Post-traumatic arthritis in shoulder

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froggylady
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Joined: Mon Jan 16, 2017 6:13 pm
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by froggylady on Fri Oct 09, 2020 12:07 am

Post-traumatic arthritis in shoulder

Hallo team
Eight years ago I fell and broke my shoulder, dislocated it and suffered nerve damage. For two years or so, steroid injections kept the pain at bay, then they stopped working. An MRI scan revealed post-traumatic arthritis, according to the consultant. However, an operation would not help or might even make it worse.

Two or three times a day I take two codeine phosphate and two paracetamol which help dull the pain. But I would like to know if there is any other treatment, physiotherapy for instance, that would help.

I should add that I am 76 years old, the correct weight for my height, and also suffer from osteoporosis for which I have Prolia injections every six months.

Any advice would be most welcome.

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Arthritis Action
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Joined: Wed Sep 28, 2016 1:27 pm
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by Arthritis Action on Mon Oct 12, 2020 4:57 pm

Re: Post-traumatic arthritis in shoulder

Hello and that sounds like a nasty injury. Exercises may well help but as you have probably discovered, we use our shoulders for so many normal activities that managing the pain can be quite challenging. Pain from the shoulder may not just be coming from the joint, but from the soft tissues, for example the muscles and tendons around the joint which can respond to hands-on therapies for example physiotherapy and osteopathy. Sometimes pain from severe arthritis can arise from nerve endings in and around the joint and medicines used to treat nerve pain, for example very low dose amitriptyline can help. Rub-on anti-inflammatory gel may also help. Finding a comfortable sleeping position with supportive pillows can also help with pain management. Shoulder replacement surgery as a last resort can actually be very effective for pain, however, obviously no surgeon can guarantee a result and it is likely that movement in the joint will be restricted after surgery, but this may be worthwhile if the pain is easier. Ask for a second opinion if your original surgeon put you off as age isn't a barrier if you are well and sometimes surgeons have patients who have had the surgery and done well who may be willing to speak to you.

Dr Wendy Holden
Consultant Rheumatologist and Medical Advisor to Arthritis Action

https://www.arthritisaction.org.uk/

020 3781 7120

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Matthew Rogers
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by Matthew Rogers on Tue Oct 13, 2020 11:46 am

Re: Post-traumatic arthritis in shoulder

Most of the time if we hurt ourselves we know what has caused it and the pain that we experience will resolve within a short period of time, usually less than 6 weeks. Sometimes once you have been living with pain for more than 6 weeks (as you have been), the nervous system will become a little more sensitive to pain than it should be and this is referred to as ‘central sensitisation’ or ‘persistent pain’ (you can find out more here: https://www.iosteopathy.org/osteopathy- ... tent-pain/ ). If you are living with persistent pain, your pain nerves may trigger off a little easier than normal. In this case, the hurt you feel is not necessarily a sign of harm. You could think of this as a sensitive car alarm that goes off in error when someone walks past.

Persistent pain is very common and effects over 14 million people in the UK alone. Frustratingly, it often does not respond to conventional medical interventions (as you have found) and needs a different kind of approach, but there are many things that you can do to manage your pain yourself with the support of your medical team, your family and loved-ones.

Keeping active, performing exercises and stretches can help, learning to pace your activities so that you don’t trigger a flare-up of your pain as well as setting goals and priorities are all very important and can help you to maintain a fulfilling lifestyle (the charity https://www.arthritisaction.org.uk/livi ... actsheets/ provides lots more information on this). Your GP might be able to refer you to a cognitive pain-management department near you that can teach you techniques that you can use to manage your symptoms yourself. There are also specific types of medication that can help with this sort of pain.

I know all this can sound a little scary, but there is hope and once you have found the right approach for you, I’m sure things will improve.
Matthew Rogers
Head of Professional Development, the Institute of Osteopathy

http://www.talkhealthpartnership.com/on ... rogers.php

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Tracy Corbett
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Joined: Wed Sep 27, 2017 12:19 pm
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by Tracy Corbett on Thu Oct 29, 2020 3:33 pm

Re: Post-traumatic arthritis in shoulder

Hello. I agree with everything that Dr Holden and Matthew have said in their comments. I would just add that a referral to a musculoskeletal physiotherapist could be very helpful for you. Your physiotherapist can help you to ascertain how much of the pain is coming from the shoulder and nerve damage, and how much is associated muscular/soft tissue dysfunction, which can be treated using manual techniques, taping and gentle targeted exercises. Your GP will be able to help with a referral to a suitable physiotherapist.
Tracy Corbett
Chartered Physiotherapist

http://www.talkhealthpartnership.com/on ... orbett.php

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