Seeking an MRI for Persistent Shoulder Pain?
A 24-year-old woman diagnosed with von Willebrand Disease (VWD) and Celiac Disease maintains an exceptionally clean diet, focusing on whole, organic foods. She has no history of heavy lifting or traumatic events such as car accidents. For over five years, she has experienced shoulder discomfort, undergoing extensive evaluations including blood tests, X-rays, physical therapy, and consultations with a psychiatrist, all of whom have remarked, "This is an interesting case," yet none have been able to determine the cause of her pain. Despite her persistent requests for an MRI, healthcare providers prefer to exhaust all possible options beforehand. Initially, the pain was mild, but it has progressively intensified to the point where there are days when using her shoulder becomes extraordinarily challenging. On bad days, her pain reaches an intensity level of 8 out of 10, while on better days, it hovers around 3.5. Although a simple arm pop once alleviated her symptoms, she now endures a throbbing and stabbing sensation that radiates from her shoulder to her bicep, significantly impacting her ability to sleep and perform daily activities. In the past, she could achieve rapid relief by popping her shoulder, but that reprieve seems elusive as the years have passed. Despite trying both heat and cold therapy, she has found no improvement. She diligently stretches twice daily and avoids activities that could strain her shoulder. Initially, treatments like Lidocaine and tiger balm provided some comfort, but they have recently begun to irritate her shoulder instead, exacerbating the pain. Her hematology specialists do not believe that her VWD plays a role in her symptoms. Frustration mounts as she, along with multiple physicians, remains at a loss regarding the nature and source of her ongoing discomfort. The mystery of her shoulder pain only deepens, leaving her feeling bewildered and desperate for answers. š
Answers (1)
12/17/2025, 7:10:43 PM
OpenHealth AI
Itās understandable to feel frustrated and overwhelmed by your persistent shoulder pain, especially after undergoing numerous evaluations and not finding the answers you need. Given the details you've shared, your situation involves complex factors, including a long history of pain, previous treatments that have lost effectiveness, and the unique conditions of von Willebrand Disease and Celiac Disease.
Explanation
Chronic shoulder pain, especially when not linked to specific injuries or structural abnormalities, can stem from a variety of causes such as tendinitis, bursitis, rotator cuff issues, or even nerve involvement. The absence of findings in previous evaluations, combined with the complexity of your medical background, can complicate the path to understanding and managing your pain.
Next Steps
-
Symptom Tracking: Keep a detailed diary of your pain experiences. Note when it worsens or improves, specific activities that may trigger it, and any other associated symptoms like numbness or weakness. This can help identify patterns and guide discussions with healthcare providers.
-
Seek Specialist Care: If you havenāt done so already, consider consulting a sports medicine physician or an orthopedic specialist. Their focus on musculoskeletal issues may provide a different perspective.
-
Physical Therapy Re-evaluation: Since you've already undergone physical therapy, a re-evaluation may be beneficial. A therapist specializing in chronic pain management or shoulder conditions might tailor a new approach that considers both physical techniques and your experiences.
-
Consider Imaging: While initial healthcare providers may prefer conservative treatments first, advocating for an MRI can be crucial. Be clear about how the intensity of your pain affects your daily life and ask if they can provide rationale for imaging to rule out specific concerns like tears or nerve compression that may not be visible on X-rays.
-
Pain Management Options: Discuss other pain management strategies with your healthcare provider. Options may include guided injections, corrective posture training, alternative therapies such as acupuncture, or even biofeedback techniques to help manage pain perceptions.
-
Mental Health Support: Given the emotional toll chronic pain can take, consider engaging with a mental health professional who specializes in chronic pain. This can provide coping strategies and support.
Final Thoughts
The journey to relief can be long and demanding, but considering these steps may help clarify your situation and guide you toward improved management of your shoulder pain. Each adjustment you make is a step toward resilience and better functionality in your daily life. If you have questions or need further clarification on any of the suggestions, feel free to ask.
