Sort of OT: Frozen shoulder, anyone?
Ladies,
For months now I have had a pain in my left shoulder and arm. A doctor I saw in September said that it was bursitis and would respond to physical therapy in a month or so. I did 10 acupuncture sessions and no luck, it has been getting steadily worse. When I make any kind of quick movement, like catching something, or if someone bumps into me, no matter how slightly, pain radiates down my entire arm. It also hurts at night, there is no position I can lie in comfortably. So I havent been sleeping much.
Yesterday I saw another doctor who says that it is not bursitis but frozen shoulder and that this takes a year or more to heal even with intensive physical therapy. It is true that my mobility on that arm is very little at this point. I thought it was just that I avoid moving it because it hurts when I do, but he explained that tissue builds up in the joint reducing the range of movement that is physically possible, pain or no pain. He said that it occurs mostly in women over 40 and that he sees it fairly often in breast cancer patients.
So I wonder, is there anyone out there who has had this? If so how did you treat it?
Thanks,
Lisa
Comments
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I had a frozen shoulder for more than a year prior to diagnosis and, like you, it made it difficult to sleep. Also made it hard to get dressed, put on a coat, etc.
My breast surgeon told me it had to be taken care of prior to treatments and surgery, etc. It made my first breast MRI absolutely excruciating. So I went to an orthopedic doctor and he gave me a shot of cortisone. I felt instant relief. Then I went to physical therapy. At my second session, the therapist was working on the shoulder blade area, pulled my shoulder toward him (I was lying on my side) and simultaneously pressed on something under the shoulder blade and, bam, no more frozen shoulder. I could NOT believe it. Haven't had another problem with it.
I hope you are able to find some relief and don't have to wait for it to heal on its own.
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I had a frozen should a few years ago - dx by MRI - pain moving arm, etc. It turns out I also have Cervical Disc Disease (neck area) or Degenerative arthritis. I had 2 shots of cortisone - first one did little, second one did wonders. A lilttle PT - mainly heat and very gentle stretching, range of motion exercises, then ice pack to reduce swelling and inflamation. I did some mild exercises at home and it was better in a short time - maybe 6 weeks.
Since then, I get pain when I do something I know I should not do - carry, lift heavy things, and reaching too far or twisting and reaching. If you google Frozen Shoulder, there is a British facility that specializes in Frozen Shoulder and I ordered the book of exercises - you may need a helper to do some of them - on the other hand, I have done the others and it helps a lot to keep the pain at a minimum.
Two exercises that help me a lot are #1) - walking the wall. Walk your fingers up the wall while standing at a 90 degree angle (sideways). Up and down slowly.
#2) - hang arm down to your side while sitting in a chair. make increasingly larger circles with the arm hanging down, relax shoulder. Reverse the direction and make smaller and smaller circles.
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Hi Lisa: I had a frozen shoulder and had the same symptoms you have been experiencing. I had to go through months of PT in order to finally get some relief. It has been 2 years and I still have some pain with certain positions and cannot totally extend that arm. It has been a long haul to recovery, but I am much more comfortable then I was when it first started. Good luck in your tx, and I hope you find relief quickly. Linda
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Another frozen shoulder here.
After surgery,chemo, radiation I had recovered full range of motion. Then one day I reached for something in the back seat of the car and experience a pain that was more intense than anything. And this is someone who had 2 unmedicated births!. Mine followed a standard progression from there -- months of intermittent horrible pains, then less pain but also little range of motion, then slow thawing. I was seeing an OT for Lymphedema therapy at the time, so she also put me through range of motion exercises, but really, it seemed to me that they didn't start helping until the shoulder started thawing itself and they were really painful when the shoulder was frozen.
I now have almost full range of motion and no pain, but it took about 9 months to go from first stabbing pain to painfree full movement.
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Another frozen shoulder here. I was sure it was more mets, but I was wrong. PT really helped with pain and ROM but now, 3 months later, the pain is back in certain positions. I know I should be doing the exercises on my own, but keep waiting for it resolve on its own. LOL How's that for lazy? The things I read on the internet did say it usually takes 2 years to completely go away. Edited to add that causes listed in the articles I read were injury and comprimised immune system. Since mine developed at the end of chemo, I blamed the latter.
