Standard Shoulder Replacement Shoulder pain - how bad does it need to be?

[Lollipop1]

Hello, I'm 56 years old and had my first hip replaced at the age of 51 my second a year later (due to oa) . At the same time I was having these issues with my hips my right shoulder stopped working properly. By that I mean that I lost a lot of movement. I was initially told it was frozen shoulder and that it would get better but with no improvement (despite doing the physio) they eventually x-rayed it & told me I had no cartilage in that shoulder (again due to oa). I tried steroid injections but made no difference. I then had an arthroscopy but 4 weeks after I broke my ankle pretty badly (open fracture) so couldn't weight bear on my leg for 6 weeks which meant using my shoulder to help me get up the stairs. Not really the best for a newly operated shoulder!

Anyway that was 4 years ago but my shoulder pain has got steadily worse . The arthroscopy did initially improve the pain but not the movement. My surgeon did discuss a shoulder replacement with and I was offered one but the operation was postponed twice due to other priorities. I lost my nerve after that especially as I was told that I may not get improved movement, although it should rid me of pain. I haven't been able to unfasten my own bra for 5 years but I've sort of got used to that. It's the worsening pain that I'm struggling with.

My shoulder constantly aches from a dull ache to a severe pain. It radiates into my neck. I haven't slept in the same bed as my husband for two years, as I need my nest of pillows to support. Even then the pain wakes me up and despite being in a different room my hubby says he can hear me shout and (sometimes) scream with pain. I'm not always aware of that so obviously must manage to sleep through some of it.
The thing is, they tell you shoulder replacement should only be done if you can't take the pain but how bad does it need to be? Am I being a wuss? My surgeon said after I decided not to go ahead 4 years ago that I could come back at any time. Is that time now or should I carry on longer?
.

 

[Jaycey]

@Lollipop1 Welcome to BoneSmart! I think with any joint replacement it's all about quality of life. Seems to me that your world has narrowed enough already. Why wait any longer?

My colleague @Jamie has had shoulder replacement. I've tagged her to come and give you some first hand advice.

 

[Lollipop1]

Thank you, really appreciate any thoughts you have and other's experiences. My hip replacements were brilliantly successful. No one would know just 6 years ago I could barely walk and despite nearly ripping my foot off at the ankle and having a six inch metal plate holding it all together, I can still wear a (sensible) chunky heel shoe or boot. I guess I'm so used to being in some level of pain that it just becomes 'normal '. I'm quite tenacious and am prepared to put the necessary effort in to aid recovery but it seems that the information was only go ahead if the pain was unbearable and even then the movement may not return. I know they have to give you the down sides but what about the positives?

 

[Celle]

My surgeon told me that he couldn't guarantee I would experience increased mobility in my shoulder and that complete recovery would take a full year, but he could promise that my pain would be significantly decreased. I'll take that!

The decreased mobility is a nuisance, but it's the pain that is limiting my enjoyment of life.

 

[Jamie]

Let me give you the gist of my advice up front in a nutshell. You are not a wuss. You need the shoulder replaced as soon as you can get it done. You won't regret it.

Now, some explanation as to why I'm telling you that. Part of the mobility issue after surgery has to do with the type of shoulder replacement you will receive - standard or a reverse procedure. With the standard procedure (shown below on the left) you have the potential to regain more movement because the surgeon is basically replacing the ball and socket joint just as it exists naturally. This type of procedure is normally done on a patient who has little or no damage to the rotator cuff muscles.

When there is damage to the rotator cuff muscles, the best option may be a reverse shoulder replacement (shown in the image above on the right). In this procedure the joint mechanism is switched to place the "ball" part of the joint on your shoulder and the "cup" at the tip of the humerus (upper arm bone). Both the ball and stem in either procedure are metal and the cups are made of high density plastic.

With a reverse shoulder replacement, the deltoid muscles take over the job of moving your shoulder from the rotator cuff muscles. This works really well, but it can mean there is a bit less range of motion with the joint.

