Cold Shoulder

Ice CubeI’m so chill, I’m ice.

Nah, just my shoulder.

It’s frozen.

One of the quirky aspects of my diabetes is the inability to have one of those well-known complications. Totally not whining about that, believe me. I’ll do without the kidney and circulatory issues, thank you very much. But the complications I do have tend to run in  the “inflammatory” circles of things. Trigger fingers (and thumbs) and frozen shoulder are my complications de l’année (of the year, because saying “du jour” would be silly…).

This is not my first time at the rodeo with my shoulders. About four months before I got pregnant, my right shoulder started to ache at night. Then it didn’t ache; it throbbed. Then it was a thousand tiny evil fairies were poking at it with thumbtack swords. I slept with an ice pack, which ensured a few hours of restless sleep and a moist side of the bed. During the day, I’d take naproxen and try not to move around so much (which is the exact opposite of what I was supposed to do, but hey… I didn’t know.).

Enter Dr. Google. My dad has had shoulder issues from a skiing fall, so he got cortisone injections. I knew that it wasn’t an injury or a torn rotator, but maybe it was something like bursitis that I could deal with easily. If you know me, then you’ll understand that to be funny (the “easily” part).

A few clickity-clacks of my laptop, and I was staring at the term: adhesive capsulitis. And if I had any at that point, I’d be cursing my luck. I did my research and cursed my absent luck even more.

Just having diabetes makes you more prone to “frozen shoulder”, as it’s commonly known. There are three stages of the condition (thank you, Wikipedia):

  • Stage one: The “freezing” or painful stage, which may last from six weeks to nine months, and in which the patient has a slow onset of pain. As the pain worsens, the shoulder loses motion.
  • Stage two: The “frozen” or adhesive stage is marked by a slow improvement in pain but the stiffness remains. This stage generally lasts from four to nine months.
  • Stage three: The “thawing” or recovery, when shoulder motion slowly returns toward normal. This generally lasts from 5 to 26 months.

I visited an ortho specialist right around the time I got pregnant, and we knew that a lot of my options were out. Thankfully, I was already entering the second stage and the pain was lessening. I grinned and stuck it out with more ice packs and naproxen.

Fast forward to last summer (or would that be rewind to summer when I’m telling the story…Oh, the things I wonder about…)…

My left shoulder began to nag me. The kid was getting heavier, she liked to rest her head on that shoulder when I rocked her, I fed her holding her on that side…. so as much as I’d like to believe that it was just normal mommy shoulder pain, I knew.

Back to the ortho specialist, who wiggled his fingers at the squirmy toddler in the stroller, shook my hand and said: “The other one?”

He told me that steroid injections don’t seem to work with diabetics and frozen shoulder (I’ve heard that before with other inflammation issues in my body) and the blood sugar gamble usually doesn’t pay off in the long run. I could do physical therapy for weeks, then come back to evaluate, or I could do “manual manipulation under anesthesia” which would provide immediate relief and  then physical therapy to keep it unfrozen.

Hmmm…. immediate relief? Sold.

So, in December, I hung out in the outpatient surgery center and waited for the very cool surgeon to come around in between his other patient operations. Got to wear a sexy hospital gown and added to my collection of non-slip socks. They gave me happy juice, a pain injection for after, then when I was under, a nerve block was injected in my neck, rending my left arm a limp noodle for about 20 hours. The doc breezed in, manipulated my shoulder to “break up the adhesions” and then strolled away. He was there for about 90 seconds. I woke up, said some funny things to the staff, and got into a wheelchair with a sling cradling my arm. Out I went…

The pain was gone. Physical therapy went on for a few weeks and I was happy with the way it felt. My range of motion was fine. Then one night, I woke up, wincing after I had rolled onto my shoulder. The ortho had warned me that sometimes it doesn’t hold and it freezes up again. This was that sometimes.

It hurts most of the time – a dull ache unless I try to reach to get something or move it in a way it doesn’t like – and then I’m sucking in my breath to swear underneath it. (My daughter is in that “repeat everything” stage and I’m pretty creative in the profanity department.) I’m on pain meds (non-narcotic) and try to do the same exercises that the PT office gave me, but the range of motion is much more limited. I know it won’t be forever; at most two years? But right now, I’d like to give my left shoulder the cold shoulder.

(As always, my diabetes is just that: mine. The way I choose to treat my diabetes and my complications may be different from how you treat yours, so don’t take what I say as the de facto gold standard. Especially in this case, because…Ow.)

 

0 comments

  1. voda

    I developed frozen shoulder (left side) last summer and by Thanksgiving needed a cortisone shot. I ultimately had two, they didn’t solve the problem but alleviated enough of the pain so I could sleep again. It is still stiff and a “dull ache” and I currently stretch it and use a little light resistance training to force it move beyond my comfort range and break it up. It helps me but it’s slow. At least I can almost pay at toll booths again without total awkwardness. hang in there.

  2. Jenn

    I’ve had the honor of frozen hip… just like frozen shoulder but(t) in the hip. Years ago I was diagnosed with trochanteric bursitis in my left hip. I know what to do to help it.. the stretches and exercises, and for the most part I do them. Then the darn thing started to freeze. Walking.. well.. that wasn’t too bad, but getting in and out of the car was a nightmare. Thankfully, it didn’t last more than about 6 months… this time. I’m sure it’ll return.

  3. seejendance

    I have wonky shoulders as well. I’ve had cortisone in both, and about four doctors tell me it’s five different issues. Plus, I’m a ballroom dancer, and keeping frame uses your shoulders a lot. I hated life in 2011.

    What helped me? Massage therapy and acupuncture. Then stretching my neck muscles. It’s a bit of a luxury to get a monthly massage, but as an athlete, I’d much rather sleep at night. YMMV.

  4. Scott E

    I’ve heard about the correlation between frozen shoulder and diabetes, but what causes it? Any ideas? Oh, and you can talk to Kelly K (Diabetesaliciousness) about steroid use and diabetes. Apparently it does work, but it causes MASSIVE insulin resistance resulting in (at least) a tripling of daily insulin dosage. I learned a lot from her recent experience.

    • theperfectd

      I did a steroid injection in conjunction with an earlier surgery and had the same insulin issues as Kelly. It was ugly. In the decision process, I chose to follow the advice of the surgeon. (Granted, I feel like I’m back to square one now.)
      I’m not sure why frozen shoulder is a (come to find out) common complication amongst diabetics. I think it’s yet another auto immune inflammatory response, but I’m not a doctor or a researcher. Speculation – all of it.

  5. StephenS

    I’ve heard of the frozen shoulder thing, but have been ignoring it for some time. If I really have this issue, I’m in stage 3 right now. I hope the future brings you less pain and more relief.

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