Upper arm pain

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Darrow112

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CALS
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AUS
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NSW
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Sydney
Hey everyone!

My mother has been experiencing upper arm pain sporadically for the last few weeks. It has been localized to the upper arm and it isn't constant at the moment but it is appearing more often, and the upper arm muscles are hardening. I was wondering if anyone else has come across this?
 
That sounds like upper motor neuron damage, as is part of ALS. It is like a spasm. Is she getting/doing range of motion exercise and massage? Those could help and are always good ideas, anyway. You want to keep the shoulder stable while moving the arm.

If she has not been exercising, it could also be immobility, but the same theory holds.

Best,
Laurie
 
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Laurie;

Our home care PT advised this week on range of motion exercises but concentrated on legs and feet. Wife can pull up and stand but does not walk.

There was no mention of upper body stuff.

My wife still has good use of her arms and hands so I assume that's why no motion exercises for upper.

Also you mentioned keeping the shoulder stable. Is there a technique for this that you can relate?

Thanks for your valuable posts

Ernie
 
Pain in the upper arm is usually referred from the shoulder. Often there is tendinitis in the shoulder underlying the problem. If range of motion is comprised, a frozen shoulder can result and is very painful.

The solution is physical therapy with range of motion to the shoulder. Sometimes a cortisone injection to the shoulder, subdeltoid bursa, or biceps tendon can help. Massage is helpful for tightness in the muscles.
 
I started having pain in both upper arms, with more pain in my right arm, which is my weaker shoulder.

I went to a very good orthopedic specialist who diagnosed me with biceps tendonitis in both arms. He prescribed a non steroidal anti inflammatory cream (sodium diclofenac) and physical therapy.

The physical therapist does range of motion on both shoulders and that has resulted in a significant improvement. My arms still hurt (especially my right arm) when they are in certain positions, but they hurt a lot less.

Steve
 
I have a torn rotator cuff and tendinitis in my left shoulder. About six years ago my right shoulder froze. I went to the emergency room and they attributed it to my neck injury. They were wrong. I went to an orthopedic doctor who ordered an MRI and it showed tendinitis and a slight tear in the rotator cuff. I tried physical therapy but that made it worse. I used ice and heat and took to the swimming pool to do gentle range of motion exercises on my own. It worked. Fast forward to ALS and my left shoulder is the bad one. It is my weaker arm. Again I had an MRI and it showed too many things to list but the torn rotator cuff was probably the source of my pain.

Last Summer I again took to the pool and it got about 75% better. Now it's very bad again. I go to my pain management neuro and will ask for a shot to see if it helps. The cannabis THC cream helps a lot but it only lasts for about two hours. Honestly, I think I re-injured it when I was lifting a heavy box down at Christmas. I had the strength but, apparently, my shoulder got hurt in the process.

I am going to try another physical therapist who works with MS and Parkinson's patients. In the past, before ALS, I was more concerned about building strength. Now I just want to alleviate as much pain as possible.

Darrow, Have you tried very gentle massage with magnesium oil or coconut oil to help your mother's muscles relax? I know when my feet tense up massage helps.
 
In ALS, the muscles keeping the joint in place can get weak and place the joint at risk.

So, for example, in the example of the frozen shoulder (always a possibility, as Karen notes), some of the exercises used to heal it could strain some of those muscles past their ability to return to baseline, and even cause subluxation (partial dislocation) of the shoulder. This is a particular risk with ALS that started in the arms, esp. if they got really skinny at onset (flail arm type).

There is also some risk with exercise that you might do for tendonitis (another possibility, as you have seen), and even just normal range of motion work. In ALS, once subluxation occurs, it is unlikely you can get the joint back in place.

Essentially, you gently but firmly hold the shoulder in its socket while you manipulate the arm. So the therapist or CALS would be using two hands -- one to reconstitute the shoulder and the other to exercise the arm. At a certain point, based on progression, of course, you stop lifting the arm past the shoulder at all. Lying down is a good way ultimately to get as much exercise of the arms as possible, safely, as there is less strain on the joint at all. Even for PALS who are still somewhat mobile, exercise/massage in bed is a great way to start the day before the effort of transferring.

The same principle applies to knees, hips and elbows -- once you see atrophy or even before, you want to use the two-hand technique in passive ROM, but they are at lower risk, generally.
 
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