Both procedures should greatly improve your pain, if not eliminate it entirely. Shoulder replacement has come a long way in the past 5 years and it has a very high satisfaction rate with patients.

I had a standard replacement and it restored my full range of motion in my shoulder. Recovery was easier than I expected other than there was a 6 week period at the beginning where I was restricted from doing anything but passive exercise with the shoulder to allow things to heal properly. You'll need to anticipate that when you plan for recovery.

Please don't hesitate to ask questions if you have them. We have a growing number of shoulder replacement patients now, so some reading of threads in both the pre-op and post-op shoulder forums should give you an idea of what surgery and recovery will look like for you.

 

[Lollipop1]

Yes, I agree I initially thought 'what's the point of major surgery if I'm not going to have a shoulder that works ' but I'm so used to not being able to move my arm that I don't think that much about it anymore- it's the pain that's getting me down- particularly at night . I guess the fact I joined this group is probably because I need the reassurance of other people who have gone through it to start the ball rolling again and speak to my surgeon.

 

[Jamie]

I hope we can do that for you, Lollipop. That's our mission here....to help you get to your comfort zone so you can make the right decision for yourself.

 

[Lollipop1]

Thank you so much for that post Jamie - so helpful and positive. I think that I'll be ringing my surgeon soon!

 

[SaraK]

Good for you @Lollipop1 - sometimes we all need someone to give us a nudge or at least validate what we're considering. Surgery seems to engender itself to that. It can be a cost/benefit sort of analysis but it seems like the only physical "cost" to you is the surgical pain and rehab time and effort and that is more an issue of when, not if, in your case. Hopefully you'll reduce or eliminate the pain and you might even increase your range of motion, good luck!

 

[djklaugh]

@Lollipop1 When you speak to your surgeon please do not minimize your pain! It looks like you've tried other options to surgery and those have not been helpful. Most insurance companies want folks to try "less invasive" procedures (AKA Cheaper) first (ie PT, steroid injections,) I know my insurance said they only did shoulder replacements for "severe pain" .... and I now have two new shoulder joints. I'm very happy to report that I no longer have any shoulder pain and they work quite well .... though I'm never going to be able to hook a bra behind my back again but front closure ones work just fine. I'm including here a link to a "pain scale" - although intended to be humorous it also is analogous to the scales doctors actually use

https://bonesmart.org/forum/threads/new-kind-of-pain-scale.52544/

 

[luvsibes]

Thank you, Lollipop1 for your post. Thanks Jaycey and others as well. I remember you, Jaycey from my days on the hip forum!

I am 2 1/2 years post L-THR and am thrilled with my new hip. I spent 4 years limping around to get the nerve to have surgery. Having never had any surgery or even a child, I was fearful. I do not deal well with wound care! I am thrilled with my new hip! (Pic is first walk on my own post THR with my husky)

During the hip journey, I began having shoulder pain (R side) as I was trying to sleep on that side to ease the left hip. While in hip post op PT my PT gave me some shoulder exercises. I've dealt with an on and off again arm/shoulder pain since. It's now in my left shoulder and I believe my dog walking is exacerbating the pain as well. I was told years ago that my neck is compressed with OA.

I am sitting with ice on my neck, arm, shoulder this morning and plan to contact my Dr. soon to see about getting xrays. Today, I hope to be able to skip dog walking and just rest the arm. I dislike not being able to take my boy out.

I will be following this forum as I decide what to do and when. (I won't wait 4 years this time in pain thinking I can fix it myself!) I hate going out during covid and am very cautious. This site was a great help for the hip journey so I'll reconnect here.

Thanks and I'll be learning from all of you.

 

[Jaycey]

@luvsibes Welcome back to BoneSmart! This shoulder area is a bit newer here. But it is already getting plenty of posts.

Please feel free to start your own thread in the pre-op area so that we can follow your journey. My colleague Celle is going to have her shoulder replaced soon. I'm sure she will share any tips she has with you.

