Ongoing Shoulder Pain not responding to physio

Hi all -

Jumping back to breastcancer.org because I have found myself in one of those 'places' where I know the support and advice from these forums will keep me sane! I have been struggling with shoulder pain for the last few years. An initial ultrasound showed I have a couple small - like teensy tears in my rotator cuff - I'm a paddler so this was not a surprise. Initially physio worked well and things settled down, but without reason the pain returned with a vengeance and has become quite debilitating. Another ultrasound showed little to no change from the original, maybe some added calcification. My physiotherapist says there needs to be more investigation because my shoulder continues to get worse, the pain is 24/7, and she says it "makes no sense". It's been difficult to get my GP to react and I've finally been re-referred back to the Hand and Upper Limb Specialist Clinic although it could be weeks, if not months before I hear from them.

I got an appointment with my rads oncologist who had me in the other day for an initial exam. He ordered blood work and sent me for chest and shoulder xrays, telling me that he would look at them right away and I could wait to speak with him. Well - he told me that he could see an "area of decreased bone density" in the region that I am having the pain, and that he would prefer to have a radiologist look at my xrays. He also ordered a bone scan. I'm trying not to be too concerned but - well - you know how it goes.

Anyone with similar experience? This "area of decreased bone density" has me a little concerned. I'm also a little sad that maybe it's not reparable soft tissue that is causing the problem - honestly, the pain is exhausting, I don't sleep well, and it's very deep and achy. UGH.