Shoulder pain for 6 months - no diagnosis

Bones, joints and muscles
1

My left shoulder has been in pain for 6 months now. The pain has progressively gotten worse and worse and it is now at the point that even moving my arm slightly is troubling. I had an ultrasound done recently which showed nothing. Everything the ultrasound could see was normal.

The pain has always been at the inside front of my shoulder, but recently it's been spreading to my bicep, outer upper chest and neck. The front of my shoulder is still in pain the most frequently - to be precise, it's the area just below my collar bone and just inside the shoulder ball. That seems to be the source.

I'll go through all the symptoms I have.

- doing these things causes extreme pain at the inside front of my shoulder: lifting my arm to the front, above my head, or to the side, picking up even slightly heavy objects, pushing or pulling heavy things.

- doing simple things such as brushing my teeth, dressing, doing my hair are painful, again at the front of my shoulder.

- lying down on my back with my arm by my side gives me a distinct burning pain in my shoulder, and at times it radiates down to my bicep. This burning pain only comes when i lie down. (Just started a few weeks ago)

- my outer upper chest, near my armpit, hurts at times when I'm resting.

- recently I've started to sometimes feel dull pain in my neck, just above my collar bone. Not frequent at all.

- if I apply heat to the shoulder I sometimes get pins and needles down my arm, and it goes numb in certain positions (lying down and sitting down). This doesn't seem to happen as much with ice treatment. (New symptom again)

- laughing causes pain, as does talking too much and too loudly. After any sort of a gathering I'm always in immense pain, even if my arm is fully rested.

- I have trouble feeding myself most of the time.

It will probably be helpful if I tell you the cause of this pain. I injured my other (right) shoulder a year ago in March. I was unable to sleep on that side, or on my front, since that injury. I couldn't fall asleep on my back and so I slept on my left shoulder, exclusively. All night, every night. After about 5 months I started feeling discomfort when lying down on it, but I made nothing of it and carried on as that was the only way I could sleep. The discomfort slowly turned into pain (at the inside front of my shoulder, below my collar bone). I would only feel this pain when lying down on it. Apart from that my shoulder was absolutely fine.

Then one morning I woke up and the pain was immense and using my arm was painful that whole day. (The pain being exclusively in the location described before - nowhere else.) Since that day I have learnt to sleep on my back.

The pain did go away after a few days of rest but since my right arm was pretty much unusable, I had no choice but to resume using my left.

So the pain would come and go depending on how much I would be using my shoulder. Driving was the worst at bringing the pain back. This on and off thing went on till about 2 months ago. Now the pain is always present.

It's difficult to use both my arms and I'm pretty much stuck at home, being looked after by my family. Even doing the simplest things has become impossible.

I'm waiting for surgery on my right shoulder for a suspected labral tear but I still don't know have a diagnosis for my left shoulder.

Any help would be appreciated. What could the problem be? What step should I take next?

2

Roblee, I think your next step is to obtain an MRI. It gives the clearest pictures for diagnosis. Ask your doctor what heshe thinks. Are you seeing a shoulder specialist?

Hope you find your answer, treatment and relief soon!

💛 Dawn, USA

3

I'm so sorry to hear of your shoulder pain. My thoughts are that an MRI would be a good choice to determine what's causing your symptoms. The rotator cuff is my guess, but I'm not a physician. Have you seen a physician who can evaluate your pain?

I've recently suffered a shoulder fracture & have been sleeping on my back, too. It's no fun, that's for sure. And daily pain is depressing as well.

My best to you as you travel on this road. Plz update us as you move through the process.

My best,

Linda

4

Thanks for the replies. I did suggest to be referred for an MRI but my doctor said there would be no point, having had an ultrasound done and it showing nothing. I found this puzzling though as from what I've researched an MRI of the shoulder can find more problems than an ultrasound can. But he was pretty dismissive of it.

He also said an X-Ray would be useless as it's definitely not bone damage.

He suspects it could be a frozen shoulder and suggested I think about trying a cortisone shot, or physiotherapy. I've been referred to the physio and haven't yet made up my mind on the cortisone shot.

Having done some research some of my symptoms do match those of a frozen shoulder in the initial freezing stage, but a lot don't. Another problem it could potentially be is a pinched nerve. That would explain the pins and needles and the dull neck pain.

But I'm just speculating, could be anything.

I'm curious about the MRI though. Should I insist on having one done?

5

I know I would feel much better having an MRI which would provide a comprehensive picture of the shoulder. I wish you all the best.

