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Old 11-30-2008, 10:55 AM   #1
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Rotator cuff problems - getting worse instead of better - hurts to lie down

I have been experiencing pain in my shoulder radiating down into my bicep and was diagnosed with a rotator cuff problem. The orthopedist says I have irritation in my supraspinatus muscle caused by pressure on the rotator cuff tendons, which also has caused calcium deposits to form in the tendon. I believe the technical term for this is shoulder impingement. The doctor does not think my rotator cuff tendons are torn, just strained (not sure if that is the correct term). I had an X-ray but not an MRI.

The doc showed me a set of simple isometric exercises to do with an exercise band. I have also purchased a book on treating your own rotator cuff and have been doing stretches and strength training exercises from that book as well. I am taking 400 mg. of ibuprofen 3 or 4 times a day as an antiflammatory. I have been on this program for about three weeks.

The problem is my pain is getting worse. In particular, the pain has gotten worse when I lie down to sleep. Unless I find just the right position for my arm, I have had a lot of pain in the shoulder and the bicep the last few nights. Is it possible I am doing the exercises all wrong? The isometrics the doc showed me seem so simple it would be practically impossible to do them wrong, and the same is true of the exercises I got out of the book, but given that the pain is getting worse I wonder if it's possible I did more damage to the rotator cuff doing the exercises too vigorously.

I realize my next step is to go back to the orthopedist, but I was hoping someone here would be able to shed some light on the situation. Is it common for the pain to get worse in the early stages of therapy? Would it help me to have some sessions with a professional PT so I can be sure I'm doing the exercises right? Does anyone have any tips for how I can get comfortable lying down? Any other suggestions or personal experiences that might shed some light on this? Thanks in advance.

 
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Old 11-30-2008, 01:17 PM   #2
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Re: Rotator cuff problems - getting worse instead of better - hurts to lie down

I have the same problem, however, the exercises are not to be done too vigorously. They are smooth movement type exercises, no jerking, etc. Better to do 3 times a day the normal number of times than many, many times each session.

Aspercreme helps me and so does a heating pad. I do not mix the two for fear of burning.

I agree it takes a while to get your arm at just the right spot in order to get relief.

Have patience, it will get better, then don't stop doing the band exercises like I did, misery will return.

 
Old 11-30-2008, 02:52 PM   #3
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Re: Rotator cuff problems - getting worse instead of better - hurts to lie down

Thanks for your input. I hadn't heard the suggestion of doing a smaller number of reps at different times during the day, but it makes sense. I will try it. I'll also try the Aspercreme idea.

How long did it take for you before you started to feel better?

 
Old 11-30-2008, 05:28 PM   #4
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Re: Rotator cuff problems - getting worse instead of better - hurts to lie down

I had a rotator cuff problem in the past. Mine also started to hurt while laying down and sleeping. I always put my arm under my pillow...and couldn't do that anymore so that sent me to the doctor...lol

I did therapy and shots, but eventually had to get surgery. I have to say...surgery was the best thing. I actually had a tear in my labrum as well..that the doc saw when he was in looking at my rotator cuff. My shoulder has been wonderful since. (5 years now)

Recovery was about six months....but well worth it. Good luck

 
Old 11-30-2008, 05:39 PM   #5
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Re: Rotator cuff problems - getting worse instead of better - hurts to lie down

I don't remember how long it took to feel better. Know it hurt for a long time. It is something that does not get better quick. That is the reason for "PATIENCE" and then some.

My shoulder was feeling great for a long time, so, I quit doing the exercises for several months and now back at square one with misery.

When I am busy during the day I don't notice the misery as much, however, as soon as my head hits the pillow it is big time pain. Don't get me wrong, it pains during the day but being distracted helps. I know it is going to hurt so I go ahead and do things in moderation and just let it hurt. Guess that is called acceptance of the pain, just learn to live with it to a degree.

Weather changes makes mine hurt worse too.

It seems strange but when I am lying on my side and drop my arm down behind me toward the bed with shoulder rotated toward the front it relieves the misery. Takes a little wiggling around with the arm to find the right spot. Quite a contortion of a position!! Does not work all the time but often.

