FUDiabetes

Shoulder eval for possible frozen shoulder tomorrow...suggestions/what to expect?


#1

Not sure the best category, so feel free to change as needed.

I believe I have frozen shoulder. Going to an orthopedist tomorrow who specializes in sports medicine and shoulder issues and who is familiar with frozen shoulder.

I hear you can do PT 3-5 times per week for several weeks but also that you can get a cortisone shot.

Since it’s the end of the year and I’m out of flex spending money until January, was hoping for the shot.

I’ve had cortisone in the hand for trigger finger before by a different doc in the same practice but was not diabetic at the time. It it pretty much the same?

What should I expect?
Anything I should say or do now that I’m diabetic?


#2

I have had frozen shoulder in both shoulders (about 10 years ago). I had a cortisone shot in one shoulder and it did nothing for me. What worked for me was distension arthrography (hydrodilitation) plus physiotherapy. It improved very quickly after that and has not come back since.

The cortisone does make your BGs go high for a while (about a week for me). I had to increase my basal by a lot until the effects wore off.


#3

I have had frozen shoulder on both sides. The first time it responded quickly to physio. The second time it did not respond to physio, acupuncture, or electrical muscle stimulation. Rather than go the cortisone or surgery route, I simply left it alone (by then I was not in much pain and could use my arm and hand again). It went away on its own within about a year.


#4

I had frozen shoulder a long time ago, 1990? I had very limited motion before seeking help. Could not reach into back pocket or pain reaching for car radio controls. So depends on how early you are at.

I had cortisone shot, with no warning of impact on BGs. (No cgm, and using nph+reg at the time). Took a few days to realize the connection. I also started PT after the injection, but don’t remember if it was immediately or later.

Have not have shoulder problems since recovery, although know I’m not as flexible as others, and some loss of range of motion.


#5

I’ve been struggling with frozen shoulder for about the past 14 months… still have limited mobility and pain, though both have improved somewhat. I have tried both a cortisone shot (helped trigger some improvement, and I think was worth it despite my blood sugars being awful for close to a week) and PT (maybe helpful at first, then not so helpful, but that’s also because the frozen shoulder PT didn’t understand at all how to work with my other chronic condition). I’m heading back for an ultrasound-guided cortisone shot this Friday actually, and, based on my prior experience, I plan to increase my basal to 150% of normal for at least the first few days.

My ortho said that while 95% of frozen shoulder cases do resolve, treatment or not, within a year, that number is somewhat reduced in diabetics and/or can take longer, and all of the treatment options are somewhat less effective for us. So I think a cortisone shot is worth trying, screwy blood sugars and all, but it’s hard to know what will or won’t work for an individual.


#6

I’ve had frozen shoulder twice in the past 15 years and both times did about 10 weeks of once-per-week physical therapy plus home excercises. Both times worked. It was slow but steady progress.


#7

With a cortisone shot, depending on what they give you the impact on BG can be dramatic. With Celestone (betamethasone) glucocorticoid, your insulin requirement could double. With Kenalog (triamcinolone acetonide) corticosteroid there might be no effect on BG. YDMV.


#8

Sorry it took so long to reply, but he said he wasn’t sure, but gave me a shot anyway of Methylprednisolone and said if I had any future problems to come back. So far it’s half worked. Its not as sharp and as painful, but still there. Messed with my BS a bit but not bad. Very frustrating. He did take an X ray but he said the Xray showed nothing. He tested my range of motion with and without assistance and said that I seemed stiff but not the typical case of frozen shoulder. I’m totally confused!


#9

I don’t think the injection is supposed to heal it instantly—more help calm down the pain and then set it in a direction of regaining motion. I had mine with ultrasound the other week. Definitely super helpful—took a few days to kick in (and initially felt irritating/painful after all the lidocaine wore off), but now the joint is way more comfortable, and I can go back to having my PTs do manual work on it. Definitely screwed with my blood sugars as expected, but was worth it for me.

Also, they do an x-ray almost always if you present with any sort of joint discomfort (they are cheap and easy) just to rule out a tumor or something wrong with the bone, but they don’t expect to find anything with it usually if it’s a more nuanced or soft tissue injury (like frozen shoulder, which affects the joint capsule tissue). They can only really see what’s going on with an MRI, which are much more expensive and harder to get approval for (and typically done out of office and need advance scheduling), so it’s rare they will do one for frozen shoulder. If yours isn’t fully frozen, it could just be that you caught it really early, in the initial freezing process, which is a good thing and when my ortho says cortisone injections are most effective.