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Arm pain anyone? #282489
01/22/19 11:22 PM
01/22/19 11:22 PM
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jagsfan05 Offline OP
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I'm a new member here and my first real post can be found here: http://forums.spondylitis.org/ubbthreads.php?ubb=showflat&Number=282477#Post282477

I was recently diagnosed in November 2018 with AS. I don't want to be the type of person that correlates everything wrong in my body due to AS, but since I'm newly diagnosed I still have questions as you can imagine. In November after being diagnosed, I was doing pull-ups for the first time in a long time when I felt a bicep pain in my left arm. Figuring this was just overuse since I hadn't lifted weights in 6 months or done pull-ups in years, I stopped and iced it for a week or so. It was still giving me some trouble at times (nothing too severe) so in mid-December, I kind of gave it a deep tissue massage which was a bad idea. It swelled up and I immediately iced it...the swelling came down but ever since then my arm still hasn't healed. It doesn't hurt every day nor is it excruciating but when it does it almost feels like a "stitching or glass shattering" type feeling in different parts of my arm ranging from my low part of my shoulder, triceps, biceps, and even down to my forearm. The pain is real hard to explain but I also notice it at times when I'm sleeping on my left shoulder at night.

Usually when I injure myself, things heal up especially with rest but this one is still nagging me at times. I haven't gone to a sports med doctor yet because I wanted to keep waiting and I spent lots of money for doc visits, MRI's, etc. diagnosing my AS. But it's now been roughly 1-2 months. I realize there is a strong chance this is just a sports med/bicep tendinitis injury of some sorts but any way this could also somehow be related to AS and if so, how and why? And how would I make it go away? I started Enbrel two weeks ago and not sure if that helps treat these types of things. The only place AS has been affecting me is in my SI joints.

Thanks!

Last edited by jagsfan05; 01/22/19 11:27 PM.
Re: Arm pain anyone? [Re: jagsfan05] #282491
01/23/19 04:51 AM
01/23/19 04:51 AM
Joined: Jan 2016
Posts: 51
Joshua Tree, CA
jtmak Offline
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So sorry to hear of your pain. I had similar symptoms last spring/summer and thinking it was a new AS symptom, I too stabilized and guarded against moving the arm/shoulder because the pain was so intense - but I couldn't figure out what triggered it. Because it became worse at night, waking me up and requiring me to get up and out of bed - it reminded me of my SI when flared -prior to fusing. Primary doc thought rotator cuff but I pushed for Rhuemy eval. Rhuemy dx frozen shoulder which is when the sheath that encapsulates the multiple musles etc that run from scapula through the shoulder area "shrinks", causing the muscles etc to become trapped and pinched.. .😫. Scapula, clavicle, bicep, tricep, elbow,and wrist pain. Now in my 3rd week of PT range of motion is improving which reflects restretching of the sheath. The jolts of pain felt before are gone. I still wake up, but not with arm pain. And while ultimately the cause is still unknown - and may be due to the AS related muscle tightness through my neck/ back, , am feeling like PT has given me a reminder that not all pain means AS. Give yourself the gift to be further evaluated. My rhuemy mentioned that orthopedics often care for my condition so she would have referred me to one if I didn't improve with PT. Good luck and I hope you get a reprieve from the pain soon.


California, USA
Reoccurring Bilateral Uveitis Dx 1985
Reiters Syndrome Dx 1985
AS Dx 2015
SI joint fused
Re: Arm pain anyone? [Re: jagsfan05] #282494
01/23/19 02:53 PM
01/23/19 02:53 PM
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SouthernMoss Online
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Sounds like it might be enthesitis. Enthesitis is like tendonitis, except that the source of the pain is inflammation at an enthesis (plural entheses), which is where ligaments or tendons attach to bone. Inflammation of the entheses is one of the things that makes AS/SpA different from other joint diseases.

One of the things that sent me looking for a diagnosis (besides eye pain) was "tennis elbow" that I had been dealing with for 5 or so months. Rotating my forearm was very painful. My rheumy said it was definitely part of the spondy and immediately put me on methotrexate. A year later we added Humira because the NSAIDs weren't doing enough for my back pain, and the Humira/MTX combination has kept my forearm/elbow under control. Occasionally I feel a nagging sensation like it wants to get inflamed and can't quite make it, but I have not had another full blown attack since being on meds.

You should definitely discuss your arm problems with your rheumy. If it is enthesitis, hopefully the Enbrel will help it once it fully kicks in.