 

[luvsibes]

Thanks @Jaycey. I will lurk for awhile and follow Celle until I make some decisions about what I'm going to do with the shoulders! Today begins my process to take this more seriously! I appreciate BoneSmart and have referred a number of folks to the site for help!

 

[Celle]

I now have a date for my reverse shoulder replacement - January 21st. I'm glad, because my pain is increasing.

I'm researching how to manage with one arm our of action - getting dressed , etc. I know I'll need my husband to help me with some clothing.

I've arranged for someone to come and give the house a weekly clean. She visited yesterday and I like her.

I'm also planning to cook extra serves of meals and have them frozen and just ready to re-heat.

 

[marieltha]

Best wishes for your surgery! I have read here often that a shoulder replacement is often less painful than a rotator cuff repair. I hope that is true for you.
I am now 17 months past my rotator repair and am grateful daily that I got it repaired. Feels and responds naturally.
I am glad you have a husband to assist, as it is a challenge to do many things.. Practice one-handing now; I was surprised how good I got at using the other hand. Showering is tricky. My husband helped a lot with that and even, as I revovered, hovered nearby "just in case".

 

[HandyWOMAN]

Yes, practice one hands ahead, it will tell what you just CAN'T do, before you are up against it! I was totally alone! The biggest eye opening for me caring for animals in/outside, was you can't tip a water bucket one handed?! Anyone with a husband, will have it a little easier. For me, I just took everything slow, can't do much else.

 

[kneeper]

Yes, I agree I initially thought 'what's the point of major surgery if I'm not going to have a shoulder that works ' but I'm so used to not being able to move my arm that I don't think that much about it anymore- it's the pain that's getting me down- particularly at night . I guess the fact I joined this group is probably because I need the reassurance of other people who have gone through it to start the ball rolling again and speak to my surgeon.

I'm starting to look into the possibility of a shoulder replacement myself. I can function fairly well (if painfully)--we know from our other joint replacements that we learn to adapt for a long time before "taking the plunge." I have weeks when it's not too bad and weeks like now when I have the pain radiating into my neck and tylenol isn't cutting it for pain relief. Thanks for sharing your experiences as you're helping others work through these questions.

 

[Railroad man]

Hello, I'm 56 years old and had my first hip replaced at the age of 51 my second a year later (due to oa) . At the same time I was having these issues with my hips my right shoulder stopped working properly. By that I mean that I lost a lot of movement. I was initially told it was frozen shoulder and that it would get better but with no improvement (despite doing the physio) they eventually x-rayed it & told me I had no cartilage in that shoulder (again due to oa). I tried steroid injections but made no difference. I then had an arthroscopy but 4 weeks after I broke my ankle pretty badly (open fracture) so couldn't weight bear on my leg for 6 weeks which meant using my shoulder to help me get up the stairs. Not really the best for a newly operated shoulder!

Anyway that was 4 years ago but my shoulder pain has got steadily worse . The arthroscopy did initially improve the pain but not the movement. My surgeon did discuss a shoulder replacement with and I was offered one but the operation was postponed twice due to other priorities. I lost my nerve after that especially as I was told that I may not get improved movement, although it should rid me of pain. I haven't been able to unfasten my own bra for 5 years but I've sort of got used to that. It's the worsening pain that I'm struggling with.

My shoulder constantly aches from a dull ache to a severe pain. It radiates into my neck. I haven't slept in the same bed as my husband for two years, as I need my nest of pillows to support. Even then the pain wakes me up and despite being in a different room my hubby says he can hear me shout and (sometimes) scream with pain. I'm not always aware of that so obviously must manage to sleep through some of it.
The thing is, they tell you shoulder replacement should only be done if you can't take the pain but how bad does it need to be? Am I being a wuss? My surgeon said after I decided not to go ahead 4 years ago that I could come back at any time. Is that time now or should I carry on longer?
.