Linda

6

Hi Roblees. The symptoms you describe sound very like frozen shoulder. A lot of doctors are unaware of this condition so google it and check it out yourself. There is a forum on here dedicated to it which is very helpful. Good luck.

7

Me again. Sorry should have said, cortisone jab may help but you should NOT stretch your arm beyond its limits at this time as this only aggravates it more. You need to find a physio that understands the condition if that's what it turns out to be. Scans and xrays are no use as your doctor says but there is one simple test a good ortho will do for diagnosis. There are a few surgical procedures available but if your already having surgery on your other shoulder you might not you might not fancy that route. Once again good luck.

8

Hi Roblee,Following symptoms such as yours and investigations I gave in to consultants advise and had shoulder replacements(I'm not suggesting this is your case)my right in 2008 and the left in 2011 after the ops both my shoulders were painless and gain full movement and strength...moving on last year I had a RTHR so it appears my major joints have Osteoarthriris that said I am very active so with my new hip and shoulders I became more active,hitting the weights and cardio on a regular routine..now in my right shoulder I have all of your symptoms,I have had an X-ray showing no bone damage or movement of my metalwork,I am back taking Naproxen which eases the pain and discomfort but am awaiting discussions with my consultant..my GP reckons bursitis or tendonitis,I need to get it sorted as it is driving me mad...so I am interested to exchange medical opinions with you..wishing you the very best in your diagnosis and treatment..Danny

9

Hi Roblee,

I also think you would benefit from a second opinion..you know your own body,and the level of pain you are in,and an MRI. My GP,who I first saw to refer me for XRay on my wrist,then shoulder and elbow,followed by an ultrasound,,said often stress fractures,which is just another name for a fracture that doesn't have a clean break,doesn't show up properly.If the rotor cuff tears,and Bursitis (inflammation)hadn't shown up,an MRI would be the next option.Cortisone helped a bit,but I still have inflammation and worsening pain.When I wake in the morning,I sometimes can hardly move my arm,as it has very little feeling.I also have the tingling,strange sensation,and neck and shoulder pain.Physio exercises are so gentle,as to be almost non existent,and because my arm is not supported at all,I am still using my right arm/hand which is my natural one to use.We are not sure if I am going to need surgery as this looks set to drag on with legal proceedings,as the shop where I had the fall,are making things hard with trying to get compensation for everythiing.I also had a Fra turned collarbone,and have Osteoarthritis in wrists,neck,spine and hips and the start of osteopenia in the damaged arm.

Wishing you all the best,and please,get it seen to,as you are going to do more damage.

Alice. 🌞💕

 

10

Thanks for the input. I have done quite a bit of research on frozen shoulder and it is possible mine is in the early "freezing" stage. I haven't yet lost any range of motion. It is physically possible to move my arm in any direction at the maximum limit but a lot of the movements are extremely painful.

Some symptoms do match, but others don't.

The pain in my shoulder is exclusive to the inside front, no pain on the outside, side or back.

The pins and needles I get every now and then are confusing as well, as they would generally indicate nerve damage. The distinct burning pain at night - is that a symptom of frozen shoulder?

I have an initial appointment with the physio in 3 weeks, so hopefully he should be able to diagnose my problem.

11

Hi Danny, thanks for the input. Hope your problem gets sorted out soon.

About arthritis, since 3/4 years I have had mild pain in two of my finger joints in my right hand, as well as the inside of my left knee. It has never interfered with my day to day life and is very minor. The knee I've only ever felt if bending my leg inwards or in an abnormal way. I'm not able to crack the two finger joints and always leave them out when cracking my fingers. They hurt immensely if I try. I had an X-ray of my fingers but the results were fine.

I have recently started feeling pain in my right elbow, but this could be due to the slightly bent position my right arm is in all night when I sleep due to my shoulder pain.

Could all these joint pains be linked to both my shoulder problems?

12

I suggest changing doctors if this one is refusing to thoroughly investigate.

13

Hi Alice,

I am seeing a physio in 3 weeks time so hopefully should get a diagnosis then, if not I'll insist on getting an MRI.

Thanks for sharing your experience. I hope you get the compensation you deserve soon. Good luck with everything.

14

Thanks for the help Linda and Dawn. I have an an appointment with the physio in 3 weeks and if he cannot diagnose my problem I will make sure to get an MRI done.

15

The burning sensation and the fact that you have full ROM albeit painful, do not point to FS but the tingling can occur. Sometimes you have to scream and shout to get anywhere with doctors so keep fighting your corner until you have a proper diagnosis and don't be afraid to ask for a second opinion. Got everything crossed for you.

16

Hello everyone. Just a quick update here incase it helps anyone else.

