MIL, 91, shoulder bone on bone

[zauberflöte]

Hi all! My poor 91-yr-old mother-in-law's shoulder has been getting steadily more painful. OS said today, bone on bone. Neither surgery nor NSAIDS are possible.
She's barely mobile, 24/7 caregivers, and has refused an injection (so far). OS says ice. (Good boy!) And move it around frequently (which hurts...) so it doesn't freeze, which I've heard hurts even worse.
Any shoulder folks have stories about shoulder injections? Graphic descriptions welcome!
Thank you all so much!!
I've just read through Jamie 's thread. Jamie, a prayer for you and DH and health overall!
That thread, with comments by djklaugh, Kssii[, and kneeper was very educational and helpful, thanks folks! If any of you have more to add, have at it right here!
Pumpkln, , that yoga move link you posted looked like something she might be able to adapt to a seated one. And the link within that article to the article about piriformis syndrome was another affirmation for me about that I've had for almost 20 years now. The first total affirmation was looking at a photograph of an osteopath treating someone, and nearly bursting into tears because I KNEW that position and trigger point pressure would exactly feel so very very good! :lol:


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[djklaugh]

@zauberflöte Oh your poor MIL! I sure hope something can be done to help her with the pain. I know from experience how truly awful shoulder pain can be. I had 2 injections into my right shoulder before being sent off to the surgeon. The first was done by my regular physician who had trouble getting the medication to the right spot in the shoulder (small person here with small shoulder) - that did not help much at all. The second one, done by an orthopedic nurse practitioner, got the medication to the right spot ..... but again did not help much. Alas, like hip and knee pain, when it is bone-on-bone there is not much that controls that kind of pain. Both these injections were a local anesthesia plus the steroid. The local worked for about 24-48 hours then the steroid was supposed to kick in .... but in my case it never did.

One thing I found helpful before surgery was, when going to sleep at night, sticking a small rectangular pillow under the sore arm. Wedging it up firmly into my arm pit and curving my fingers over the edge to keep it in place. Seemed to keep the shoulder from moving around too much which helped to ease the pain a bit.

If it's available to her -and if she'd be willing to try it - maybe acupuncture could help. I have a friend who did that for knee pain while waiting an inordinately long time for knee replacement surgery. She did find the acupuncture helped a lot with controlling her pain.

Best wishes to her

 

[zauberflöte]

Thanks @djklaugh !!! I like the pillow, stuffed bear idea, we can try that. She already peels the oxy cannula off after a couple hours, what's one more thing in bed with her :lol:
People were also suggesting the pillow to support the neck, keeping the shoulder from curling in from body weight. I do that anyway, cervical PT while asleep!
You know, when you're 92 next month, afraid to die, and can't remember anything for five minutes, and everybody around you is just trying to help, it must be pretty confusing.


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[Nannyannie]

I feel for your poor MIL - I am now waiting to see a surgeon about my r shoulder. It has not been good for a long time but really didn't like me being on elbow crutches when I had my hip done (wow, 3 years ago!). Injections have helped me but they really are a temporary fix, lasted a few months while gradually wearing off - I guess even a short respite would be good for her. My own mother suffered from vascular dementia in her 80s and used to look at the scar on her knee in bewilderment. We would make a comment like "I wonder if everyone has such a neat scar after a knee replacement" and her face would brighten as she remembered!
Best wishes to you and family
Anne

 

[zauberflöte]

@Nannyannie thanks Anne for your support! I'm sorry you are having to go through this :( i am not sure you could pay me enough to use any kind of crutches!!! My wrists hurt any time I put weight on them, and some of my finger joints too. We're a walking mess, aren't we?



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[Pumpkin]

zauberflöte,
This is a second hand report on shoulder injections from a friend who knows, be sure they use some kind of imaging to be sure they get the injection in the right place, ultrasound, or fluoroscopy are some choices.
If your MIL sleeps on her back, put a folded over hand towel (about 1/2 inch thick) under her elbows, it will bring her arm into a more neutral position in relationship to her shoulder joint and may be more comfortable.
Wishing her and your family all the best, caregiving at the end of life is challenging, rewarding, and exhausting.

 

[Pumpkin]

Glad the links were helpful, I recently learned a new gentle hip flexor stretch. On your back, do a heel slide, as your leg goes out straight, squeeze your rear end muscles. It tilts your pelvis slightly and will give your deep hip flexors a gentle stretch. It is good for THR's, it protects the joint. It may also help with your back.

 

[zauberflöte]

Thank you Pumpkln !
I will have to be the medical advocate on this one unless my recent bi-knee sister in law steps up to the plate. The other three sibs don't know how you have to beat the medical profession over the head sometimes. Making sure an injection is guided goes up to the top of my list. And I never would have thought of the towel fold for neutralizing position. Will pass on immediately!
Guess what? I tried your hip flexor stretch only just standing and tensing glutes -- I can feel a good pain in one of my tendonitises. Thanks!!!
Awwwwww, as I'm writing this, news comes in that Granny's caregiver can't stand to see her in such pain. Dr office phoned in "something", I hope she gets relief!