Doing one gentle rep each of the exercises just before bed helps to keep it from hurting so much and allows me to go to sleep. I do wake up during the night sometimes in pain.

I take Limbrel for inflammation. I have inflammation all over my body. Limbrel is a prescription. It is not a concocted chemical, it is made from the bark of a couple bushes/trees. The way Limbrel works is by blocking the enzyme that causes inflammation. Works different from Celebrex. I cannot take over-counter anti-inflammatories anymore, too hard on the stomach. Limbrel has worked great (not a cure tho) , however, it reduces the misery to a more livable state.

Last edited by Misty800; 11-30-2008 at 05:42 PM.

 
Old 12-01-2008, 07:59 AM   #6
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Re: Rotator cuff problems - getting worse instead of better - hurts to lie down

if things simply are not getting better after this time,i would go to either your primary or the ortho and demand an MRI. you really cannot tell anything much just from a plain x ray alone,the MRI will actually show you what is actually there or not there. it would also show any tears in the rotator too. i had been having pain in my shoulder area for many years,but i had no real clue just how bad things were til i had the MRI done last nov. that was after the rest of my already partially torn(my ortho told me this)supraspinatus had just 'let go" on me one morning while simply lifting,or trying to lift,my purse off the top of my fridge. i pulled up,and immediately felt severe pain and something felt 'not right"? i had a completely torn supra and the one directly under it also had a tear and alot of bone spurs that had to be cleared and about four other things that needed to be fixed while he went inthere. i wished back then that i had actually had that MRI much sooner,BEFORE the rest of that tendon just snapped on me. it would not have been as in depth a surgery and my pain and rehab would not have been as long or as bad either. catching tears before they completely let go,really IS the best way to take care of that rotator cuff crap,believe me.

my personal opinion about PT is anyone who is being sent,REALLY should have that MRI first just so you and your surgeon really know for certain what your real needs are or whether PT is going to cause you even more problems too. its one of those better safe than sorry things. if your pain is extremely severe,you just need that MRI before doing PT. FB
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Old 12-01-2008, 09:14 AM   #7
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Re: Rotator cuff problems - getting worse instead of better - hurts to lie down

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my personal opinion about PT is anyone who is being sent,REALLY should have that MRI first just so you and your surgeon really know for certain what your real needs are or whether PT is going to cause you even more problems too. its one of those better safe than sorry things. if your pain is extremely severe,you just need that MRI before doing PT. FB
I appreciate your input. My pain (fortunately) isn't severe during the day. It's at night when I'm lying down that the shoulder and bicep start to hurt a lot.

I see your point about MRIs, but I think sometimes some doctors like to send patients for expensive tests when a simple examination would be enough to diagnose the problem. This happened with me with an unrelated injury I had a few years ago; the doc (not the same one I'm seeing now) sent me for an MRI without even examining me first. It seems to me that an experienced orthopedist who has treated many rotator cuffs should be able to tell the extent of the injury from the patient's symptoms without an MRI. My doctor did do a series of range of motion tests on my shoulder and arm.

On the other hand, it's true that my shoulder has gotten more painful in the past couple of weeks since I've started the exercises, and that is what is worrying me and led me to post here.

I think I'll continue with the anti-inflammatories and exercises (gently) for another week and if there is no improvement or if gets worse, I'll call the doctor then and see if he recommends getting an MRI.

 
Old 12-01-2008, 07:13 PM   #8
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Re: Rotator cuff problems - getting worse instead of better - hurts to lie down

I was diagnosed with shoulder impingement last year. I started by doing therapy for a few months. Unfortunately, I can't treat the cause of my impingement and things got bad enough that I went in for surgery after a year of pain.

I did have a cortizone shot at one point. It really helped. It was also diagnostic of what was wrong.

I had an MRI. All it did was confirm the surgeons original diagnosis of the impingement. He, and the PT, both made the original diagnosis just based on the movements that caused me pain. I had a lot of pain doing upper movements.