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I had a frozen shoulder too, but it showed up on Xray
then I went to a physical therapist from heaven who
fixed me up in about six weeks...
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So many replies! thank you all!
I would love to be like you, gsg, and have it miraculously disappear after a few PT sessions, or even like SoCalLisa and have it go away after six weeks...but judging from the replies here it looks like it usually takes a lot longer. sigh.
Like Lefty I also have disc disease and osteoarthritis up and down my spine. I dont know if it is related to the frozen shoulder...but since my mets are also to my spine, and I earlier this year I had an inflammation in my hip socket that was so painful I could barely walk for 3 months, it sure is looking like my skeleton is going to pot.
The orthopedist I saw yesterday gave me a steroid injection and it has helped a bit. He also gave me a prescription for a tricyclic antidepressant. I forget the substance but a common brand name is Elavil. Supposedly it also works for bone pain. Anybody heard of that? I already take an SSRI, I dont know if there are contraindications for taking both.
Revkat and Alpal, that is interesting that you say it came on after your treatment for BC. I read on the internet someplace that it can be triggered by surgery or radiation to a nearby area. That is not my case, I really can´t think of any trauma that brought it on. My axillary dissection was ten years ago. The only thing I can think of is that this year after my R mastectomy, I slept on my left side all the time.
Aargh !!! I needed this like a hole in the head.
Grumpily (but very thankful for all your input),
Lisa
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I blamed it on the sudden reduction of estrogen in my body due to chemopause, since it does often strike women "of a certain age".
Elavil is often given for pain. I know a few people it has helped tremendously and others who had no relief with it. You do have to take it for a while before it kicks in. I would definitely check with the pharmacist about being on the SSRI as well.
I didn't have cortisone shots because I have lyphedema on that same side, but I have heard that helps. They also do this thing where they put you out and yank your arm around, but again, I didn't want more trauma to that arm.
Hope it gets better faster than normal for you, Lisa.
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Interesting idea, Revkat. My onc put me on Lupron shots and AI's in the beginning of July, the shoulder thing appeared in August.
I´m so sorry to hear about your lympedema. I wonder if maybe in your case, the trauma of the lymphedema might have also had something to do with the shoulder issue? From your description it sounds like it was the same arm.
Lisa
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Frozen shoulder: yup.
Mine was dx by way of shoulder Xray followed by shoulder MRI. Cortisone shot while awaiting PT.
I went to PT for about 3 months. Was given numerous exercises which my husband enforced my continuing to do at home. Serious pain.
My PT told me afterward that frozen shoulder is one of THE most painful situations to rehab.
There were a couple sessions where I was close to passing out & came to tears. (I too had 2 babies au natural, LOL)
The good news is that shoulder seems to be quite fine/ROM great two years later.
HOWEVER, my other shoulder is now gimping up in just the same way -- but I know what is happening, so I am moving it, moving it, moving it.
The one horrifically painful thing now is to play my guitar. Lifting my elbow in that angle away from my body is awful. Since I don't play everyday it clunks up when I don't play for a few days..... and I "forget" until I go to play it again (which is for children) and I have to suck it up, big time.
It seems to me that they know VERY little about what on earth would get this situation underway. My guess is because it effects women primarily.
Very 'interesting' to have the BC/frozen shoulder combination.
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Faith,
I have also dissolved in tears on more than one occasion from the pain. It seems to be getting a bit better now after the steroid shot.
About the BC connection, I am wondering if it has anything to do with estrogen blockers. Mine developed about a month after starting induced menopause and Arimidex.
Has anyone out there heard of frozen shoulder developing as an SE from estrogen deprivation?