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[Josephine]

Why doesn't she like the idea of injections? My shoulders have both been crapola for about 10 years. I've had cortisone injections every 3-6 months during that time and have been very very satisfied with the results. However, some doctors have a tendency to be negative about it and even say you can only ever have three! If so, then I;m in serious dodo as I must have had about 20 over the years, often in both shoulders at once.
Cortisone shots: are they safe and is there a limit to how many?

As an alternative, I've also used a TENS machine which has also been very effective.

 

[SarahJane]

your poor MIL -- hope she gets some relief soon. she's lucky to have your advocacy -- it takes a special person to work with elderly with memory issues

 

[zauberflöte]

@Josephine thank you So Much for stopping by!! She's 92 next month and was offered the injection the second she first heard it was arthritis. She hurt, she probably had to pee, she couldn't breathe, and she was exhausted from the dr visit :lol: i'd say that's why she's agin 'em, those injections.
I am glad to hear you've had that steady success-- I'll tell her about you! Do you vet guided or seat-of-the-pants ones? And I should have thought of TENS myself! They sell them in the CVS now, who knew?
Managing an elder's health care by committee (4 sibs and me) is pretty interesting. One daughter had bi knees 11 months ago and breezed through it on her own, so I'm the walking library of knowledge re joints here ;)
Where does it hurt, folks? When the patient says it doesn't hurt where do we ice?



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[zauberflöte]

@SarahJane thanks for your support


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[zauberflöte]

Yet another question, sorry. This lady is pitiful in pain.
Has anybody ever been prescribed voltaren gel and a lidocaine patch to use alternately? Like, patch on for 12 overnight, then gel maybe once during the day?
Her PCP is also pitiful. He has pooh-ppoh-ed both injections and PT. Lord give me patience!


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[Kssii]

I have had some success with the voltaren gel, but none with the cortizone injections. I have had good success with Tylenol 3--I take it at night. My best help comes from have a massage of shoulder and of trigger points from my PT guy. Sometimes get 2-3 pain free days afterwards. Small pillow under the shoulder if sleeping with the sore arm up is good or if sleeping with it down, pillow on top of the sore shoulder propping the head up a bit works well. The shoulder needs to be out away from the body a bit--this is my favorite position. I haven't had the tens used as my team doesn't think it helps bone on bone pain?? One thought--while ice is normally good for the inflamation, there are people for whom it doesn't work. I used ice for months and then sudden it started giving me problems--caused muscle spasms around the shoulder joint. I now use heat which can help a lot to ease pain. I am planning on trying a PRP injection--expensive!!--but I am trying to hold out until fall at least before giving into a replacement. My MRI this week showed extensive remodeling of the glenoid and the ball (it is "flattened,") plus several partial tears. Even then, a lot of the time I am still pain free--but when it does hit it is a 7-8.

 

[Nannyannie]

Hi @zauberflöte - have you managed to get any pain relief for MIL?
I finally saw a surgeon (a Professor, no less!) yesterday, he went to manipulate the shoulder joint and it made a lovely scraping noise. " Oh, that's bone-on-bone, I won't do any more - do you want a replacement?" I thought about it for at least a nanosecond before saying yes! He is booked until the end of March and we have holiday organised at the end of April so looks like May/June time. Until then I will keep taking the Tramadol - messes with my brain but the only way I can carry on daily life. At least I'm not on the oral morphine like when my hip got so bad.
Just thought, my late Mother used to have Tramadol patches, they lasted several days - she used to forget to take tablets, but the patches worked well. You could put them on her back where she can't take them off.
Best wishes
Anne

 

[zauberflöte]

@Nannyannie I missed this one-- I think you have since gotten your shoulder done Hoping it goes well with time
I'm cruising around the forums looking for back advice for my mom, and decided to maybe post here in "other" joints.
My own second hip not time late February, so I don't spend time here just now :(
Interestingly, my m-i-l's shoulder is not bothering her much these days. She had three injections, and the shoulder has been pretty quiet for many many months! The other one, however...sigh...
Thanks all for your helpful support and info and comments!

 

[Kssii]

I am very happy since I had a PRP injection. (Platelet rich plasma) I had it done last February, and even with being on a cancer drug that causes joint pain I am every so much better. Actually reached into the upper shelf of the cabinet today without thinking about it--something I haven't done in over a year. See my thread about this procedure.

 

[Kssii]

Well more than four years later and yes, I am still doing well. I can’t believe how well the PRP worked for me. Hope other will check it out.