It is difficult to sleep. I prop my arm on a squishy pillow. Heat is also good at night. I also tried ice at times too because my shoulder is constantly inflamed.

I did have bicep tendonitis that developed as a result of the impingement. It got better when the rotator cuff was feeling better. I also had bicep relief from massage and TENS treatments at the PT.

 
Old 12-04-2008, 07:33 AM   #9
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Re: Rotator cuff problems - getting worse instead of better - hurts to lie down

Hello Everyone, Just joined this board and this will be my first post. Wish me luck!

LG, I have had two shoulder surgeries. I am just 4 weeks post op on my 2nd one. I guess this is why I joined this message board, I'm at the peak of my pain right now. It will get better, but its a slow process.

Your situation sounds just what I went through with my first injury. In May 2004, I injured my shoulder while pushing a lawn mower up a hill at my house(not very exciting) and I knew immediately that something bad had happened. It felt like two rubber bands had snapped in my right shoulder. Within a week I had had MRI, which showed partial tears in my shoulder. It was decided to try P/T, to help build up the support cast of muscles and hopefully avoid surgery.

I faithfully went to P/T for 7 weeks, until the pain and inflammation became unbearable. It was decided by my Ortho that we should try to go with the shoulder being scoped and repair the tears, plus any bone spurs that were preventing me from having successful P/T. I had the surgery, actually had more tears than they had thought, but all were partial tears. I also had a lot of spurs in my shoulder from years of baseball, that were remove with the acromioplasty.

I went through almost two months of hell after surgery, with post op pain, P/T pain, and other related problems with the meds. But one day my shoulder started to feel better, P/T became easier, then I had to dedicate one strong week to fight off the urge to take any more pain meds(they make you feel so good). Looking back, it was the right thing to have surgery. Since that time I have had not one problem with my right shoulder, it feels great, I just hope it continues that way.

In closing, the problems with pain that you are having after P/T may be from spurs that are existing in your shoulder that are actually being aggravated by your rehab. That is where you come in and have to make a choice on how to proceed further.

Hope that helps.

 
Old 12-05-2008, 08:40 AM   #10
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Re: Rotator cuff problems - getting worse instead of better - hurts to lie down

Thanks for the reply. I have been doing a lot of reading and it seems that most rotator cuff problems do improve with exercise/PT. But also it is apparent that sometimes surgery is the answer. I have a follow up appt. with my doctor in a few days, and we'll go from there.

 
Old 12-08-2008, 11:28 AM   #11
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Re: Rotator cuff problems - getting worse instead of better - hurts to lie down

Update on my situation: I have been taking ibu 4xday and doing the gentle isometric stretching with a stretch band, and my shoulder seems to be better the last few days. I can reach over my head and take things down from a shelf without any difficulty. It's not pain free by any means, but I would describe the feeling as soreness rather than pain. I've also been sleeping propped up on a couple of pillows and with my arm on a cushion in the hope of taking the pressure off the shoulder, and that has helped too.

What has continued to get worse is the pain in the bicep. If I move my arm in a circle, during some parts of the rotation the bicep hurts. Simple tasks like cutting up vegetables with a knife are painful. This symptom seems to be getting worse instead of better. Does anyone have any insight or comments about this? I had originally thought this was referred pain from the shoulder, but maybe there is something more going on. I have seen a product called a "bicep cuff" that supposedly helps with bicep tendinitis and other problems by giving support to the muscles; has anyone used this product, and with what success?

I do have an appt. with my ortho doc on Thursday.

 
Old 12-09-2008, 07:17 AM   #12
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Re: Rotator cuff problems - getting worse instead of better - hurts to lie down

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Does anyone have any insight or comments about this? I do have an appt. with my ortho doc on Thursday.

I think I remember you saying that you never had a MRI on your shoulder. If this is true, you really need to get this done, to know how to proceed.
You can have a partial tear, or a full thickness tear. The MRI will show that.

If you have a full thickness tear, P/T will not help. You can learn to live with the pain, with the possibility of injuring it further. Or, you can opt to have surgery. The longer you wait on surgery, the percentage increases that you will have a less successful procedure.

