u/Active-Bus7907

Age: 72

Sex: Male

Height/Weight: 5'8", normal weight range Medications: Butrans patch, thyroid medication, salt pills.

Smoking status: Non-smoker

Location: Midwest, US

Background: Over the past three years, my family member has had the following procedures: arthroscopic meniscus repair (right knee), arthroscopic supraspinatus reattachment (right shoulder), and reverse total shoulder arthroplasty after the first repair failed. There is also a known 50% supraspinatus tear on the left side.

Cervical spine MRI shows multilevel degenerative changes with severe right foraminal stenosis at C5-6. EMG shows mild chronic C5/6 radiculopathy.

What's been tried: Steroid injections, cervical epidural, nerve blocks, peripheral nerve stimulator (removed due to increased pain), acupuncture, rheumatology workup (normal), and a major clinic review that declined to offer an appointment.

Current status: Prior to this, he was fully independent and walking 10,000–15,000 steps daily. He is now at approximately 1,200 steps/day with a 10-minute standing tolerance and pain at 6-7/10.

Pain management has described the pain as mechanical in nature and not consistent with a surgically correctable issue. No clear path forward has been identified.

Question: Are there specialist types, diagnostic approaches, or treatment avenues that are commonly overlooked in cases like this? What would you want ruled out at this point?

My family member (early 70s) has been dealing with escalating pain for the past three years following a series of orthopedic surgeries — shoulder (twice, including a reverse total shoulder arthroplasty), knee, and now a spine component. Gone from fully independent and active to about 1,200 steps a day. Pain is 6-7/10 most days.

We've been through orthopedic surgeons, spine specialists, pain management, epidurals, nerve blocks, nerve stimulator, acupuncture, rheumatology workup, and even a major clinic review. Nothing has moved the needle.

The current thinking is that the pain is mechanical in nature but no one has a clear path forward. We're not sure if we're missing something, asking the wrong questions, or just haven't found the right specialist yet.

Has anyone navigated something this complex? What helped? What do you wish you'd done earlier? And has anyone worked with a nurse case manager or patient advocate who was actually useful in a situation like this?

My family member (early 70s) has been dealing with escalating pain for the past three years following a series of orthopedic surgeries — shoulder (twice, including a reverse total shoulder arthroplasty), knee, and now a spine component. Gone from fully independent and active to about 1,200 steps a day. Pain is 6-7/10 most days.

We've been through orthopedic surgeons, spine specialists, pain management, epidurals, nerve blocks, nerve stimulator, acupuncture, rheumatology workup, and even a Mayo Clinic review (declined to see him). Nothing has moved the needle…it’s only gotten worse.

The current thinking is that the pain is mechanical in nature but no one has a clear path forward. We're not sure if we're missing something, asking the wrong questions, or just haven't found the right specialist yet.

Has anyone navigated something this complex? What helped? What do you wish you'd done earlier? And has anyone worked with a nurse case manager or patient advocate who was actually useful in a situation like this?

My dad (early70s, Milwaukee area) has been through multiple surgeries over the past few years — shoulder, knee, spine involvement — and is dealing with significant ongoing pain that hasn't responded to a number of interventions. He's seen orthopedic surgeons, spine specialists, and pain management, and we're at a point where we need someone who can step back and help us make sense of everything.

Specifically looking for a nurse case manager or patient advocate with experience in complex orthopedic or musculoskeletal cases — not general chronic pain, but someone who understands the surgical and specialist landscape and can help coordinate and prioritize next steps.

Has anyone in Milwaukee worked with someone like this and would recommend them? Or know how to find the right person?

Thanks in advance.