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Shouldering the Burden

Shouldering the Burden

Of all the joints in my body associated with the dreaded RA flare, by far, the most painful for me, are my shoulders.  When I first stared exhibiting symptoms of RA, over 20 years ago now, I remember thinking that I would sell my soul if only my shoulders would stop hurting.  I was unable to wash my hair, let alone brush or comb or style it.  I could barely lift my fork to eat, let alone cook or clean.  I could barely type on the computer, let alone do other work-related tasks.  I could not even hug my family members which may have been the cruelest of all at a time when that support and love meant the most.  I think that is why when I get even the slightest twinge in my shoulder(s) to this day, it is often accompanied by anxiety and panic at the mere thought of what is in store if a full-blown flare develops.  

RA shoulder pain

I recently mentioned this to my rheumatologist and he admitted that shoulder flare pain is the most stubborn to treat because there are so many joints within the shoulder and directing the treatment can be difficult at best. I am not a good candidate for prescription pain medications for relief as they do not agree with me systemically.  So, I have to rely on OTC medications and homeopathic treatments like heat and massage.  They generally work to a degree, but when my shoulders are in full flare mode, there is nothing that gives me significant relief.  To make matters worse, sleeping with shoulder pain is essentially impossible.  No matter how you attempt to assume a sleep posture, the shoulder is impacted.  Therefore, when said shoulder is painful, sleep alludes you.  If I am lucky, I might get an hour of uninterrupted sleep when I have shoulder pain. Generally, that is not the case.  I just have to wait out the flare and hope I do not lose my mind in the meantime.

Some ways to avoid shoulder flares

So, over the years I have figured out a few things that have helped me to avoid shoulder flares as much as possible within the context of the chaos of RA.  First of all, I am exceptionally tuned in to the sensations in my shoulders these days.  What I mean by that is every morning and throughout the day, I do some level of range of motion in my shoulders to “check in” and see how they are doing.  If I even feel the slightest bit of pre-pain (fatigue or stiffness) I scale back on any activity that might involve the use of my shoulders.

In addition, I have a list of movements I can no longer do that are sure to trigger shoulder pain.  Some are obvious, like shoveling, while others were not so easy to determine.  For instance, I can not carry grocery bags at my side anymore.  I have to carry them from underneath. If I forget and carry a bag by it’s handles, at my side, I pay a price within a few hours!  To this day, I still forget and sometimes lift bags that way only to pay a stiff fine later.  I think it is because it is hard to remember not to do something when there is no pain in the joint in that moment.  But it is a habit I continue to try to nurture.

I also believe that strengthening the muscles and tendons in my shoulders has helped me a great deal.  The trick there is doing it in such a way that you do not bring on the very pain you are trying to prevent.  I cannot, under any circumstances, do strength training exercises in the traditional way.  But I can do them in the water, a joint neutral environment.  I do 15 different strength training exercises in the water with aqua weights and I have no doubt it has helped to strengthen my shoulder muscles, tendons, etc. providing support to the joints.

I am also a firm believer in massage.  I go to an amazing therapist who uses hot stones and is very in tune with how to massage RA patients.  She is a blessing I am most grateful for.

If we manage what we can with regard to our shoulders we can lessen the burden to them and hopefully have fewer shoulder flares in the future.

Nan

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The RheumatoidArthritis.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

  • 2mra
    9 months ago

    This topic hit the spot for me. Thanks for writing it Nan. I can see I have company in the shoulder pain department. You’re right! It is terrible and keeps us from doing many things that we need to do. Or painfully having to push through most. Even putting mugs in the cupboard or trying to get something 4 pounds out of the cupboard.

    I’ve had RA for 35+ years but the shoulder pain has been with me for(I’m guessing) only 5 years. My neck pain, much longer. My fingers, wrists, toes, feet and… knees(from osteoarthritis) went first.

    My shoulders and neck have been creaking every time I hugged someone( It’s been mentioned that I need an oiling…HA!). before the Pred which usually means I need replacements or other surgeries to my shoulders which I do not look forward to. I have heard of other people who had the surgeries where they are in more pain now.

    I’ve tried most of what you’ve mentioned and they did help some. I’m on many meds, so I didn’t try the muscle relaxer or aqua exercises. I had to up my Pred recently to 15 mg from 4 mg which has helped a lot. I also am using a TENS machine which takes away the pain for hours. I can wash and comb my hair again and some other chores and sleep without much pain. I’m wondering if my shoulders aren’t affected by my neck injuries from RA too. I also had a torn rotary cuff in my left shoulder which did NOT help my situation.

    Thanks for sharing about your shoulders. Feel Better soon.

  • Monica Y. Sengupta moderator
    9 months ago

    Hey @hwb0w4! Thanks for sharing your story. I am so sorry you’re dealing with these kind of shoulder issues. I can’t imagine how painful you feel.

    You mentioned the Prednisone. I had to increase to 15 over the Christmas holiday because I flared so badly. It helped so much but because of the side effects, I was happy to bump back down to my normal dose. I wrote an article last year about it. I thought you might find it interesting: https://rheumatoidarthritis.net/living/gotta-love-it-gotta-hate-it-you-just-gotta-take-it/

    All the best, Monica

  • 2mra
    9 months ago

    Thank you for your comment Monica and for sharing about your experience with the Prednisone.

  • Jodyguthrie
    9 months ago

    I too have been fighting shoulder pain for about 2 years now. Seems it really started in my knees for almost 2 years. Then moved to my shoulders. I was on the verge of surgery and being out of work for at least 4 months- if not longer. I did everything- pt, shots, OTC meds, heat/ice, etc. I signed myself and my husband up at the gym late November. January we finally started going. He has shown me some workout things that could help strengthen my shoulders- over time, 3 weeks? I have to say there is a difference in the pain. It is less-still there- I still have the impingements in both, but the muscle/joint pain seems to be better somewhat. I’m not on the verge of surgery as I was so dreading it. I don’t lift heavy and if it hurts I don’t do it. But like most with shoulder pain- insomnia is automatically part of it, which ,makes you more tired, which makes the pain more intense, and round and round it goes. I have also started taking a half of a muscle relaxer at night before bed.

  • Monica Y. Sengupta moderator
    9 months ago

    Hey @jodyguthrie! Thanks so much for sharing your story. I am sorry you also deal with shoulder pain but I am glad you’ve found some things that help! I have been told that strengthing the muscles around the joints helps support them. I guess it makes sense that the pain is decreasing a little bit!

    I also often take a pill before bed. I have to get the rest somehow. If I don’t (like you said), I end up in that lovely cycle we call ‘trying to manage our symptoms!’

    ~Monica

  • DeGee
    9 months ago

    Oh! Do I ever understand this!
    I once forgot to take my Lyrica (before we even knew what was going on) and the pain radiating down my arms not long after the dose was due was coming in waves.
    I’ve considered the aqua size they have at our Y (kind of pricey). That may be the ticket.
    Thank you for having one more post that helps me know I’m not a total basket case.

  • Lawrence 'rick' Phillips moderator
    9 months ago

    I am so thankful that I do not have shoulder pain from RA. I did hear that carrying a bag is one of the major irritants of shoulder pain. Of course i heard that form my wife while she was carrying my items around. Hence I now carry a purse.

    Darn she was right.

  • Monica Y. Sengupta moderator
    9 months ago

    I had to start wearing a backpack because carrying my bag did irritate my shoulder.

    I do get some shoulder pain but it’s mostly from my posture. I slouch over the computer screen all day! But, that’s a me problem, not an RA one!

    ~Monica

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