If you have a partial tear, P/T will help. But if you have any bone spurs in your shoulder, like I had. P/T will actually aggravate the process, as I posted before.

Best of luck, keep us posted

 
Old 12-09-2008, 07:45 AM   #13
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Re: Rotator cuff problems - getting worse instead of better - hurts to lie down

i have to agree with the above poster about just getting that MRI. this will at least actually "show' what is or is not really the underlying issues,and there can be many,espescially if you were ever involved alot in sports that required throwing or having your arms above your head. i played softball for thirteen years which also contributed to my overall problems too. i had ALOT of wear and tear crap along with my one complete tear and the partial under the top one too. i am not too sure what you have against getting that MRI,but it would at least give you some direction to the right places. either PT or possible artho surgery,or learn to live with the pain,unfortunetly that is what this comes down to,what are you willing to just live with. i truely wish i had gotten my MRI alot earlier BEFORE my tendon completly tore, the surgery is just much more in depth and a more painful longer recovery. with that MRI,it would at least show you what you actually have going on in there and can make the better choices as far as therepy or surgical repair. despite good orthos knowing just how certain ROMS are just suposed to be when they move body parts around,that still really doesn't give the whole picture of the rotator cuff as a whole. my ortho was rather suprised that i had soo much real damage and bone spurs within my shoulder/joint area. we had to do alot of seperate cuts and also a biggie where he had to reattach that tendon. you just have no real clue as to what the heck is going on with any body area til you take that good look inside. i found that out the hard way, a few too many times actually.

just finding out for certain what is actually there would help dictate a good solid treatment plan for you and would not end up with you being sent for the wrong type of PT which could actually exascerbate certain injuries,or even create new ones in some cases. the choice of course is up to you,but i really would ask your ortho about that MRI at this point. i do wish you luck with this and hope nothing is actually torn up there. please keep us posted. FB
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Old 12-13-2008, 12:42 PM   #14
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Re: Rotator cuff problems - getting worse instead of better - hurts to lie down

It has been one month since I have been doing the exercises with the exercise band and also gentle stretching. I'm not working with a PT; I'm doing the exercises on my own. I discussed what I have been doing with the doctor on Thu. and he showed me a few stretches, which I was glad to see were exactly the same as the ones I got out of the book on treating your own rotator cuff. He also said using moist heat on the shoulder is very helpful. Bottom line, shoulder is getting enough better that I'm feeling optimistic. I can lie down with only some discomfort. I am down to taking ibu once or twice a day instead of four times.

It's true that I have not had an MRI. I discussed this with the doctor and he said that as long as the shoulder is improving, he doesn't think it's necessary, but if it takes a turn for the worse let him know and he would go ahead and schedule it. Part of my reason for not demanding an MRI is the cost; I'm pretty sure my health insurance would pay for only part of the cost, and right now I'm working very part-time and having to pay for an expensive medical test would be a real burden.

The doctor emphasized that being consistent doing the exercises and having patience is needed since it takes a long time for this injury to get better. But I am encouraged that it has gotten noticeably better in just a month. My technique with the exercise band has improved during this time. I have developed a technique of doing just enough to push the edge of the "comfort zone" without actually starting to feel any pain. This is helping.

My main discomfort now is actually my arm (bicep), not my shoulder. I unfortunately didn't emphasize this enough at the doctor's appt. so I didn't get too much feedback from him, except his comment that bicep tendinitis frequently accompanies a R.C problem. I'm using a sports rub on it and hoping that rest will help. But if anyone has any comments or any specific techniques that have helped with bicep tendinitis, I'd love to hear them.

Last edited by Local Girl; 03-16-2009 at 03:07 PM. Reason: incorrect information

 
Old 02-02-2009, 06:12 PM   #15
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Re: Rotator cuff problems - getting worse instead of better - hurts to lie down

Who took care of you?I also have a bone spur,but my ortho didin't tell me if partial, upper, lower, full....& this happened years ago, & never did go away.
I heard someone has to sprikle shower you in a chair for 2 mos.! I have no sig. other to do that! HELP!& Thanks!

 
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