Rotator cuff help please

[Sux2buthen]

I have a tear, it's been a few months but only just diagnosed from an ultrasound
Suddenly it feels like the pain has escalated beyond anything it was before
They have suggested physio and that's fine but what else can I do in the meantime? Anyone at all have any advice?
I couldn't reach to cut my bloody toenail on the bath last night, and sleep is becoming a joke
Any advice will do, thank you

@Ansumpasty , I injured my shoulder in a car accident, but I didn't know that I had torn my rotator cuff immediately because I had other injuries that were more serious and I was pretty out of it (I broke my back and my scapular, plus had a head-injury). As soon as I could, I did 12 weeks of physical therapy, but the shoulder pain and weakness was the one thing that it didn't help. I took the anti-inflammatory during that time (I took meloxicam, plus ondansetron to prevent nausea, as it did upset my stomach).
The person who referred me for the injections was the orthopedic surgeon. I had one round of steroid injections without ultrasound, that wasn't quite so effective, so they then referred me to a doctor who only does them with ultrasound. You could see where the muscle was torn, and the needle going right in. I went from being unable to lift my arm at all, plus constant cold pain in my shoulder and the top of my arm, and real shooting pain if I forgot and tried to extend it, to nearly perfect within two days.
I am in the US, so I know this might make a difference as (for those who have insurance at least) it is easy to get long-term physio and go straight to see the orthopedic doctor.
I hope you get some relief soon. The constant pain just makes you miserable.

I would also say that meloxicam is known to cause fewer GI side-effects than naproxen, so it might be worth asking for a different anti-inflammatory if yours is bothering your stomach.

Thanks, @Ruthietuthie. I’ve been wearing a sling the last couple of days and it helped so much. Did a few gentle stretches last night and felt a twinge when I forgot about my arm for a split second and went to reach for something. It’s completely set my back and I was up all night in constant agony 😔

I am seeing the physiotherapist again in 10 days, so I will ask about these injections. Thank you!

I injured my shoulder at the gym in early August. I have had Phisio privately and taken anti inflammatories but it is still niggling most of the time and excruciating when it catches as I get dressed or do up shoes. I’m having an ultrasound guided steroid injection on Friday with more Phiso to follow. I have put on weight, can’t do yoga and am totally pissed off with it all.

How did you referred for the injections- was that through your GP? I’m I’m so much pain and absolutely worried sick. Please let me know how you get on with the injections!

I went to the phisio privately and he advised that GP could do the injection but that would be without ultrasound guidance. I’m having the injection done by a radiologist at a sports clinic, so then I will know exactly what the damage is and the injection will be targeted at the right area. It costs £150. My GP is not very pleasant, so I am pleased to be able to avoid her! I will report back next week.

Good luck- yes, please let me know how you get on!

@Astrabees, I hope that the guided injection really helps. For me, it was miraculous - so much better within 24 hours, seemingly perfect within 48. Of course, the tear is still there, so it might need doing again in a few months, but for some people the injection is enough to take down the swelling and allow enough healing that you don't need it again.
I am in the US (with good health insurance, thankfully) so my GP referred me to the orthopedic surgeon, who then referred me to the ultrasound doctor, having reviewed my scans. I am glad that you were able to get in to the private clinic - and 150 pounds, while it is a significant amount, is money VERY well spent in this case. I know how miserable the pain is, plus the struggle of not being able to do any of the things you used to. You will be so relieved.

I did it many years ago. I’d say it was a year before I could reach out my arm or sleep on that side without pain. It’s a very tricky one to heal.

I have this and it's very painful particularly at night I have had an injection on one side but need one on other side now.
my whole arm can ache and get pins and needles even my hand aches

I had the injection with ultrasound yesterday. It didn’t hurt significantly more than a COVID jab. The ultrasound showed no significant damage in the shoulder just some thickening in the bursa and a little on the A C joint. I was warned it would be uncomfortable for a couple of days but today there is a mild ache in the shoulder but the whole are feels more relaxed. I’m supposed to relax for two days and go back to phisio in a week or so. The doctor told me your tendons weaken considerably after age 45 so whilst you should exercise and do weights to exercise some caution if you get any pain or discomfort. I think there may be some months of recovery ahead. So, don’t be frightened about the injection, it is not nearly as bad as I’d feared. Good luck to all of you with this miserable affliction!

Brilliant- thanks for updating, @Astrabees !

I damaged my shoulder when I ran for a bus, tripped, and put my hands out to save myself. I can't take NSAIDS by mouth, as they upset my stomach; but I find the 12 hour Voltarol gel very good. I use the Joint Pain Relief 2.32%, the stronger one.

If the pain has ramped up you could have calcification. I had this recently and the pain was unbearable. I was given co-codamol and naproxen, I didn’t take many of the former but had a few days on the naproxen to calm down the inflammation, and then after rest in a sling, ice etc, I started very gentle physio. I can at last sleep again, it is only occasionally waking me up a few weeks on. To sleep you need a pillow under the armpit if you can get one there, to open up the joint. Try to sleep on the opposite side, with another pillow in front (there are helpful videos on YouTube) or on your back with the bad shoulder supported with a thin pillow under it. You basically need to pad around yourself until you are in a less painful position.
It is hellish, I sympathise.

what I dont understand some days its unbearable and other days not too bad though always there
thinking of going back to physio and asking for injection on the left side like I had on the right though still hurts on right but not nearly so much
I did mine by lifting with someone else a solid wooden table never knew it even existed before that

I have had the same...a physio has really helped.

3 days post injection now and I have no pain at all. It is so blissful to be able to get dressed and sleep as normal again . I did a little gentle yoga this morning. I know it is not really properly better but this is progress and I will book some more phisio sessions to hopefully sort it out for good.

@Astrabees, so pleased to read this. It really is miraculous, isn't it? And glad you are back to yoga.

Reading this it seems a tear can be treated with injection? Ive been recommended surgery but currently it doesn't really hurt. It is generally uncomfortable and I avoid doing any exercise because of it....

@Indigoo03, I understand it depends on the degree of the tear. If the tear is partial, even if it is quite severe and really painful, then a cortisone injection really helps and is seen as preferable to surgery. For me, it took down all the pain and meant I could fully recover movement, which was a big deal as I was in dreadful pain 24/7 and couldn't lift my arm much at all.
The injection is temporary - it takes away the pain by taking away the inflammation - but it lasts a good few months. And sometimes that is enough for the tear to heal or for other muscles to learn to compensate, so some people don't even need another session, although for me I do need it repeating. As we were discussing above, I had my cortisone injection done under ultrasound guidance, which is the best way to get a really accurate treatment.
If the tear is full thickness or very very severe, then surgery is the only way. But the surgery does often fail. My Dr. explained that, for my partial tears, to do a surgery they would have to cut through the tendon that remained, and that the repair they created would be inherently weaker than even my torn tendon, hence why it is a repair that fails. If your pain isn't too bad, and your movement not too impeded, I would definitely ask about an injection instead. The worst that can happen is that it doesn't work, but it is worth a try. As a few of us mentioned, it really seems almost miraculous. Within 24 hours or so, and completely by 48 hours, I was pain free and back to normal.

@Sux2buthen

surgery and a lot of physio

Surgeon gave more info .. appears my tendons are wearing away so matter of time..a bone spur is not helping either and all is making a bicep tendon out of place. Said easier to fix now rather than when higher degree tear/full tear

Hi - any recommendation for a good private shoulder orthopaedic please in central or north west London. Dealing with shoulder pain last 6 months and is awful. Thanks.

Is it a company plan or self funded? @user1469642396

Company plan