Shoulder Soft Tissue Injury?

[237SJ]

Last week my mum turned over in the night and heard a few "snicking" noises in her shoulder/collarbone area. We happened to be at the cancer unit the next day so they did an x ray and said there was no fracture. I was relieved as I was sure (with bone metastasis) that something had snapped. The doctor said the pain was bone met pain (she hasn`t had that so far, touch wood) but surely if it was that, it wouldn`t come on suddenly? He prescribed co-codamol which isn`t doing much at all. We have to see him regarding the pain management again this week. It was marginally better the other day but she was going up the stairs at my place (no stairlift) and pulled on the bad arm again which set it back. That also sounds like tissue injury to me. She can`t raise her arms above her head and reaching down also hurts. I`ve never challenged a doctor but how do they react when you do. Is it OK to suggest and MRI and do they even have gaps for unscheduled MRI scans in the way they do at x-ray?

[Canary42]

Since the NHS now concentrates on saving money instead of saving lives you will have to make a big fuss - but go ahead and do so, you've a right to.

[237SJ]

Well yes, you`re probably right there Canary

[Sqad]

237SJ...what is " met pain" that you mention in your OP.
due you mean metastatic pain?

[237SJ]

Yes, sqad.

[Sqad]

Well......from your OP.....the X-Ray showed no metastasis so I can,t understand why the doctor said that the pain WAS bone metastasis.

Before I go on......can you put me right.

[Mamyalynne]

Sqad, I may be reading it wrong but I think she has Bone metastases but the X Ray showed no fracture.

[237SJ]

We know there is metastasis in the arm although it`s not the worst one she has. I just can`t see how it would suddenly start hurting and why it would only hurt at the shoulder when she moves it in certain positions. If she`s sitting still, it doesn`t hurt.

[Sqad]

mamy...yes, I have read it again and I agree, no fracture but evidence of metastasis.
Sorry SJ, I am a bit slow today.

Metastatic pain can come on quickly and suddenly without the evidence of a fracture and this indeed does sound like what has happened.

As for an MRI......what would be the point as a conventional X-Ray has already identified a boney metastasis.
I think that bone pain management is the important factor here.

[Sqad]

SK...we have cross posted.......the sit of the metastasis in the shoulder will determine the positions of muscles which wil or will not cause pain.

[237SJ]

Thanks sqad. I was kind of wondering if the fact that she has known bone mets there might have confused the issue and the doctor was assuming it`s pain from that when in fact it`s something else.

[bednobs]

i agree with sqad -what would your ideal outcome of an MRI be - if it is soft issue injury, the treatment is the same as if it was a met causing the pain, and depending on your mum's general health, similar to treating a fracture conservatively. The main thrust of treatment for thise would be pain relief

[Sqad]

237....bednobs has summed up the situation perfectly.

The diagnosis of shoulder metastasis and pain is based on conventional X-Ray findings and as bednobs has said an MRI would not take us any further.