Turns out the problem was in my pectoralis minor. There is a lot of tightness in the muscle and quite a few trigger points are present too. These were referring the pain into my front shoulder.

I have started self massaging and stretching my pec minor and there is considerable improvement in my shoulder. It will take a while to fully get rid of the problem but it definitely seems to be the pec minor and the treatment seems to be working.

If anyone has symptoms such as mine, don't rule out the problem actually being elsewhere.

It will help to try and locate any trigger points which might be causing the pain and I would highly recommend reading "The Trigger Point Therapy Workbook" by Clair Davies.

17

Thanks for the update....as I have already had both shoulders replaced I think my problem might be different from yours,my consultant thinks my Glenoid(shoulder cup bone)is wearing out(Osteoarthriris ) so next week I have a cat scan,the worst scenario is a Glenoid replacement....

Good news you have diagnosed your shoulder issue...have you ever tried a TENS machine,they are quite reasonable and can give you a good result?

Will update on my shoulder issue when the results are available...

 

18

Your exactly where I am today! OMG! I feel for Sympthiz totally...! I would of never expected Pectoralis.

19

Hi Roblee,

I hope you are doing good now. I am a 25 year old healthy software engineer from India. I have been playing basketball more since three years. Coincidently I have a closely similar case as yours. Only difference is my left shoulder has labrum tear and right has the symptoms as your left had.

I am done with my Arthroscopic bankart repair and capsular plication on 6th Oct on my left shoulder. My rehab has been positively progressing well. But something in my right shoulder has been bothering me for more than a while now. After the surgery I had to use my right shoulder more than ever. I slept for almost 3 weeks on my right side. Did cross body movements to wear shrt or bath my left shoulder. The rehab for my left shoulder such as forward elevation with a crane stcik, my right shoulder beared the weight of the left shoulder. Such activity was done for three times a day 20 reps each. Now after the surgery on my left, while the medications were on I had no pain or discomfort in my right. After three weeks of the surgery I went to the supermarket and carried home about two-three kgs(or less I think) on my right shoulder for 700meters. It pained that night but weared off again. After 5 weeks, I went out with my basketball team for a tournement to support them and only once I short a basket with my right shoulder just casually, I could feel shooting pain on the top of the joint immediately as I short. since then the pain is constantly wandering.

Since over two/three weeks now, I have been feeling tenderness, clikcing, irritation on my AC joint and the area below and under the collorbone. When I walk and swing the arm to-and-fro I hear some clicking at each step i take while walking and this has been continuing everyday at exactly the tip of the shoulder head. When I rotate my shoulder, the AC joint and top of the shoulder continously rubs and irritates a lot as if the bones are cracking and passing through some broken stones. There is mild stiffness in the scapula and locking feeling in the mornings specially but not too frequent. I am unable to lift and brush my hair for more than two minutes. The hand feels stressed and little weak. I visited my doctor and he prescribed Carnisure and Ezact MR tablets. I never encountered such a pain in my right shoulder except once before the surgery for two weeks I had similar symptoms but not so disturbing. I ignored it then thinking it is just mild sprain. I had the Xray done yesterday and everything is normal as told by the doctor.

Also, there is something that I need you to know that happend Before the surgery of my left shoulder. (about two months before), I played basketball for 30 minutes with my right shoulder alone. I remember well that night I had sever pain in my right shoulder and it continued for three to four days. Then there was a constant pain in my AC joint, top of the shoulder and clicking sound started. The MRI did not show anything.

So the symptoms are almost the same as before the left shoulder surgery. Right now I cannot do much excercise with my right shoulder to support my left and also the right is pretty strong most of the times but every time ther is constant irritation in the AC joint, clicking sound at every rotation, clicking at every two and fro swing of the armw while walking. Its distrubing and bothering me everyday now. My doc says I need to be busy and start using my left shoulder for some minor activities as its 8 weeks pst surgery.

What do you think can be the problem? I do not want to let it go unnoticed.

regards

Atishay

20

Hi, it sounds to me as if you are having problems with rotator cuff. The symptoms you describe are exactly the same as I experienced some years ago. It does not have to be an injury, mine was caused by inflammation which can just happen. I was not diagnosed correctly for 18 months , pain killers anti inflammatories, physio even acupuncture did nothing, and the pain was excruciating, like you I could hardly lift my arms. The rheumatologist diagnosEd it in minutes and I had two steroid injections under my shoulder blades at the back.The pain relief was almost instant and has lasted many years. But I have to warn you the injections have to be spot on or they are not successful. I do hope you get something sorted, i really feel for you because I know how painful it can be.All the best.