Ginny - 58 year old female
Dx with USpA in March 2013; changed to AS in July 2015
Iritis and Scleritis, both currently in remission
unicompartmental knee replacements: right-June 2014, left-Aug 2018
MTX, Humira, Cyclobenzaprine, plus Celebrex as needed
Supplements: Folic Acid, Vitamin A, Vitamin D, Calcium, Fish Oil, Culturelle probiotic, Melatonin (as needed)
Re: Arm pain anyone? [Re: jagsfan05] #282497
01/24/19 01:45 AM
01/24/19 01:45 AM
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Philadelphia
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David01 Offline
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My enthesitis pain is very different from my adhesive capsulitis (frozen shoulder) pain.

It feels like I am being stabbed with an ice pick when I apply pressure to a single enthesitis point. When I lie on my back or side and apply body weight over many enthesitis points it can feel like I am on an open wound or broken glass. Fortunately my biologic numbs the pain down quite a bit so that I can function.

The frozen shoulder pain manifests itself in my upper arm. It appears when I reach behind my back, above my head, and when I try to sleep on my side with my hand under my pillow under my head. Sudden movements can be brutal. I am fine with my arm at my side. My physical therapist thought that I might have a torn rotator cuff since the symptoms are similar.

Diagnosis of the shoulder started with a simple x-ray. It was followed up by an MRI. Both were ordered by my Rheumatologist. The radiologist made the diagnosis.

Physical therapy did help somewhat after a couple of months, but the pain mostly continued. I then saw a shoulder expert orthopedist who sent me me for an ultrasound guided steroid shot. I understand that it is not effective for everyone, but for me it was awesome. I felt 95% recovered for the first two months. The effectiveness seems to have dropped now in the third month, but I am still much better off than I was before the shot.

The nice thing about frozen shoulder is that it eventually gets better. It just takes time.


--Dave

52 years old
Dx: colitis - Sep 2014
Dx: ulcerative colitis - Oct 2014
Dx: ankylosing spondylitis - Nov 2014
HLA-B27 neg
Re: Arm pain anyone? [Re: jagsfan05] #283020
05/05/19 11:08 PM
05/05/19 11:08 PM
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jagsfan05 Offline OP
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Thanks for the replies everyone. I posted this back in January and just wanted to post an update that I'm still having trouble with this issue. It seemed to have gotten better over the past 1-2 months but it's still coming back here and there. The tingling sensation has seemed to go down. I can't sleep on my left shoulder still and at times, it still bothers me and flares up doing push-ups. It only usually comes around when direct pressure is applied to it. I saw my rheumatologist last month and she said it doesn't seem to be anything wrong structurally and that it might just take more time to heal if it came as a result of the bicep injury in December.

Well here I am and I'm still having issues with it. A couple months ago I did some PT stretches for it for a couple weeks but I wasn't sure if it was really helping so I stopped doing them. I started Enbrel in January so I've been on it for four months now...I feel it's helped some with my SI joints but not 100% and it hasn't helped solve this issue of my left shoulder/arm. Just not sure what to do now. Has anyone had this exact issue and solved it somehow? Whether with specific PT exercises to share on ones I haven't tried or something? I guess I'm just hesitant to go to my sports med doctor because I think he will just image me determing everything is fine and then send me to PT. Which will then just be doing some of the same exercises I've already been trying with a hefty price tag. With what I've described, can I label this as something specific? Is this frozen shoulder or just enthesitis, etc.? What are the differences between the two in addition to what David said?

It's driving me nuts and I just want to get back to lifting weights so bad. frown

Last edited by jagsfan05; 05/05/19 11:37 PM.
Re: Arm pain anyone? [Re: jagsfan05] #283024
05/06/19 08:46 PM
05/06/19 08:46 PM
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Winston Offline
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It may be that you're just not giving it time to heal. Lay off the push-ups and other upper-body work entirely for a few months and see if it helps. It's hard, I know (I get depressed when I can't exercise), but that may be what it takes. As you get older, you'll discover that this only gets worse. Things that used to take days or weeks to heal will start to take months or years. Sometimes things never heal and become chronic or recurring problems. Such is life, unfortunately.

If it's enthesitis, you might find this website helpful/informative: http://enthesis.info/

Did your rheumatologist offer you a topical NSAID, such as Voltaren gel, to use to see if it helps? It may.

Edited to add: The tingling you describe would concern me a bit. Have you considered seeing a neurologist to make sure there's no nerve impingement in the shoulder or elbow? I suffer from a elbow issue, ulnar neuropathy, that may or may not be related to my AS. It causes numbness in my hand and some intermittent elbow pain. The Enbrel I take for AS doesn't touch it, but that doesn't necessarily mean it's not AS-related. Biologics work great on the spine and for the general constitution issues (e.g., fatigue) but aren't always that great, standing alone, for pain and inflammation in the peripheral joints.

Last edited by Winston; 05/06/19 08:54 PM. Reason: added something

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