sure you see your doctor a day before or on the day your sick note ends.  The doctor will give you another sick note if your condition has not improved.

5.  If you do not get any pay whilst you are off sick, you may have to contact the DWP with regard getting benefit called Unemployment Support Allowance.

6.  Look on the web or the telephone book for your nearest Citizens Advice Bureaux to give you help and advice if you are not sure what to do.

7.  If you get prescriptions and have to pay for them, ask the chemist for the receipt and a form to claim to get free prescriptions.  You do have to provide proof of your income.  Otherwise it may be cheaper for you to look into getting a prepayment certificate.  It depends how many medications you get in a month whether it would work out cheaper for you or not. So do your sums.

8.  If you belong to a works union, contact them so that you can get help from them.

9.  Keep copies of all communications/letters between your employer.  If you are asked to attend to a meeting with your employer, tell your union so that you can have a union rep present with you.  If you do not belong to a union, ask a trusted work colleague to attend any management meeting with you.

Take notes what they tell you and write it all down afterwards.  Your union rep or your colleague will be your witness.  The union rep may speak on your behalf.

***********

Even with arthritic bone problems, you still can get acute spasms and overuse or prolonged use can also cause more aggravation.  When experiencing acute problems (pain that is very severe or comes on suddenly), you rest and do little gentle exercise.

When you have a chronic problem - one that is long lasting (chronic conditions can still have acute flare ups), aches and pains, but no flare ups, this is when you will be able to do more of the exercises that your physiotherapist has given to you.

You may find hydrotherapy helpful.  Ask your physiotherapist about hydrotherapy.  They may be able to offer this for you.  What you don't want is to get frozen shoulders, so the gentle exercises will keep the mobility.

As you are experiencing pain in the shoulder as your arm hangs down when you walk, ask your physiotherapist about having a supportive sling.

As your doctor about steroid injections, acupuncture (you can get that on the NHS) and analgesic creams.

Let me know how you get on.
Best of luck.
Avatar universal
Took me long enough,but i finally got sent to a doctor that can send me for MRI tests.Will have to wait couple of weeks for a letter to come with an appointment date.Meanwhile I got a doctor's note,will keep me alive till I get those tests done :D Although it might take few months for the process.Thanks for all the help and advices,will keep you all informed,when they hopefully find whats wrong with my shoulder.Have a friend that has almost the same issue and didnt know what do till now,so hopefully whoever has similar problems will read this post for some really useful information.

Take care,
Arvydas
547368 tn?1440541785
Thanks so much for the update. It's very much appreciated. So often when we respond to a thread we obtain no response - we don't even know if the oerson read what we wrote. Not so with you! Thank You!

If we do get the good response such as you've done - than often the person never posts again.  We're left wondering how the person is doing! Not so with you! Thank You!

I am delighted that you will have an MRI (Magnetic Resonance Imaging).
It's an excellent diagnostic tool. The magnetic field and pulses of radio wave energy looks at structures inside the body that cannot be seen in an x-ray or other scans. It will record any bone structural problems, cartilage problems, torn ligaments or tendons or similar types of issues.  

I wish you well and will look forward to future updates. Again Thank You.

~Tuck


4851940 tn?1515694593
I do hope that your doctor has requested an MRI, not only of your shoulder, but also from the top area of your spine.

Having read your post again, just reminded me that some years ago I experienced pain in the top of the shoulder, but the pain ran down all the way to the elbow.  The physiotherapist applied pressure to a specific point in the upper spine once at 2 sessions and this actually stopped my problem.  There was impingement of nerves.

Today I have had an ultrasound scan on my shoulder because of lack of movement due to severe pain after a heavy fall off a 5" ramp over 2 months ago.  Xrays done soon after the injury showed no bones broken.  Today the result of the ultrasound scan shows a torn tendon in the rotator cuff and also impingement.   The pain from this not only inhibits different movements, but the pain travels down to the elbow and sometimes to the hand.

I will find out next week what remedy will be offered.  Acupuncture, hydrotherapy and physiotherapy as well as analgesic creams have not helped.  I cannot take anti-inflammatory drugs.

Will be interesting to know what your MRI shows up.

Hope you get your appointment soon.

Best wishes.
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