By Wendy Crawford
NOTE: This is a personal recount of a shoulder
problem written in laymen’s terms. The author is not a medical professional.
For medical advice, please consult your physician for the best course of action
pertaining to your condition.
IIt all started about 11 years ago when the side
of my left upper arm began to ache. It was one of those aches that is just kind
of always present and didn’t really matter what I did or did not do. Keep in
mind at this point, I had been paralyzed for 25 years due to a C5/6 level Spinal
Cord Injury that I sustained in a
motor vehicle accident. To say that my arms have been overused is probably an
understatement! Given that the prevalence
of shoulder pain rises to a peak of 50% of the general population ages 55-64
years old and much higher for
wheelchair users, it is unfortunately a common problem.
I first went to my general practitioner who
thought I was having an inflammation issue and recommended that I start taking
large amounts of Advil, several times a day. I wasn’t thrilled about it but if
it was going to remedy the situation, I was willing to try it.
After a month or so, this pain was still present
and it didn’t seem like it was helping at all. It was also recommended that I
go to physical therapy to exercise my shoulder and rotator
cuff along with ultrasound therapy on the side of my
arm. I had some slight relief but the pain still lingered so finally I was
referred to an orthopedist.. After having an X-ray, she pointed to the tiniest
microscopic dot and told me that was calcification forming which was causing me
pain. I was finding it hard to believe that such a tiny speck on the x-ray
could be the source of so much discomfort. I was also confused because it was
the side of my arm that hurt not my shoulder. She explained that it was called
“referred pain” which is very common with shoulders. She gave me a steroid Cortisone shot in the shoulder and told me to keep exercising.
Gradually, the shot did not last as long and the
pain was increasing. I was going about every four months until my
orthopedist retired. I was ecstatic to find another orthopedist who actually
worked with professional baseball players so had a lot of experience with
injured, overused shoulders.
He too took x-rays and I had much more
calcification than before and some arthritis. He suggested that I possibly get
surgery but I wanted to try every option first. We continued with the Cortisone
shots but he also referred me to a specialist who did a procedure called “ultrasound
guided barbotage“.
When I met with the new doctor, I wasn’t sure
what to think. After seeing my X-rays and doing an ultrasound, he painted a
bleak picture; I was the worst case of calcification that he’s ever seen. He
told me “ You could get surgery but it will be a disaster for recovery. You
could do nothing and you will be miserable or we can try the ultrasound guided
barbotage and that might work.” Given these negative options, I chose the
latter.
I changed into a hospital gown and was able to
stay in my wheelchair. First he cleaned the area and then numbed it by
injecting all around my shoulder. Just the numbing was painful so I wasn’t
looking forward to the actual procedure.
After the numbing took affect, he used the
ultrasound to find the spots of calcification. He then injected a long syringe
and moved it back-and-forth breaking up the calcification. The movement kind of
reminded me of someone getting liposuction on television!. Even though my arm
was supposed to be frozen, the pain shot down my arm and I must admit that I
used a few choice words to get through it. It took about 20 minutes, I think,
but felt like an eternity and then he gave me a Cortisone shot to help the
inflammation from the procedure.
I had to keep my arm moving so as not to get frozen
shoulder and slowly went back to
doing exercises. I saw him about every six month. At this point, I had pain in
both shoulders so we kept doing the procedures on both shoulders for a total of
three per shoulder.
The good news is that my right shoulder
gradually got better and has not had any pain there since! Keep in mind, I have
omitted all exercises above the shoulder, as recommended by the doctor.
There are a few important factors that I would
like to emphasize. I have been susceptible to urinary
tract infections since my injury and
I’ve taken a lot of antibiotics, over the years. One of those being Cipro which I took off and on. One day, I noticed a warning that it can
be harmful for your tendons and my doctor confirmed this was true! I have no
idea how much this contributed to my shoulder problems but I wish that I
would’ve been more thorough in my research and asked for an alternative drug.
The second main point is after years of getting Cortisone shots, one of the
nurses was going over the post-procedure care and happen to mention that my
blood sugar would rise temporarily. I found this interesting because I had
recently had my blood sugar checked and it was told that I was becoming insulin
resistant. I was shocked that no one had mentioned it before so that I could’ve
been more careful in regards to my diet. Thankfully, it is temporary but
definitely motivated me to find other options for my left shoulder. Lastly, I
recently learned from my urologist that Cortisone can make you more
susceptible to urinary tract infections so be aware of the side
effects of Cortisone, prior to an
injection.
Stay tuned for Part 2 to learn more about my
non-surgical quest for a happy and healthy shoulder.
References:
Epidemiology of Shoulder Pain
Association of Shoulder Pain with the
Uses of Mobility Devices in Persons with
Chronic Spinal Cord Injury
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