Increased pain in areas of weakness

CathyRachelle

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DX FIBRO
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03/2022
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I’m relatively new here and i have another question I hope you can help me with. I have a tear in my rotator cuff and osteoarthritis in my hip. My doctor gave me a cortisone shot in my shoulder and it no longer hurts all the time, neither does my hip. However, when I have a flare ( extreme exhaustion, pain randomly throughout my body including jaw and ears, neuropathy like pain in my feet) my affected shoulder and hip are the most painful. When the flare abates, they no longer hurt. My question is, is it common that areas of weakness are subject to greater pain during an episode? Thanks for your help.
 
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cookiebaker

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Hi CathyRachelle... that kind of pain is pretty common for me... areas of previous injury, or surgery, seem to feel the worst.
I had surgery on the big toe of my left foot a long time ago, and when things are bad, just resting that side of my foot on the bed hurts. i have to prop the foot up so the toe area isn't touching anything.
 
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Badger

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I have found this too be the case and one of the worst parts of Fibro for me. Injuries may eventually heal but still hurt, impact mobility and become very painful during flares. Some are worse than others for me and I've picked up a lot over the years. Seems like the best we can do is gentle activity, work closely with physios during recovery from operations / injuries and use the likes of hot / cold compress for comfort during those flares. Elsewhere relaxation techniques will help to cope and manage nagging pains. There may be advice from other members on other options worth consideration. Atb
 

JayCS

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Hi Cathy - My thoughts and experience on this are...:

Cortisone like other meds in suppressing pain & inflammation for a while supports the body's efforts to heal itself whilst causing other problems. The suppression does not heal through enough though, so the pain will re-occur if we don't try deeper and more continual methods like manual therapy and supps.

Aside from that, old pains like the others have said often come up again in flares but also on their own, esp. even if they have not been thoroughly treated by working on the muscles, ligaments, tendons, posture, movements etc. involved.

Cortisone for me is a clear no go, never had it and I doubt I ever will. People may have succeeded in pressuring 'best' pain killers on me when at first overwhelmed by fibro, but my experience fitted with my knowledge of how they "work", and what cortisone does is "even worse" IMHO.

Regardless of trying these meds though or not, I'd always seek out the 20 forms of manual therapy etc. one by one, even re-visiting, till one helps me and gets closer to the root of the problem - lots to try.

Why they come up in a flare I think is not just the old injury / problem itself, but that our body is busy with lots of pain and that interacts with postural and other problems that will allow or cause the problem to reappear quicker.
Quite some researchers believe that this proves the mechanism is a "central sensitization", i.e. the central nervous system over-reacting (similar to pain amplification - hyperalgesia). I beg to differ that it's just the amount of bodily problems we have, many small injuries which they can't measure or "see", and an as yet undetectable energy / pain overload maybe at a cellular level, that results in an actual pain overload.

Amongst other things I have a shoulder problem flaring now due to being away from home a few days (plus many additional problems), as I can't lie on normal mattresses, so have to sleep on a thin mat on the floor, and the shoulder is probably related to an old clavicle break. Massage gadget & acupressure / trigger pointing it is helping.
 

CathyRachelle

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DX FIBRO
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03/2022
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NJ
Jay, I can’t thank you enough for your detailed and highly informative reply! Do you suggest seeing an orthopedist to pursue more physical therapy? I tried physical therapy in the winter without any improvement. At that time I didn’t know I had a tear in the rotator cuff. My rheumatologist suggested this as well. He also suggested acupuncture as a possible help. Thanks again for taking the time to reply!
 

JayCS

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Jay, I can’t thank you enough for your detailed and highly informative reply!
Thanks, you're welcome! I'm actual a bit nervous I'm not writing nicely enough 😊, cos I'm totally knackered & flaring and brain is only managing ideas at the moment, not how to put them well... so good to know you're not taking it the wrong way! :cool:
Do you suggest seeing an orthopedist to pursue more physical therapy?
Hardly any of my orthopedists had any understanding of what'd be necessary, except one who was also osteopath.... Normal physical therapy and 70% of what was offered in my fibro/rheum clinic harmed the way it was being shown to me, rather than helped, but at least they offered a whole array specifically for fibromites, and it was astonishing and telling to me that I was the only one who had to opt out of "easy" things like Qi Gong. Instead I'd suggest to
a) try out all the kinds of self-applied physical therapy using youtube for exercises, stretches, acupressure, gentle yoga and massage devices, starting & increasing in baby steps. It's about listening to our bodies and creatively varying, combining, imagining what might help us best.
b) use a list of physical therapy types which should include various kinds of osteopathy, Jones technique, myofascial release, acupressure and look for therapists near me offering that, or use some kind of good local directory if you have that. Before making appointments, I'd first have a look at which type would seem to be best for me, then look for reviews, personal recommendations by patients, support groups or docs you know. If you need a prescription I'd then go to my PCP/GP saying exactly what I want. Many of the good types may not do insurance, but there may be workarounds for that, like asking a therapist what would need to go on the prescription. They often use several techniques and some of them may be more easy to get paid for than others.
I tried physical therapy in the winter without any improvement. At that time I didn’t know I had a tear in the rotator cuff.
A good physical therapist would probably have found that tear... I'd only do 2 or 3 sessions of a type if it isn't helping. It is good to give them a certain chance tho. Even if they don't know fibro, some have a knack of empathy and listening, but they may need a few sessions and our detailed feedback.
He also suggested acupuncture as a possible help.
I'd also call that physical therapy in the widest sense. It does have a certain amount of evidence to help with fibro, so I'd always suggest trying it.

Unusually, Western acupuncture considerably harmed me, Chinese acupuncture (despite thicker needles) is the only thing increasing my energy.... But it was a hard slog, cos it didn't seem to be sustainable (even after 15 sessions!), until I discovered by analyzing my diary/blog that I need to focus on improving my sleep more and never forgo my cold showers for it (and at the same time minimize some mid-term trigger events I hadn't been taking seriously). That's the only expert physical therapy I now do, for everything else I am self-sufficient. And actually even there I am doing the hardest bit of the work myself.... 🤠

I think we'll have the most success if we learn to treat ourselves. But learning the tricks first, together with a few experts will be necessary. My main expert was an acupressurist & cryotherapist, but she used a great deal of methods and also things she'd though up herself. Had various conditions, incl. something like fibro herself. She'd actually bought her "cold barrel" for whole body cryotherapy cos it was helping her so much. (Ah yes, cryotherapy is another kind of physical therapy I forgot to mention...)
 

sunkacola

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I think we'll have the most success if we learn to treat ourselves.
I agree.

Having said that, I am very glad that I have such a skilled chiropractor and a good acupuncturist as well. I consider them part of the treatment I give myself, but only because I have integrated what they do into my daily care for myself, and have done enough experimentation that I know what they can and cannot help me with in terms of managing fibro.
 

Stressedout

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Absolutely. Fibromyalgia goes to your weakest area & can spread from there. I’ve had rotator cuff surgery. My tear wasn’t even that bad & it was 4 months going to pt 3x / week.
 
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