Shoulder and arm pain

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1

I had breast cancer in 2008, WLE, re-excision, full lymph clearance, 6 x FEC, 4 weeks of radiotherapy to the affected breast, 5 days of intense radiotherapy to the scar area, 5 years 6 months Tamoxifen. I have had ongoing shoulder pain on and off on the opposite side for 5 years, coinciding with menopause.

I had a nuclear bone scan in 2019 that didn’t show any spread. I was recently referred for an ultrasound and physio assessment by my GP. At the physio assessment I was initially told an ultrasound could be 6 months, but then the assessor referred me for an MRI and said it would be a couple of weeks “to rule anything out” but that it looks like a frozen shoulder. The 2 weeks makes me think it must be the 2-week cancer pathway and this has panicked me.

I know frozen shoulder is common in women around the menopause and I can’t have HRT but has anyone experienced a frozen shoulder turning out to be bone mets? The pain is worse at night and I have a limited range of movement in that arm. My shoulder, the long bones in my arm and even my fingers hurt.

Thanks in advance for any replies.

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I understand your fear , after lumpectomy SNB I suffered with a frozen shoulder due to a rotator cuff injury . In my case this was caused by a fall and like you the pain went down to my elbow and into my wrist and fingers and affected the range of movement . A year later I had another injury in the same place with a trapped nerve and some loss of sensation - all this was also on the opposite side to surgery. When I kept injuring it or the pain came back for no particular reason I did worry a bit and mentioned it at my Holistic Needs Assessment which resulted in a visit to the BCN clinic ( nothing to worry about ).

I was helped a lot by an Osteopath , a lady I have been seeing for years and later Physio. To be honest I’m not sure why an ultrasound was suggested as XRay and MRI are usually more useful for musculoskeletal problems - as to the timescale once you’ve been referred to MRI they do seem to get you in pretty quickly . Long before I had breast cancer I had my first neck/ shoulder injury and it took 12 weeks for my GP to refer me for an MRI but once she had done that I had the scan within 3 weeks. It is possible that they would have taken your medical history into account which just means they’re covering all bases and not that they think that there is anything going on other than a frozen shoulder .
It is hard not to worry , I do hope you get some help for the pain as it sounds like you aren’t sleeping well which will be aggravating everything. xx

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Hi

Can’t comment about bone mets, but I have had frozen shoulders in the past. First was left one then the right one. It was thought to be connected with my menopause. I wouldn’t wish the pain on my worst enemy……zingers are excruciating and bought me to my knees several times. The first one took 12 months to clear up, during which I had treatment from a chiropractor, the second around 9 months. The pain for me was top of arm and all round shoulder area. Ice packs, heat and exercises with deep tissue massage sorted me out.

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The zingers are excruciating - especially when trying to do up my bra or putting a towel around me after a bath. I also feel completely exhausted all the time but bloods are fine apart from high cholesterol. I hope this is “only” a frozen shoulder. I have seen an osteopath three times and had a couple of deep tissue massages but I’m reluctant to have a steroid injection unless it’s guided by ultrasound because the osteopath said it can make things worse if the wrong tendon is injected. I have been taking cocodamol at the highest strength for a few months.

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For frozen shoulder there is also an option for hydrodilation- which can be very effective immediately. Available on nhs in some hospitals

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Yes it’s quite debilitating and having pain all the time really wears you down. I was put on Naproxen which didn’t particularly agree with me but it did help the nerve pain.I’ve also used stick on heat patches .
Have they suggested Amitriptyline at all ? It’s an anti- depressant but it’s usually prescribed at night because it helps you get to sleep . It’s now used for pain as well because it desensitizes the nerve endings though it takes a month to work properly. I haven’t had it but my partner was given it to help with constant head and neck pain following a head injury and it did help him.
I used to swim lying on my back kicking my legs and flapping my arms at my sides and then gradually extending the arm movement then just kicking my legs when my arms and shoulder started to hurt too much.
I didn’t have an injection but I know quite a few people who have had it done and in every case it’s helped - maybe you could get another opinion about it ? I also know a few people who have had sub -acromial decompression surgery with mixed results . Mine improved a lot with Physio though it was painful doing the exercises to begin with and made the pain go up into my neck and caused a lot of migraines . I’ve been told that the muscles in the sub - acromial area are quite small and after a certain age you lose muscle mass and those particular muscles are then no longer strong enough to cope with the job they need to do so if you can get them stronger with Physio somehow it will help. Xx

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Hello Mermaid72

Thank you for your post.

It sounds like you’re having a difficult time with ongoing shoulder and arm pain. Nearly everyone who has been treated for cancer worries about it coming back (recurrence) or secondary breast cancer, so you’re not alone in being anxious about this. The uncertainty and fear of breast cancer returning is very real when people have aches and pains. It can be frightening when faced with a need for further investigations. Remember symptoms can have many causes.

An MRI scan is an effective way to examine almost any part of the body, including bones and joints. It is important to have your symptoms fully assessed. The results of the scan can be used to diagnose conditions, plan treatments and assess how effective previous treatment has been for you. It sounds as if the physiotherapist can see how difficult it is for you and wants to be thorough in their assessment.

As @JoanneN and @bigpickle say, they have had frozen shoulder problems in the past and @JoanneN found that an MRI was useful for diagnosing her musculoskeletal problems.

Once the MRI results are available and the cause of your pain has been identified by the images the physiotherapist or GP can help find ways of managing your pain.

Do call our helpline if you would like to talk this through or have any further questions. The helpline team have time to listen, talk things through and signpost you to more support and information if necessary. Your call will be confidential, and the number is free from UK landlines and all mobile networks. The number is 0808 800 6000, (Relay UK -prefix 18001).

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Best wishes

Helen

Breast Care Nurse

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