Bad Shoulder Pain from PsA?

General
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Hi! It's been a while since I've posted. I could please use some support and advise.

My hubby has had PsA for about 4 years. He has been going to a Rheumy for a few years now since he was finally diagnosed. Hubby is always in a lot of pain, mainly his hips, spine ( severe degeneration causing nerve pain ), fingers, shoulders. He has previously been on MTX injections( terrible side effects ), but is now on Arava for over 7 months. Hubby has a heavy physical job. He comes home in so much pain every evening. Rheumy prescribed Naprosen 375mg. - 2 - twice a day. Does not even touch his pain most days.He's been on that for over a year.

Hubby has had bad shoulder pain now for quite a few months. Rheumy told him his PsA was 'mild'! Hubby is never ever been a complainer of pain, even when he had a perforated appendix!! Hubby keeps telling family physician & Rheumy about his bad pain in his hips, spine and now shoulder pain. It's like he is getting the shrug off about the shoulder pain!! Sorry, no pun intended! Now they are trying to tell him maybe he has sleep apnea causing his pain!!! Yes, I know this is possible, but I don't believe it one bit in his case! His PsA pain goes through severe flare ups & can go from hips, to spine to fingers to shoulders and sometimes all the above! Hubby is being sent for an MRI due to the nerve pains he is getting down his legs.We know he has severe degeneration in his spine!! I am a nurse, so I do understand many medical issues, but it ticks me off when doctors shrug off what you tell them.

Hubby is getting discouraged with going to the family doctor and more so his Rheumy. I'd like to see his Rheumy deal with being up all night due to excruciating pain after slugging it physically all day at work!! Hubby is a tough guy, but there is a limit! Hubby is also on a statin drug which also can cause shoulder pain, that they ruled that out after stopping his Lipitor for a period of time, with no change.

So, I am asking you, those who would know best having PsA, if you get bad shoulder pain and if so has it been attributed to PsA? I am not sure if it's time to search for a new Rheumy. One who listens & doesn't shrug off your pain and ignore comments like ' I have trouble making it through my physically heavy work day'!! Yes, he has to use his hands and arms all day to do his work! Hubby is 62, but can't afford to retire. It is so frustrating. I know how it is suffering from chronic pain issues myself. One feels like you explain your pain and problems to your doctor, but it's like they don't truly care on how you function in pain. Not looking for a miracle or cure, just relief!

Does anyone suffer with severe shoulder pain? If so, is it attributed to PsA and if so, what helps to alleviate the pain? Do you suggest we see another Rheumy? Hubby is at the point of not wanting to go to anymore appointments as he feels they don't believe the pain he is in anyways and feels they are dismissing his shoulder pain as PsA.

Any advise would be greatly appreciated. I'm worried hubby will give up going to the doctor all together as he feels they are not listening and dismissing how much pain he is in.

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I dealt with the pain for 12 years before asking for pain meds. I take enbrel(have for 12 years) and also take percocet 10/325 (and tylenol #4 when not bad). I have not had a problem getting the from my last 4 doctors and he shouldn't either. He can find another doctor or try a pain managment DR.

I owned a landscape company so I know how the pain can be. A few years ago I could climb trees for 12 hours and now have a hard time climbing off the couch. I also have a high tolerance for pain/suffering. Most of the time my wife can't tell when i have a cold or broken back. That's my wife...so, I'm sure the DR has no idea. The key is to go to a DR that actually takes your word for it. If they don't you either tell your DR why this is going to be your last visit or flat out find a new DR.

The fact about PSA is that, like me , the physical signs can be limited on the outside. I have never had skin psoriasis only under my nails. I do have a lot swollen fingers and toes and x-rays show bone damage but, most of my symptoms are internal. I have severe fatigue. I have pain in my lower back, hand, feet, neck and elbows. None of wich can be seen or tested for or guaged by anyone other than me.

However, a stranger would never guess how I really feel. Most of my family doesn't even know. If your doctor doesn't believe you... find a new one. If your DR thinks you should "grin and bare" it while they try to figure out a solution find a new DR! I have no problem letting them know how many other doctors I could go to either! It's not about them!!!

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I have shoulder issues as well. I was put on Enbrel, which I have been on it for five months. It has helped but my rhumey today wants me to be 100% pain free, but is there really people 100% pain free. He believes I have fibro so he is putting me on an antidepressant

Keep going to a doctor who believes you. Never allow a doctor to shrug things off!

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I have many, many joints involved, and that includes terrible shoulder pain when things are bad. (both in the joints, in the tendons around them, and in a tendon that runs up under my shoulder blade). I’ve never “asked” the Rhuemy if it’s from PsA - it’s always at the same time as about 20 other joints are flaring, and I don’t do any other activity that might cause it, so there’s really no question.

There have been a number of other posts here about it from others in recent months.

I’d suggest that if you’ve got insurance or you are in Aus / Uk (sorry, haven’t checked where you are), it’s time to look at biologics. I haven’t personally found anything that touched the shoulder pain much except getting the disease itself under control. (actually ditto most PsA pain…)

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Unfortunately, here in Canada, Biologics are not covered. The rheumy told my husband it would cost him $20,000 per year out of pocket if he decided to go on them!! Ridiculous!! Few insurance plans cover them. We do have medical coverage that hubby pays for through his employer, and it is still not covered at all. That is totally not an option for him, as we cannot afford it!!

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Aren't biologics covered if you fail all the other medications? I have a friend in Canada getting biologics covered because of that situation. And boy, that rheumy sounds horrid. I am very matter of fact with my dr. about my pain. And luckily he understands that just because I'm speaking about it matter of factly and not wailing and sobbing on his white coat that I'm still having severe pain.

