Shoulders and tremors!

First of all, apologies for not having been around for a while. I always feel guilty when I disappear for a while - sometimes I vanish from here because things are good and I don’t want to be reminded of when they’re not (I just want to forget about PsA!), and other times its because different things are bothering me instead of the PsA, and it takes a back seat. This time around, it was the latter, with the stomach issues still continuing from last June. But onwards and upwards…or downwards! But I just wanted to start by sending well-wishes to everyone, and I will try to pop in more often in the coming weeks!

I’ve been having problems with my shoulders the last few months. The right one mostly. It started with it aching in bed, not allowing me to sleep on my right side. So, you know what happens next - I start sleeping on my left side, and so that shoulder plays up instead. But much of the pain in both cases has moved towards the biceps, which seems a bit odd.

Coinciding with all this (and maybe linked), is an issue with tremors. Some of it makes sense. My fingers tend to shake a bit when I do certain things - like hold a book open. You know the ones, those damned paperbacks that won’t stay open and the writing goes right into the centre margin! So you either have to grab the edges for all their worth or bend the book open so far that the pages pop out! But I know that this is possibly linked to RSI, too. My thumb started quivering in the run up to the UK election in December. I realised that I had been scrolling through Twitter and news websites on my phone too much. I stopped and it got better. Not perfect, but better.

I also feel as if my arms have a tremor when I make certain movements or put pressure on them in a certain way. For example, if I’m sitting hunched forward with my elbows on my thighs, I feel as if the top of my arms are quivering. They’re not. But it feels that way. It’s like that feeling you get when you’ve done too much - like moving house and you’ve been emptying boxes and you realise you should have stopped three boxes ago, but didn’t, and now you feel like you’re shaking because your muscles are knackered. My assumption is that this has to do withe shoulders/biceps issues, right?

But there’s more. I tend to have a sleep in the afternoons. I hop into bed, set the alarm for an hour later, and have a kip. But, starting around November, I began to get a kind of internal tremor when doing this. It’s like your whole trunk is vibrating or shaking, but it’s not - not that I can see anyway. I didn’t find out what it was, but it was happening quite alot - but only in the afternoons. Trust me to be weird. It’s only in the last week or two it has happened at night.

I have a scenario in my head, and I don’t know if it’s right or wrong. My assumption with the afternoon issue is that I don’t really go to sleep properly, it’s a kind of half-sleep half-awake issue and the “tremor” is a kind of reaction to being half awake and half asleep. I’m rather prone to that situation where you feel being sucked into sleep and then become conscious but can’t move anything for a number of seconds. I think it’s called sleep paralysis. It’s quite common with bipolar. And in my mind I’m assuming it might be linked to that - or perhaps my brain is fighting against sleep because of the fear of the paralysis. Then came the other twitches I mentioned from the mobile phone usage, and then after that came those that presumably are linked to the shoulder. As I type this, my biceps feel heavy, tired, and trembly. I think, with my bipolar and hypochondria, I have become fixated on the idea of twitches and tremors after these three things, and my brain is possibly playing tricks on me and making everything seem worse. When I had the various stomach tests last year and they came back clear, I told my GP that at least it would be putting the hypochondria to bed, but he warned me that it would probably just fixate on something else. And I think this is it!

But does any of that sound familiar to anyone? Does anyone else get trembling with their arthritis. It makes sense, I guess. If I try to straighten my knees out full, my legs shake, for example. The trembling hand when I’m trying to do a wide movement is actually not my hand, but my shoulder jerking as it attempts the movement. If I do the same movement by swinging my body instead, the jerks don’t occur.

But any comments, as always, are very welcome


I can feel my muscles twitching internally in my legs if I’ve say gone for a longer than normal walk. I assumed it was just lactic acid moving about. I find that twitching kind of pleasant though. It a well used muscle twitch feeling. Makes me feel virtuous.

Otherwise I can tremble a little if I’m really really anxious, angry (most of all), frightened or completely overtired. I can tremble too on steroid meds most certainly, and even if I take too much asthma inhaler. That type of thing. None of it lasts long and none of it hurts.

I can too can do the sleep paralysis thing, the jerking and the sensation of falling, all in that twilight time between wakefullness and sleeping.

But I think you’ve got a shoulder issue going on though, The beginning of bursistis or issues with your rotator cuff. I would see a physio about that, pronto. Shoulder issues are horrible. Personally I think if you got that sorted much of the rest might fall away.

Do you think Benepali is still doing its job?

Hey Poo. Hope you are well. Or, as well as we ever get!

I think my shoulders must have a fair amount to do with my twitching and tremors, as I can feel it now as i sit on my computer chair. If I put my elbows on the arms of the chair, I can feel a tingle in my shoulder. Likewise, when I’m typing and my fingers are hovering over the keyboard, the shoulders and top of the arms really tend to ache. Luckily I’m at the physio tomorrow.

