Scapulothoracic bursitis – cortisone injection

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scapulothoracic bursitis ultrasound

I had my cortisone injection into both of my right scapulothoracic bursa under ultrasound yesterday to treat scapulothoracic bursitis.  The doctor was lovely, and chatty and discussed the rarity of the condition, and told me she could clearly see the inflamed bursa, and excess fluid, at both the tip of the scapula and the lower area, where the pain is usually the worst.  Diagnosis confirmed.

She injected both areas, and by the time I had driven home I could already feel a reduction in pain.  Of course this would be the anesthetic, as they also inject local anesthetic along with the cortisone/steroid.  The anesthetic acts immediately and is long lasting, and the cortisone takes a few days, even a couple of weeks to reach full effect.

scapulothoracic bursitis ultrasoundThis morning the shoulder blade pain is still improved, it’s only a little worse than the left shoulder, which has the same problem, but much less severe.  Everything is symmetrical for me in Rheumatoid Arthritis land, though the severity does vary.  But so far, so good. I hope for more improvement over coming days.  After feeling like I have had a knife lodged underneath my shoulder blade for several years, it’s good to feel some relief.  I’m almost more aware of it now, because I’d become so accustomed to blocking that pain out.

So now its wait and see if I get more improvement, and how long the relief lasts.  And decide whether surgery to permanently remove the bursa is worth going through yet another surgery.  I don’t have to decide that now, or even think about it. So I won’t.  I have plenty to do today that doesn’t involve my shoulder, and being able to ignore it completely is a very good sign.  But we’re still in anesthetic territory now, so I’m trying to not get too excited.  New thing for me, not getting over optimistic. Much more sensible.  Much less disappointment if the pain returns full force tomorrow!

She advised to rest the arm for the rest of the day, and to not do any upper body exercise for three days.  I asked her about my yoga/pilates class on Sunday, and she said fine, but NO down dogs!  I agree, down dogs are very hard on the shoulders and the wrists, and I have been putting most of my weight on my left shoulder and wrist for many years. I have still been bearing some weight with my right arm, however, and even light weigh bearing is a big difference to not being able to use my right shoulder at all.  A large portion of the class is either on my feet, or on the ground doing core work though, so I still intend to go, and just skip the portions of the class I can’t do.  The yoga/pilates has improved my back pain considerably, so I don’t want to miss the class if I can help it.  There is also spin class today, which is a possibility.  I don’t need my arm for that at all.  Wait and see how I feel.

I have had other doctors recommend completely different things, post cortisone injection. Some say go ahead and exercise right away if you feel fine. Others say don’t do anything for a week.  All I can do is follow their recommendations, and listen to my body.  And hope the relief continues for a long time.

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