Wednesday, October 20, 2021

What Causes Shoulder Pain After Surgery

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After Rotator Cuff Surgery

Causes of Shoulder Pain after Spinal Surgery done for Back Pain – Dr. Hanume Gowda

I am a 56 year old female who usually has a high tolerance for pain. I had rotator cuff surgery on 12/15/16. I had one anchor placed during arthroscopic surgery for a full rotator cuff tear and bone spur removal. I’m having lots of pain, especially at night. I slept in a recliner for one week. Now I’m sleeping in the guest room propped up on pillows. And by “sleeping” I mean a few hours here and there. I miss my real bed and my real life. I’m weaning myself off Demerol, because I don’t want to become an addict living in a van down by the river! No offense to drug addicts I just don’t want to join them.

Physical therapy is very painful, but I’m doing my exercises daily….well, not as many reps as I should because it hurts so much afterwards. About a week ago a “therapist” we’ll call Hitler just about yanked my arm from my body. Things have been going downhill since, and it isn’t me on skis!

I’m really over this whole experience!

I want my right arm back…the one I use for everything!

I’m hoping to return to school to teach 95 seventh graders in four days. Too ambitious? I did practice driving left-handed for a month before my surgery,

Thoughts? Advice?

  • Posted 4 years ago

    I had cuff surgery on 11/15. Still can’t right arm. Therapist tells me only can do range of mtionr until doc says

    strengthening is next. Read it can take up to a year for normalcy. Haven’t driven since surgery.

  • What About Tendon Transfers

    A tendon transfer is an operation where the tendon of another muscle around the shoulder is moved to replace the rotator cuff tendon. There are a couple of tendon transfers that have been described for this purpose . The first is a large muscle in the back of the shoulder called the “latissimus dorsi muscle.” While this is a large muscle, the tendon is actually very thin and not very big. While this operation was once advocated for patients with large rotator cuff tears with pain, the results were not as good as initially reported. This operation is helpful for only a minority of patients and has lost favor among shoulder surgeons .

    A second muscle and tendon transfer that was described once was the use of the deltoid muscle and tendon as a buffer or spacer for the space where the rotator cuff tendons were located. This operation was largely a failure and is no longer recommended.

    Tips For Relieving Intestinal Gas Pain

  • Walk. The most important thing you can do after surgery to prevent and relieve gas pain is to walk. Walk early and walk often. I know its not easy, but I promise you that your doctors and nurses are not being needlessly cruel when they ask you to do it. Walking encourages the peristaltic movement of the bowels, relieving gas and constipation. In addition to preventing gas pain, there are many other benefits to walking after surgery such as preventing blood clots and preventing ileus intestinal stoppages.
  • Leg exercises. Other types of movement like pulling the legs up to the chest and releasing them, rocking back and forth and turning from side to side may also help by stimulating the bowels. Be careful though, because these exercises may be too painful to do, depending on the site of the surgery.
  • Heating pads. Heating pads may also provide relief. Remember if you had abdominal surgery, you may have some numbness on your abdominal wall. Do not apply a heating pad to numb skin or burns could result.
  • Hot tea. If you are allowed to drink, hot tea is a great remedy to help gastrointestinal motility and relieve painful gas pains.
  • Medications. Some prescription such as simethicone, which allow gas bubbles to be eliminated from the body more easily, may be used to help with gas pain relief.
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    Revision Surgery Due To Infection

    Surgical cultures obtained from shoulders requiring revision of a prior arthroplasty due to pain, stiffness, or loosening are frequently positive despite the absence of preoperative evidence of joint sepsis. Often these cultures are positive for organisms such as Propionibacterium acnes and Coagulase-negative Staphylococci that are less commonly recovered from revision surgery in other sites of joint replacement such as the hip or knee.

    These organisms are distinguished by:

  • their presence on normal skin,
  • their failure to engender systemic manifestations of infection such as elevated C reactive protein sedimentation rate and white blood cell count,
  • their failure to produce local clinical evidence of infection such as redness swelling and tenderness,
  • the low yield of cultures of joint aspiration, and
  • the difficulty in eradicating infections with these organisms.
  • We recently completed a study regarding cultures obtained at the time of revision arthroplasty. The abstract from this as yet unpublished study is reproduced below.

    Methods: The culture results from 193 consecutive shoulder arthroplasty revisions for pain or stiffness, but without clinical evidence of infection, were correlated with a host of preoperative and intraoperative observations. Univariate and multivariate logistic regression models were used to identify factors predictive of a positive culture for P. acnes or other organisms.