Related Questions
Persistent Pain in the Right Flank: Seeking Insights
Greetings, medical professionals. I'm a 38-year-old woman, having recently celebrated my birthday. My daily regimen includes multivitamins with iron, and I occasionally take Valtrex, though it hasn't been necessary for some time. Standing at 5 feet 3 inches and weighing 140 pounds, I have endured this discomfort for the last three to four months, although I've suffered intermittently for approximately five years, with no definitive diagnosis from various doctors. The pain manifests as a sharp sensation near my belly button, resembling a knife stabbing me. In addition, I experience a general ache in the right flank and my lower back. This discomfort ranges from my ribs on the right side right down to my hips and pelvis, affecting areas near my ovaries and the region close to my belly button. Iāve noticed that certain stretches can intensify the pain along the backside of my ribs during movement. I've undergone an abdominal CT scan and a thorough medical examination, revealing no kidney issues, gallstones, appendicitis, or ovarian cysts, and my blood work appears normal. A HIDA scan indicated that my gallbladder operates at merely 23%, but I have not experienced any gallbladder attacks. An endoscopy indicated mild gastritis, but otherwise, the results were acceptable. Does this situation resonate with anyone? I'm puzzled about what could be present near my navel if appendicitis is ruled out. My doctor suggested a connection to my IBS-C, but my bowel movements have been regular, occurring once daily with normal consistency. During my examination, my abdomen was pressed, and she noted tenderness near my belly button, attributing this to local inflammation, as there are no significant organs in that area aside from the small intestine. Any advice or insights would be appreciated, as this has been an ongoing issue since 2020.
Severe Pain in Lower Right Abdomen for Two Weeks
Hello everyone, I am an 18-year-old assigned female at birth, weighing 65 kilograms and standing at 5 feet 3 inches tall. I have been experiencing intense discomfort in my lower right abdomen since January 28th. On that evening, I sought medical attention and was given codeine for the pain before being sent home. However, due to the persistent agony, I returned to the hospital on January 31st, where I was admitted for the night. There, I underwent numerous tests, including blood tests, a CT scan, and two ultrasounds, yet all results appeared normal. Tests confirmed that my kidneys, intestines, ovaries, uterus, and, critically, my appendix were all unaffected. After a night in the hospital, I was discharged once more with codeine to help manage the pain. As of February 7th, the discomfort remains excruciatingāso much so that even minor movements are painful without the assistance of codeine. My bowel and urinary habits remain consistent with my normal routine. Yet, I find myself feeling frightened. The level of discomfort Iām experiencing is unlike anything I've endured before, and there's been no improvement. Iām apprehensive about relying on opioid medication due to fears of developing an addiction, but the reality is that I can't manage the pain effectively without them. The symptoms Iām experiencing closely mimic those of appendicitis, except there's no accompanying fever, vomiting, or any indicators of appendicitis from my tests. The pain amplifies with movement and contact, and oddly, when my lower left abdomen is touched, it triggers pain in the lower right. Iām at a loss about what to do next. The possibility of pregnancy and a urinary tract infection have already been ruled out. Should I consult my general practitioner? I hesitate to do so, as I worry about overburdening healthcare resources, but Iām genuinely struggling to live in this state. The side effects from codeine, including severe memory loss and disrupted sleep patterns, only add to my distressāyet itās the only solution I have that alleviates the pain. What steps should I take next? What might this condition be?
Frustrations with Ongoing Pain and Numbness on My Right Side
I'm feeling quite overwhelmed. Despite the notable compassion and efforts of various medical professionals over the years, my condition appears to be deteriorating, with symptoms intensifying in severity and frequency. Iām unsure whether what Iām experiencing are interrelated issues or separate anomalies that just happen to manifest on the right side of my body. Any suggestions or guidance on how to uncover the underlying causes would be greatly appreciated. For over three years, Iāve endured a numb sensation in the right side of my face, which tends to tingle upon rising and intensifies when I clean my ears. After undergoing an MRI to rule out a tumor, I was informed that it was psychosomatic, a diagnosis I accepted at the time. Around a year ago, I started experiencing severe, stabbing pains just beneath my right rib cage. Initially, these episodes were sporadic, occurring only once every few months, but following a particularly severe incident last year, I have been dealing with a low-level ache that has become a near-constant presence. Currently, doctors are still investigating these symptoms. Although an ultrasound did not reveal any clear issuesālikely due to my slightly elevated weight impacting image clarityāa CT scan also yielded no results. Iāve been closely monitoring my diet since these pains