Any help on pain management for shoulder osteonecrosis?
Monday, November 30th, 2009 at
3:38 pm
My mother was diagnosed with temporal cell arteritis 3 years ago and has been on large doses of steroids for treatment. She now has avascular necrosis of the shoulder and is in extreme pain. She currently takes 2 lortabs and 2 kadien a day for the arteritis and is getting no relief. Surgery doesn’t appear to be an option in her current condition. We need some pain relief!
Filed under: Shoulder Pain Treatment
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There is a treatment that uses ice water that is circulated around the shoulder via a pump.Ask a physical therapist to help you out.
these are probably options you and your doctor have already explored. How about Anaprox. and then aleve like every 4 hours for around the clock relief or if you guys want try percocet (but percocet on a longterm basis could have terrible side effects). Good luck.
Lortabs and Kadien are for treatment of the osteonecrosis and not for the temporal arteritis, which is treated with prednisone. You need to get your mother to taking Fosamax or Calcitonin to make sure she doesn’t develop additional bone abnormalities or fractures. Compression fractures of the backbone or a broken hip are both very common after long term corticosteroid treatment for temporal arteritis.
If your mom is completely off the prednisone and she can’t have surgery on the shoulder (joint replacement surgery in someone with osteoporosis doesn’t work well anyways) then she needs to strengthen her bones with the drugs mentioned above, take a high dosage of calcium and vitamin D each day, do regular exercise or physical therapy to keep motion and strength in the joint and also figure out how best to manage her pain. Adding Tylenol or naproxen 4 times a day might help lower her pain threshold. Taking a stronger strength of Kadian might help. Exercise, however mild, helps lower pain, so walking or lifting small weights daily can be helpful. Also exercising in a pool where resistance is slight is very helpful.
There is no easy answer but these are some suggestions that helped a relative of mine who also suffered severe skeletal damage after long term prednisone treatment for temporal arteritis. Today she is doing much better and her pain level is much less than it was ten years ago, so there is hope if your mom is willing to keep trying all the various options. good luck
Once your mom is off the pred. the issue of bone avascular necrosis can be addressed. Often the bone will come back on its own after a period of time, and since it is not a weight bearing joint, like the hip, it may not suffer a major deformities. The issue here is pain relief hoping the bone comes back. If the pain is so severe, she may want to consult a pain doctor. Perhaps she is a candidate for narcotics.