    Culture-specific intravenous antibiotics are used for a minimum of six weeks.

    Revision Surgery Due To Superior Instability

    Prolotherapy for Rotator Cuff Injury

    Loss of the integrity of the coracoacromial arch can be a major problem following shoulder arthroplasty, allowing anterosuperior escape of the proximal humerus from the glenoid. This problem is often caused by prior surgery attempting to repair a large rotator cuff tear. It is most commonly seen when an acromioplasty has been performed, compromising the stabilizing effect of the coracoacromial arch.

    In this situation a reverse total shoulder arthroplasty may be considered.

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    How To Dress After Shoulder Surgery

    In the early phase of your recovery, you should wear loose-fitting clothing you can easily put on and that fit over your sling. Wear shirts with a zipper or easy-to-use buttons, rather than having to pull them over your head. Shirts that dont require you putting your arm above shoulder level will be best.

    Wear bras that close in the front to make them easier to put on during your early post-operative phase. If you dont have or cant purchase a bra like this, put the bra on backward where the clasp is in the front, and then twist it around to your back once clasped.

    Wear shoes you can put on easily with one hand, preferably with no laces, since trying to tie shoelaces with a single hand could be a big challenge. Velcro or slip-on shoes are best.

    Things You Need After/post Shoulder Surgery

    To help make your recovery a smoother process, consider buying the items below before going in for your shoulder surgery.

  • Detachable showerhead: Youll likely need to keep your incision dry for a certain period. Detachable shower heads make it simpler to avoid wetting your incision.
  • Shower chair: A shower chair will help minimize your risk of falling since you can sit down while you shower. These are helpful after youve had surgery or if youre taking pain medications which can make you dizzy or tired.
  • Waterproof bandages or plastic bags and athletic tape: You may want to cover your incision with a large waterproof bandage or plastic bag using tape to keep it from getting wet until your doctor says its OK to do so.
  • Pump soap: Use soap from a pump container to make showering simpler with one arm.
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    What Type Of Surgery Do I Need

    Surgery can relieve your pain and restore function to your shoulder. Some are done on an outpatient basis. For others, you may need to stay in a hospital.

    The most common types are:

    Arthroscopic repair. After making one or two very small cuts in your skin, a surgeon will insert a tiny camera called an arthroscope and special, thin tools into your shoulder. These will let them see which parts of your rotator cuff are damaged and how best to fix them.

    Open tendon repair. This surgery has been around a long time. It was the first technique used to repair the rotator cuff. If you have a tear thatâs very large or complex, your surgeon may choose this method.

    A large incision is made in your shoulder, then your shoulder muscle is detached so the surgeon has direct access to your tendon. This is helpful if your tendon or shoulder joint needs to be replaced.

    Both of these surgeries can be done under general anesthesia, which allows you to sleep through the whole thing. They can also be done with a âregional block,â which allows you to stay awake while your arm and shoulder stay numb.

    You can talk to your doctor ahead of time about the type of anesthesia you prefer.

    What Happens During A Cholecystectomy

    Pain Management Tips After Shoulder Surgery with Dr. McKay

    You may have a cholecystectomy as an outpatient or as part of your stay in a hospital. The way the surgery is done may vary depending on your condition and your healthcare providers practices.

    A cholecystectomy is generally done while you are given medicines to put you into a deep sleep .

    Generally, a cholecystectomy follows this process:

  • You will be asked to take off any jewelry or other objects that might interfere during surgery.

  • You will be asked to remove clothing and be given a gown to wear.

  • An intravenous line will be put in your arm or hand.

  • You will be placed on your back on the operating table. The anesthesia will be started.

  • A tube will be put down your throat to help you breathe. The anesthesiologist will check your heart rate, blood pressure, breathing, and blood oxygen level during the surgery.

  • If there is a lot of hair at the surgical site, it may be clipped off.

  • The skin over the surgical site will be cleaned with a sterile solution.

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    What To Do About Your Pain

    Pain after surgery is a normal occurrence. Your surgeon should prescribe or recommend appropriate pain medication for you to take after your procedurethis does not mean you will have no pain, it means your pain will be tolerable.

    If your pain suddenly increases or becomes unmanageable, it is important to contact your surgeon. This can be a sign of a change in your recovery.