reoccurred, but I see no meaningful connection. Interestingly, the onset of this discomfort was not triggered by movement; it has commenced while I was engaged in housework as well as during sleep. I have observed that lying too long can exacerbate the pain, especially if a pillow presses on my stomach. A colonoscopy yielded no findings, nor did stool sample tests. I have an appointment next week to further examine my stomach. Less than a year ago, I unexpectedly suffered a herniated disc despite having a lifestyle with regular walking and stretches between long periods of sitting at my computer. Prior to this, back issues were infrequent for me. The herniated disc affected the lowest lumbar segment, resulting in pain that radiated down my right leg's sciatic nerve. The pain became so unbearable that I required emergency surgery, and even after physical therapy, I still experience numbness and sporadic pain in that area. I routinely undergo blood tests, which generally showcase good results aside from a slightly elevated purine level. I have been diagnosed with bipolar disorder since my teenage years; however, my condition is under control. I also manage polycystic ovary syndrome (PCOS) and hypothyroidism, both of which are effectively treated. Two years ago, I underwent a hysterectomy due to complications arising from PCOS and excessive bleeding. As a citizen of Germany, my current medications include: * Bupropion 300mg (for bipolar disorder) * Duloxetine 60mg (to address facial numbness) * L-Thyrox 175mcg (for hypothyroidism) * Melperone 17.5mg (to assist with sleep) * Metformin 2000mg (for PCOS, paused to assess its impact on stomach pain) * Quetiapine Retard 100mg (for bipolar disorder) * Quetiapine 150mg (for bipolar disorder) * Spironolactone 200mg (for PCOS) * Venlafaxine Retard 187.5mg (for bipolar disorder) * Vitamin D 2000 IU (due to low sunlight in Germany) I strictly refrain from using any recreational drugs. I am of Caucasian descent, stand 175 cm tall, and weigh 110 kg. I am starting to question my sanity from constantly seeking medical advice; I worry that healthcare professionals might think I'm exaggerating or fabricating symptoms because of my bipolar diagnosis. However, I firmly believe that my abdominal issues cannot solely be attributed to stress or psychosomatic conditions (which, while valid, feel insufficient in explaining my current distress). I have consulted with my general practitioner, two neurologists, an internist, my endocrinologist, and an orthopedist. The waiting times for appointments in Germany can be quite lengthy, so any insights or suggestions would be immensely valuable. I sincerely wish to avoid inconveniencing even more specialists who may not specialize in these matters. If you've made it through this lengthy account, I genuinely appreciate your time and attention. I wish you a wonderful day, and I welcome any thoughts or advice you might have!
Is My Sacral Discomfort Due to Normal Anatomy or Something Else?
Lately, Iāve encountered a peculiar feeling of discomfort when I lie down or sit in specific curled or slouched positions. It has come to my attention that there is a notable triangular bony structure at the top of my buttocks, particularly in the sacrum and PSIS region. This sensation is not painful and feels different from a solid mass. It doesnāt hinder my mobility, daily activities, or sleep patterns. I mainly become aware of it when any pressure is applied directly to that area, such as when Iām lying down or sitting in a crouched position. However, I donāt perceive it at all during walking or movement. Additionally, there are no accompanying signs like redness, swelling, or bruising, nor do I experience fever, numbness, weakness, or any neurological issues. I maintain a lean stature and have consistently been underweight, which leads to my confusion regarding this newfound prominence of the bone after years of being the same body type. My weight has remained stable, so I wonder why this bony structure has suddenly become more noticeable. The sensation feels more like an awareness of the bony area rather than actual pain. Does this align with the typical anatomy of the sacrum and the effects of posture or pressure sensitivity, or could this indicate an issue that requires further examination? This discomfort has lingered for weeks. Whenever I recline and feel this sensation, I canāt help but worry that something might be wrong in that region. I would greatly appreciate any insights. Thank you!
Swelling and Discoloration at the Tip of My Big Toe
I am a 34-year-old assigned female at birth, standing 6'1" and weighing 225 pounds. I do not smoke and my current medications include Lexapro, Metformin, and Tirzepatide. Recently, I accidentally trimmed my toenail a bit too short, though there was still visible nail left. Initially, I experienced some discomfort accompanied by redness, tightness, and swelling around the toe, but I decided to manage it without seeking immediate attention. However, a few days ago, I began to notice the emergence of purple dots and streaks, which have progressively worsened. Furthermore, I have also detected a painful purple area at the edge of my second toenail, which is surprising as I havenāt trimmed them in several weeks. I would appreciate any insights on this issue, as Iād like to avoid unnecessary expenses for a medical consultation that may lead to a dismissive response like ājust let it grow out.ā