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July 21, 2017  
REFERENCE: Ask an Expert

Below are some of the most-recently-answered questions from our Medical Experts. We recommend you read over these questions as well as search our "Frequently Asked Questions" to see if your question has already been answered.



Question:
I am a 48 year old female with RA. For 3 years I have had various degrees of shoulder pain. I was getting relief from steroid injections but lately that isn't working. I have good range of motion and the pain is minimal during daily activities. At night I experience severe pain that wakes me nearly every time I turn over. I don't sleep much and it is nearly impossible to move my arms without severe pain. MRI's have been negative for a cuff tear. Any suggestions?

Dr. Hasan
Dr. Hasan is an orthopaedic surgeon specializing in shoulder, elbow, and general orthopaedic problems. Dr. Hasan has received the M.D. degree and a Ph.D. degree in biomedical engineering, both from Vanderbilt University. He completed residency training at Rush-Presbyterian-St. Luke's Medical Center in Chicago followed by fellowship training at both the University of Washington and the Texas Orthopaedic Hospital in Houston. Dr. Hasan has published a number of articles in peer-reviewed journals and presented his research efforts at national and international orthopaedic conferences. Dr. Hasan’s areas of interest include: arthroscopic and open surgery of the shoulder, elbow, and knee as well as joint replacement surgery. He currently practices at Cincinnati Sportsmedicine and Orthopaedic Center.


Answer:
Rheumatoid arthritis can affect the glenohumeral joint (ball and socket joint). The first thing to make sure of is that you do not have any significant arthritis in that joint. Regular xrays are usually adequate, as well as a careful examination. The fact that your motion is relatively good (espeically if it is smooth without much roughness) suggests that any arthritis is probably not too severe. Patients with rheumatoid arthritis can also have stiff painful shoulders, just like other patients. You should try anti-inflammatories, range of motion exercises, and activity modification first, to see if these help. Lastly, another source of pain may be synovitis or inflammation in your joint (that may not be apparent on MRI) or bursitis over the rotator cuff (the MRI should show this, as well as any rotator cuff tendinitis).

   
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