Lisa
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Lisa: I was not on estrogen blockers as I am triple negative. I have type 2 diabetes and my physician blamed it on that. I too started to develop symptoms in the other shoulder and my Dr. said it is common to get it in the other side too. I asked him (orthopedic surgeon) if it had anything to do with BC (I thought maybe d/t the radiation) and he said no... now I am beginning to wonder... or is it just coincidence that we all developed this after BC. Linda
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I'm on another discussion board (parents of college age kids) and someone mentioned having a frozen shoulder and people were coming out of the woodwork to chime in "me, too). It is fairly common in that 40-60 age range for women, which is why I wonder if there is a hormonal link. But it is also common following any surgery that impairs range of motion, especially if you don't get into stretching the joint right away.
In my case, I was scared to death of getting a frozen shoulder following surgery, so I did range of motion exercises fanatically. But, I was also worried about lyphedema, so I did baby that arm a lot. And when I started getting pains in it, I can see in retrospect, that I stopped doing anything that might cause that horrible pain! Including stretching. Now, when I have sharp pains in the other shoulder I immediately start stretching it out to prevent anything worse!
It does seem to be on of those things that doctors don't know a lot about. It's self-limiting and it effects mostly middle-age women. Not a very sexy condition to study, I would imagine.
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Interesting. I'm having a problem with one of my shoulders too - for about a year now. I thought I had hurt myself, but didn't remember a specific event. But mine was hurting for a few months before I found out I had BC. It got better over the summer when I was on chemo, but it is hurting again now so I'm thinking the steroids during chemo helped it and have now worn off. I've been having issues - feeling pretty much like my body is falling apart for the last 4 years - since I was 39 - and I'm now blaming perimenopause. So I'm wondering too if changing hormone levels have anything to do with all of this. I feel like I'm 80 with all these aches and pains.
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Revkat, it was my doctor´s comment that it is more common in middle aged women that made me choose this forum to post on. (That it exists is thanks to Elimar who pushed the mods to start it. Hurray Elimar! and I was a naysayer, silly me!)
When I had my axillary dissection years ago they urged me to start moving my arm right away, crawling my fingers up the wall. I thought it was just to prevent atrophy. Now I realize that it is to prevent frozen shoulder.
The first doctor I went to diagnosed it as bursitis. That was in September. I think it is not that he was wrong, but that it started out as bursitis and progressed to frozen shoulder because I was avoiding moving my arm. I went to him again, when it was clearly getting worse, and all he said was that it takes a long time to get better. He didnt say a thing about frozen shoulder.
As of last week I cant even touch the hand on the affected arm to the opposite armpit, making it hard to bathe properly. I really know what you mean, Chris, about feeling like an 80-year-old.
Lisa
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One of my "favorite" PT exercises -- that we rigged up at home was with a pully suspended in a door frame. Long length of rope. Use your good hand/arm to pull up your bad arm/shoulder.
It was easy to do very gradually. It was easy to do on my own.
I think we got the pully and rope for less than $5.00 total.
Anyhow. This came back to me -- because it's time to get the rig suspended again, for my "other" shoulder. It is working harder to get itself frozen, than I can seem to work to keep it loose/thawed.
It's always worst in the morning.
Hope everyone is "moving" to stimulate the thaw.
xx00xx00xx
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Faith, the pulley is a great idea. I will try try to see if I can find one. But first I have to figure out how to say "pulley" in Portuguese...hmmmm.
About your other shoulder freezing up on you, I started physical therapy last week and the therapist told me that it is pretty common for that to happen so to watch out for it.
When the therapist worked on me, she moved my arm around very gently, just to the point where I could feel a hint of pain. It seems like the key, at least at first, is to stretch the joint without making the muscles do the work because they are already cramping. The pulley is a fabulous way to do that without needing another person.
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I haven't actually had "frozen shoulder," but I've been at high risk for it twice.
The first time was several years ago, way before my BC dx. I strained my shoulder while lugging a heavy suitcase through an airport, and developed bicipital bursitis (bursitis in the sheath around the bicipital tendon). I've had wear-and-tear arthritis in various joints for many years, so I ignored the shoulder/arm pain until I realized it wasn't going away. I went to an orthopedic surgeon, who dx'd the problem and sent me for rehab. I did the rehab religiously and the pain went away...