Can you take a written list in to the dr. with all the symptoms? Often it's hard to say all the things that is bothering oneself, because it can make you feel like a whiner when it is said out loud. At least that's how I feel. I've had docs that ignore verbal info, but take it more seriously if it is written down. Something like a pain diary would be helpful to show how bad it is.

Your hubby DEFINITELY needs better pain management!

weezee said:

Unfortunately, here in Canada, Biologics are not covered. The rheumy told my husband it would cost him $20,000 per year out of pocket if he decided to go on them!! Ridiculous!! Few insurance plans cover them. We do have medical coverage that hubby pays for through his employer, and it is still not covered at all. That is totally not an option for him, as we cannot afford it!!

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Hello i have horrible shoulder pain, they did xrays,mri. It didnt show much of anything. I kept telling them i am in pain.Finally he did this full body scan to see if i have inflammation. I am full of it and finally was diagnosed with psa.

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My shoulders were starting to become symptomatic after my elbows were fully involved. As PsA affects all joints and all tendons I do not know if it was tendon or joint pain. I was having some swelling there also though difficult to assess. Elbows were easier to assess as the little ball of fluid hung right off of it. I thought at fist I was gaining weight in my elbows! The only thing that really helped the body wide pain is a biologic and mtx. Heat/ice/vicodin kept me from going insane but just barely.

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I was recently diagnosed with PsA with spondylitis.. I am only using MTX at the moment (waiting for the magic 12 week mark for insurance to cover a biologic). I also have a Norco 10/325 prescription that I use if the motrin and ice/heat don't work.

Oddly enough I have had a few unusual episodes of shoulder pain. My left shoulder often is sore and achy but just yesterday I had a sudden pain like the "funny bone" feeling when you hit your elbow. Thing is I was laying totally still on my back at the time. After the sudden pain my arm was weak and I lost grip strength in that hand. I called the rheumy and he said it was the disease, enthesis? sorry for the spelling...I went in for a prednisone shot and that seemed to help. It is my understanding that this is a disease of the tendons, ligaments and joints...

For what it is worth I totally support pain management and I believe in appropriate use of narcotic pain relievers to bridge the gap until the right treatment is found. We are all different and it may take a while through trial and error to find what works. In the meantime I don't want to be in agony...

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I have severe shoulder pain most of the time due to the PsA. My left shoulder is one of my trouble spots and it is almost always in pain. To alleviate it, I rely on my pain meds first. Naprosyn was a joke for me. First if all, it is an anti-inflammatory drug so it only targets the inflammation which is the source of the pain. But when the inflammation is very severe it is not enough. For me, it never helped the pain! I think it would be worth while to ask for something stronger and to take an anti-inflammatory AND a pain medication. The anti-inflammatory drug or NSAID I now take is Nabumetone and I also take Tramadol which is only for the pain. When these dont work, I add some heat therapy and medicated patches (Salonpas works great) to the mix.

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Weezee,
I’m in Canada too, and I know that here in Ontario there is a substantial program that will pick up extraordinary drug costs. I think your rheumy isn’t telling you the whole story: a biologic will not cost you $20K out of pocket.
I went to the Canadian Enbrel site and found this –
http://www.enbrel.ca/en/pdf/AMEE_8943E_Patient_Tear_Pad_QA_P06.pdf
I think it’s worth giving them a call to see what they say.
Good luck with this!



weezee said:

Unfortunately, here in Canada, Biologics are not covered. The rheumy told my husband it would cost him $20,000 per year out of pocket if he decided to go on them!! Ridiculous!! Few insurance plans cover them. We do have medical coverage that hubby pays for through his employer, and it is still not covered at all. That is totally not an option for him, as we cannot afford it!!

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Hi Seenie!

I'm in Ontario as well. Hubby was not told by his rheumy about a program here that will pick up huge drug costs. I only know of one for low income earners. Maybe it is the same. Once hubby told the rheumy he did not have coverage for biologics, it was basically, too bad, keep taking Arava then & Naprosyn. Naprosyn does so very little for him & mostly nothing at all for pain relief

It is amazing how doctors DO NOT LISTEN to what their patients tell them, especially when it comes to pain. When you discuss pain with some doctors, they treat you like you have the Bubonic plague!!

Thank you for sharing the Canadian Enbrel site! I'll check it out!

Seenie said:

Weezee,
I'm in Canada too, and I know that here in Ontario there is a substantial program that will pick up extraordinary drug costs. I think your rheumy isn't telling you the whole story: a biologic will not cost you $20K out of pocket.
I went to the Canadian Enbrel site and found this --
http://www.enbrel.ca/en/pdf/AMEE_8943E_Patient_Tear_Pad_QA_P06.pdf
I think it's worth giving them a call to see what they say.
Good luck with this!




weezee said:

Unfortunately, here in Canada, Biologics are not covered. The rheumy told my husband it would cost him $20,000 per year out of pocket if he decided to go on them!! Ridiculous!! Few insurance plans cover them. We do have medical coverage that hubby pays for through his employer, and it is still not covered at all. That is totally not an option for him, as we cannot afford it!!

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I started having shoulder pain a few months ago. I have a fairly physical job on a military base and thought that might be the cause, carrying ladders around and such. I also have old shoulder injuries and was not sure if the pain was from the old injuries. I was about to call an Ortho, but decided to do a test...I did a prednisone spike and lo and behold, within two days the shoulder pain is gone, along with the back pain and the swollen legs and toes. Darn it, it's the disease. Wish I could keep taking the prednisone, but I know it's bad for you. I would say that yes, PsA can cause shoulder pain. Best of luck

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That sounds like me. Elbows ans shoulders and where the forearm muscles attach. Doc moved to Cosentyx to see if that is going to help.

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