It’s interesting you mention getting a trembling with the inhaler for asthma. I only had one for a few months, but I remember that causing me to tremble too - and this is quite similar to that, only more severe.

As for the Benapali…I’m not sure. I had to stop it and start it so much last year due to the stomach issues and shingles and whatever else I picked up, that I have to admit I don’t feel as if it ever quite got back to full strength. That said, it’s only my shoulders that hurt at the moment, but they really do ache now, and something will have to be done if that continues. TYping and writing is one of the few pleasures I get now, and so in a way it’s more important that being pain free in my legs, to be honest. GP in ninety minutes!

Best of luck.

Having had Imraldi hate me after Benepali just stopped working, I’m now on Cosentyx since November and doing extraordinary well this far. Fingers crossed it continues.

Best of luck at the GP.

Thanks. The GP visit was…inconclusive. Which I guess is understandable given the amount of loose ends that somehow seems as if they should fit together in some way: the trembling when trying to sleep, the shoulder pain and shaking, continuing stomach issues, twitchy muscles, health anxiety, amitryptaline. They are probably all linked. Somehow.

At least I did get some diazapam out of the doctor, which eases some of my bipolar anxiety symptoms - and has eased off the trembling in my body this evening. There was also a decision to try increasing the amitryptiline for a few days. My stomach problems will benefit, and there’s also the theory that my anxiety symptoms will be eased too. On the other hand, it could make the trembling worse if that’s the cause. But apparently I started on it in August and didn’t get the trembles until november, so perhaps that doesn’t add up.

My guess at this stage is:
1.) November: Trembling started when I was trying to sleep in afternoons.
2.) December: Thumb started twitching due to overuse
3.) January: Shoulder arthritis causes arm weakness, hence more tremors.
4.) I put the three things together, my brain comes up with some horrible muscle wasting disease, and so anxiety kicks in, leading to where we are now.

I’m hoping I’m right (on the cause, not point 4!)

I can definitely relate to both the shoulder problems and a kind of internal tremor. The tremor, for me, is like a vibration or buzz in my trunk and as far as I can remember I’ve only noticed it at night and it’s more frequent if I’ve had a glass of wine a few nights running. Have also seen mention of it on the fibro group and heard - and not relevant to you @darinfan - it’s also something alot of menopausal ladies complain about. It’s a weird feeling for sure. I get general shakes from extending my arms and put that down to the constant inflammation I have in my shoulders and elbows.

The shoulder issues, though, have now been going on for 7 years or so. Like you I find avoiding the worst side at night just causes the other side to kick off. At the moment I’ve got similar stuff going on in my hips as well so it’s really hard to get comfy … LOL, it’s never the shoulder and hip on the same side! Voltarol 12 Hour Emugel P slathered on before bed does help a little bit if I’ve not already taken an oral NSAID. But when my shoulder got too much to bear I found having an ultrasound guided steroid injection worked perfectly as it went exactly where the inflammation could be seen. I know you’re local to me … I’ve had private GP referrals for this at The Global Clinic on the Watton Road.

Hope the amitriptylene does the trick and isn’t a cause for you because I find it really, really helpful. Hang in there.

Thanks. Just seen physio and she seems to think the hand tremors are from the shoulder, which is a bit of a relief. Was fine in bed last night, but was shaking when I woke - but it was just around the shoulder I was lying on. I think alongside this I am getting panic shakes as well - or, rather, thinking about the trembling is causing it during the day/evening, and they are in my trunk or even legs. But a dose of diazapam got rid of them yesterday evening so am thinking they can’t be much to worry about.

I’m going to try to keep chilled (naturally or with the help of the diazapam) for the next few days and hope the day shakes gradually go away. I will update!

Time to see an orthopod. I would bet dollars to donuts that you have a problem with your acromions not unusual with PsA. The clue is sleeping on your side which increases inflammation. Its a simple arthroscopic repair (acrmioplasty) if that’s the case. If I could be so silly as to suggest you prop pillows on each side of you for night or so so you sleep on your back. With a Thin pillow and see if that makes any difference in your symptoms. If it does its acromions. There are other explanations but the fact it is bilateral is suspicious.

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I had that surgery just over year ago. Fairly straightforward recovery, no extended sling time.

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Yep! Unfortunately the muddle the NHS is in here in the UK means this kind of thing is totally off the radar and I was laughed out the room when I asked about surgery, likewise arthroscopies for my knees. You’re not being silly about the pillow suggestion TJ, they are game changers for me, likewise the one underneath my knees. In the absence of a bank balance to pay for private surgery it’s a case of best management.

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Just to follow up, as the pain and ache in my shoulders and tops of my arms has faded away a bit, so have the shakes and tremors. Not entirely, though - for some reason I still get them if I try to lie down during the day…but not at night. But hey, I can live with that!

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