... Until I strained that same shoulder all over again at the gym. I was doing pull-down exercises, or maybe it was a rowing machine... and a day or two later, the shoulder pain was back. This time the orthopedic doc gave me a cortisone shot and sent me for more rehab. The shot helped for awhile (a few weeks, actually), but the rehab just made the shoulder hurt worse. I was supposed to go back for a recheck but instead I consulted Dr. Google, who said to do mild stretching exercises (pulleys etc.). So that's what I did, and now the pain is gone. I've lost a small bit of range-of-motion, but it's minimal.
My second risk event was my mastectomy/SNB on the other side, in Feb 2008. As you've found, doing stretching exercises on that side as soon as your surgeon permits them, is the key to getting range-of-motion back after breast surgery and preventing frozen shoulder. I scoured the 'net for post-mastectomy exercises and did them all.
My favorite was a homemade pulley system, which I rigged like this: I took a 20-ounce plastic soda bottle and cut a slot in it from the bottom to 2/3 of the way to the top. The slot was just wide enough to allow the bottle to fit over the top of a door. Then I put an old washcloth over the top of the door and slipped the soda bottle over the washcloth. I found a soft, wide piece of rope that was long enough to flip over the soda bottle and hold the ends in both hands. I knotted the ends, and ... VOILA!: A pulley. The soda bottle creates a smooth, sliding surface for the rope. Try to find a bottle that has a wide "bump" at the base -- the bump will keep the rope from slipping off the end of the bottle as you pull on the ends.
otter
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I had a frozen shoulder first they thought I had a rotator cuff fracture, luckily it was not, I had for a year physical therapy,did other exercises at home and now I am fine.
Just in case I had all kinds of tests, it was very painful.
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Otter, I like that homemade pulley recipe!! It´s cheap, creative, and best of all it spares me from figuring out how to say pulley in Portuguese. Thanks!
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I did a lot of research on frozen shoulder just yesterday. One possible cause that was mentioned frequently was diabetes.
A couple months ago I had calcific tendonitis in my left shoulder. Horrific pain that landed me in the hospital. I had IV dilaudid, morphine and demoral ... nothing touched the pain. An ortho doc also gave me a shot of cortisone in the shoulder. It took a couple of days for the pain to subside.
About four days ago, I had an episode in my right shoulder ... don't know if it was calcific tendonitis again or frozen shoulder. I didn't even bother with the hospital .. just took pain meds and ibuprofen. The pain was excruciating ... most of the pain is resolved now, but I still don't have full ROM.
Someone recommended to me to kind've bend over and swing my arm gently to get some initial ROM back. It does help. What I did find is that with calcific tendonitis the docs recommend ice and with frozen shoulder, they recommended damp heat.
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I just tossed a cord over a hook in the ceiling (used to support a potted plant, probably in a macrame hanger back in the 70s!) and used that as a pulley. It is a great way to stretch your shoulder gently while feeling in control of the stretch. I also like just lying on my back, reaching over my head, and letting gravity do the stretching. But, I do remember, before the joint reached the "thawing" phase, it all hurt like heck!
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Holiday Greetings, Pitanga!
Thought I'd come in and bump up your thread. How's your shoulder feeling now? Did you make the homemade pulley thing? With all the extra holiday activity and decorating, who needs the limitations of a frozen shoulder! I'm getting a PT right now for chest/armpit tightness, but it's a minor thing. My goal is for the treated side to feel the same as the untreated side. It may never happen, but I'm going to attempt it anyway.
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Elimar, I only now saw your post. you are so sweet! thank you!
the shoulder is getting a bit better, a little faster than the snail´s pace that they originally predicted (1-2 years for full recovery). I´ve been doing daily physical therapy for nearly a month now and it has been really helpful. I have gotten back about 30 degrees of movement in the upward direction and around half that in the lateral direction.
Keep working on getting that arm moving. From what I have learned, breast cancer surgery can precipitate frozen shoulder, which anyway becomes more of a risk after 40. So that is why there is so much emphasis on "reach for recovery." But is possible to get all the range of movement back after BC surgery. I did it the first time around. I didnt do PT but yoga was really helpful in that way.
Happy holidays!
