What causes burning pain in anterior right shoulder?

Posted on Fri, 27 May 2016

Question: I have burning pain in front right shoulder like I have a heating pad on it. I take methaltrexate and Predisone but not helpingX going on a year. It was pretty sudden on set and first treatments if Predisone helped for like 4 months. Doctor weaned me off the steroid and now in back on. This time no help. It's spreading to other shoulder. Blood work .33 for weak positive RA. I'm really tired of the pain.

Answered by Dr. Neeraj Kumar (36 minutes later)

Brief Answer:
Get investigated and consult a Rheumatologist

Detailed Answer:
Hello, welcome to HCM,
I have gone through your question and understand your concerns.

For Rheumatoid arthritis involvement of shoulder joint is less classical. Involvement in rheumatoid usually occurs in joint of hand, wrist, neck.

You can get anti CCP tested for rheumatoid arthritis.

Any neck pain?
Any trauma?

Any headache, vomiting, fever, swallowing difficulty, speech abnormalities.

You can add Pregabalin or Amitryptiline for pain relief along with Methotrexate and Steroid.
Confirmed diagnosis is important for treatment of Rheumatoid arthritis.

Opinion of a second Rheumatologist will be helpful.
Hope you found the answer helpful.

Do get back to me for further queries.

Regards
Dr N Kumar
Neurologist

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Neeraj Kumar (1 hour later)

Blood work, I assume same test you mention, was 33 "weak positive for RA. Spinal fusion in 2014, but Test in April '15 ruled out spin. This is the second Rhumatologist and I started Amatriptelyne last night. Maybe I should go to a sports medicine Doctor? Side effects now are sleeplessness and heart burn. I'll keep trying.

Answered by Dr. Neeraj Kumar (6 hours later)

Brief Answer:
Take treatment as advised, visit a neurologist

Detailed Answer:
Hello,
In view of cervical spinal fusion possibility of nerve root compression is there.
You should take pain modulator drugs like pregabalin or amitryptiline or gabapentin.
The dose of amitryptiline can be increased as it induces sleep as well. You can increase it to 25 mg in a week.
For heart burn you should take a proton pump inhibitors regularly.
A visit to a neurologist or neurosurgeon may help by examination and assessment regarding nerve compression.
He is the right person to manage cervical radiculopathy.
Regards
Dr N Kumar
Neurologist

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Neeraj Kumar (2 days later)

Thank you so much.

Answered by Dr. Neeraj Kumar (2 minutes later)

Brief Answer:
Wishing you good health

Detailed Answer:
Hello,
You are always welcome for your medical queries.
Wishing you good health and early recovery.
Kindly rate the response before closing the thread.
Regards
Dr N Kumar
Neurologist

Above answer was peer-reviewed by : Dr. Naveen Kumar