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Discussion:
Shoulder pain
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Hey everyone. As some of you know, I'm not yet diagnosed with RA, I have an appointment with a rheumatologist in a little bit less than a month now, and I'm trying to write down all symptoms I have to give the doc a clear picture. The main trouble is my knees, but lately (the last few months) I've had some troubles with my right shoulder, and I'd like to pick your brains about it.

Every morning it feels as though I've slept weird on my shoulder. Note that I mostly sleep on my back (if I do fall asleep on my side my cat will let me know quite loudly that he wishes me to sleep on my back so he can sleep on my stomach!). It hurts especially in the morning, but also throughout the day. It used to only come once in a while, so I assumed I had just slept in a bad position, but now it's there almost every day. The pain is what I assume is the rotator cuff. It hurts when I lift my arm up and out, like when I get dressed, for example. No swelling or sore to the touch, just hurts when I use the arm.

So, is this something I should bring up with the doctor, or do you think I just need to get a new bed? Does anyone recognize this type of pain? I don't want to come across as a hypochondriac when meet the doctor as I assume he won't take me as seriously then, so that's why I'm coming here first.
Posted on 09/02/13, 06:51 am
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Reply #1 - 09/02/13  9:30am
" Hi MushyMushy, Yes this is something to mention to our doctor along with your other symptoms. It seems this is more than the way you are sleeping or even an new bed option. But whether it is RA it probably is not as RA is almost always bilaterally. ? a tear in the rotator cuff, that is known to really hurt. Hopefully you can get this solved sooner or later. Maybe your PCP can help address the problem of the shoulder while you wait for the Rheumatologists appt. or even ortho if you can get one sooner? Best of luck to you. "
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Reply #2 - 09/02/13  10:00am
" Christine26, thank you for your reply. Yes, the bilaterallity (?) made me think too. Some times when I wake up I will have similar pains in my left shoulder, but it leaves pretty quickly. Also, I've read that with RA it can start on one side, and then hit the other one after a while, so it MIGHT go over to the other one as well. If it's not RA in my shoulder, I'm thinking it could be something connected to it, an inflammation of some sort.

I'll put it on my list of things to bring up with the doctor, I'm glad to hear I'm not being too paranoid and that I should look this up. "
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Reply #3 - 09/02/13  10:48am
" Shoulder pain (exactly as you describe) was part of my initial RA onset and continues to be a problem area. Oddly enough, like you, my right shoulder is far worse than my left. My ROM is very limited, especially in the right shoulder, but I am working with a PT now to at least maintain the flexibility I have. "
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Reply #4 - 09/02/13  10:48am
" ....and what we won't do for our cats, LOL! "
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Reply #5 - 09/02/13  10:58am
" Hi Mushymushy, I too have the same pain in my shoulders, left and right, with the right shoulder the predominant one. I was considering an orthopedic dr. when my rheumy said no, it's RA. So, I was put on prednisone and the pain is gone for the most part. When I go off prednisone, who knows. I feel for you, because the pain is excruciating. I will pray for you, and best wishes. Oh, by the way, happy Labor day. prayers "
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Reply #6 - 09/02/13  11:04am
" Yes, pain anywhere in the body should be discussed.
Something to keep in mind is there are various forms of arthritis.
You want an accurate DX so don't leave anything out.
Shoulder pain can be from the actual shoulder anatomy or even the neck (cervical).
Let the doctor determine.
Wishing you the best of luck.
Sammy "
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Reply #7 - 09/02/13  11:21am
" Thanks everyone, I'm glad I'm not alone with this pain (although I'm not glad anyone of us has it!). I'll definitely bring it up and let the doctor determine how to move forward with it. I get more and more nervous as the appointment comes closer, and I second guess every symptom I have, trying to give it a different reason (such as "no, I've just slept weird") so it's good to get some people behind me who can help push me :) I guess I'm one of those people who don't want to be a burden, so I keep downplaying everything, even when it's really bad. Sigh. I'll work on that bit too :) "
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Reply #8 - 09/02/13  11:42am
" Oh how I remember that - I would wake up in the wee hours and could not move either shoulder half an inch without experiencing excruciating pain! Of course my hands, fingers and wrists were stiff and swollen and my elbows hurt, too. It was so painful to even get out of bed. Then I would spend most of the morning on the couch with a pack of frozen peas on each shoulder and some Advil until I could move. I had to give up my beloved swimming during this time also. I am so thankful that is over now. All this to say I know what you are going through and feel so bad for you - I would not wish it on anyone. But remember there is always hope and things will get better! "
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Reply #9 - 09/02/13  11:46am
" I've had major surgery on both shoulders(including rotator cuff repair) so maybe I can help.

There are 2 main areas where arthritis can set up in the shoulder. You have the shoulder itself with it's ball insocket joint and the far more likely cause of pain...the AC joint. The AC joint is where the collarbone and scapula come together on top of the shoulder just in from the shoulder. Follow your collarbone up and all the way out and you'll find the area of the joint. That small joint holds the major shoulder muscles upward so we can have the range of motion we do with our shoulders and the rotator cuff tendons go through it. It also has one of the biggest bursas in the body under that joint....a frequent cause of chronic shoulder pain, especially after sleep.

So the rotator cuff tendons can tear and it usually happens at that joint. What these tendons/muscles do is move your arm in a specific way. If you let your arm just hang down straight, then twist your arm so your palm is facing forward, then twist it all the way around the other way so your palm is facing all the way out...that is the rotation of the rotator cuff muscles/tendons. Main symptom is weakness when raising the arm upward and outward although I had no problems with that....it was found during surgery to everyone's surprise. An MRI can usually show a tear but it doesn't mean it has to be fixed. The surgery involves up to 5 months of recovery time...why when I tore the left one I declined to have it fixed(there are 4 rotator cuff tendons so tearing one may not do much).

But RA tends to hit the main shoulder joint and xrays will show that. Osteoarthritis tends to hit the AC joint. Either can cause bursitis to hit and tendonitis or bursitis can be as painful as arthritis in a joint if not more so.

So the doc will have a lot to look at to determine what is what but you do need to tell the rheumy when you see him/her. Everyone jumps to some kind of arthritis but I can tell you, after at least 100 cortisone shots per shoulder over the past 35 years, bursitis and tendonitis can be far worse pain than any form of arthritis. I've had tendonitis shut down all movement of my shoulder and bursitis drive me to tears. I eventually had surgery to remove the ends of the collarbones and work on the rotator cuffs and do a whole bunch of clean up in the AC joint and shoulder joint and it really helped but after 9 years, I am back to where I was before...getting cortisone shots.

At least I have a great doc who gives shots that hardly hurt...a blessing with arthritis!

Jen(both early on-set OA and RA) "
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Reply #10 - 09/02/13  4:08pm
" Yes..it was one of my first symptoms and just on the left side. I thought I just slept funny too. Def tell the Dr about it. "

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