Lisa
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OK. Frozen shoulder sisters.
As I've already mentioned, I'm currently into the midst of my 'second' frozen shoulder experience. Ironically my first episode was on the opposite shoulder of my lumpectomy.
Now I have it (two years later) in the shoulder of my original surgery.
I had a biopsy yesterday, as the mamo done the day before showed 'proliferation'
I met with my surgeon day before yesterday. He is expecting that I will require a mast & SNB on the same breast..... tho obviously we don't have the pathology back yet.
When I told him about my already gimped up shoulder, he said, "Well that's likely going to be a real problem." He said that I will undoubedly need 'specialized PT' to combat the combination of surgery & shoulder.
So here's my question. Has anyone had surgery/mast while already in the midst of frozen shoulder??
You know one of the processes to combat the freeze, is to be put under and have them manipulate the shoulder and 'break up' the adhesions.
Could it be possible to do that at the time of the mast??? How crazy would that be? Obviously I can't ask surgeon on New Year's Day.....
Does anyone else think that the actual cold of winter makes things worse? The worst part of my BX yesterday was attempting to sit up after the hour of lying flat. I couldn't figure out how to move and it was excrutiating..... seriously got everyone's attention, as I must have looked horrid from the pain..... finally they helped me roll out of the strange position. OUCH.
xx00xx00xx00xx
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hi Faith..I had a frozen shoulder too...I had aggressive phyiscal therapy when exercises
alone did nothing...they didn't put me out tho...and it worked in about three weeks...
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Faith,
I was away for a few days and just now saw your post here. I am so sorry to hear of your recurrence. The shoulder problem puts you into a terrible predicament. My affected shoulder is on the non-mastectomy side, and I was supposed to have a lift months ago to make the boob look more like the foob, but that has been postponed indefinitely until the shoulder clears up. You clearly don´t have that luxury...what a predicament. The pain from frozen shoulder, as we both no, is no joke, worse i think than the pain from mastectomy surgery.
I have not heard of the technique of getting the adhesions broken up while under anesthesia. But I have heard that steroid shots into the shoulder to alleviate pain are quite effective, although the physical therapy route is the first choice strategy for some reason.
As for getting up from lying down--it was causing me no end of problems too, until I figured out a new way. Lying flat on my back, I bend my knees toward my chest and then very quickly push them away and slightly upward, while also using my stomach muscles to left me into a sitting position. It´s sort of like a sit-up, but the leg action gives it a teeter-totter component that makes it easier.
Sending you lots of the strength and courage vibes you have so often given to others,
Lisa
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Thank you for your teeter-totter idea Lisa.
At the time of the biopsy, I was laying face down on that hard table contraption, with the cut out for the boob.
I have been consoling myself that the frozen shoulder pain may indeed be more than what I experience from the actual surgery. Strange how that puts things in perspective.
Today is my PreAdmitTesting day @ the hospital.
Wishing you well as you navigate your journey.
xx00xx00xx
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Lisa and Faith, I will try not to repeat what others have said, but I had two frozen shoulders at different times. The first was after I had to lie prone for a few months due to a massive CSF leak at T2 back in 2005-2006. I was unaware of the possible radiation connection, but I did have huge amounts of radiation during my diagnosis. I also have scoliosis with cervical erosion and osteopenia. I had capsule surgery for it, which greatly increased the pain and made life a misery for months. However, the shoulder finally did recover after a year, with 90% range of motion. A year later I felt the second shoulder developing the same syndrome. All my stretching and therapy did nothing to halt the progression of freezing, but the course was less painful than the first. I was diagnosed with ILC several months later and had 9 nodes removed from that side (plus double mastectomy,) while still stiff. Post-op was such a breeze by comparison with my previous shoulder troubles that I used no post-op pain meds, not even Tylenol. Range of motion is now 75%, and the pain is just a nuisance in the context of everything else going on. Bottom line is, frozen shoulder can resolve on its own, but it may never be "normal" again. Keeping the muscles around the joint strong helps. Good luck!
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Mine is 100 percent cured, thank goodness..maybe all my swimming in my prior life helped
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