    Your pain should, in general, slowly improve each day after surgery. Don’t hesitate to use your pain medication as it is prescribed, as “gutting it out” can actually slow your recovery and prevent you from being up and moving in the days and weeks after surgery.

    How To Relief Shoulder Pain After Laparoscopy

    Shoulder pain after a keyhole or minimally invasive surgery will go away on its own after a few days. If you our pain is disturbing enoughand you really want something to relief it, there are a few things you can doto help. They include:

    • Take some pain killers like Paracetamol or Tylenol. You can take up to1gram four times a day.
    • If you can get hold of peppermint oil liquid, many persons have reportedfinding this helpful in overcoming their shoulder tip pain.
    • Warm bath and hot drink. This helps warm you up internally and increasesrate at wish the trapped carbon dioxide inside you escapes out.
    • Have as much rest as possible. Seating up, standing and walking worsensthe pain. Lying down and having as much rest as you can in the next day or twowill help.
    • If despite all the above measures you still suffering with this shoulderpain after laparoscopy, do not hesitate to call your doctor, especially if thislasts for more than 5 days.

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    Obesity Is A Risk Factor Too

    Of all the factors studied and analyzed, obesity stands out by far as a major risk factor, followed by cigarette smoking. During 1968 and 1974 a group of approximately 17,000 women ages 25 to 39 years of age were recruited to a study conducted in Oxford, England. By the end of 1981, 227 of the women in this study had developed gallbladder disease. This is a fact that was confirmed via surgery. Solution: Moderate exercise, walking, jogging, gym workouts help the body burn excess pounds and this is highly beneficial from a digestive standpoint.

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    There Are Different Types Of Gallstones

    Most common type of surgery for shoulder pain given to ...

    Gallstones can range from the size of a tiny grain of sand to larger than a golf ball. Eighty percent of gallstones are cholesterol stones. The remaining twenty percent are called pigment gallstones. Cholesterol gallstones are nearly undetectable from surrounding fluids because their composition is nearly identical gallstones are composed of bile, which is high in cholesterol, and cholesterol gallstones are composed of this same bile. That is why someone with a high concentration of cholesterol gallstones can have an ultrasound and it will come out negative for gallstones or liverstones in the liver. Cholesterol gallstones, in our humble opinion, are the worst type of gallstones you may have because they are silent, obstructive and prevent the liver from performing all sorts of important functions. It is only when the liver has become too saturated with these cholesterol deposits, that the resulting ultrasound test may show a white mass that is commonly referred to as a fatty liver deposits, but by then the condition will have been present for a long time.

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    What Happens If You Dont Pass Gas After Surgery

    Ileus is the medical term for this lack of movement somewhere in the intestines that leads to a buildup and potential blockage of food material. An ileus can lead to an intestinal obstruction. This means no food material, gas , or liquids can get through. It can occur as a side effect after surgery .

    Causes And Symptoms Of Rotator Cuff Problems

    Sometimes, your rotator cuff tendons can become pinched by the surrounding bones or can tear. Issues like these can happen due to an injury such as falling on your arm. However, wear and tear over time can do a number on your shoulder as well, causing severe pain.

    Common symptoms of rotator cuff problems are:

    • Weakness
    • Trouble raising your arm overhead
    • Pain occurring mainly at night
    • Cracking sensation when you move your shoulder

    You can treat many rotator cuff problems at home. Your doctor might suggest shoulder arthroscopy if you have a condition thats painful and doesnt respond to nonsurgical treatment. While you need to know how to prepare for shoulder surgery, you also need to know proper postoperative recovery tips.

    These rotator cuff surgery recovery tips could help make the healing process better, allowing you to start participating again in physical activities.

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    How Much Does Rotator Cuff Surgery Cost

    The price of rotator cuff surgery will depend on several factors. Estimates range from $6,628 to $11,180, but talking to your insurance carrier is the best way to get an accurate estimate for you. The price of the surgery will hinge on variables such as your insurance coverage, your annual deductible, your coinsurance and your out-of-pocket maximum. The cost of the surgery will include the surgeon, anesthesia, imaging, lab tests and the hospital. You could receive separate bills for each of these services. When talking to your insurance company, it can be helpful to reference specific codes related to shoulder arthroscopy. Commonly used codes for arthroscopic rotator cuff repair include:

    • 29821: Shoulder arthroscopy

    Biceps Tendonitis And Tears

    Treatment for nerve pain after shoulder surgery

    The most common cause of biceps pain is inflammation of the tendon. Inflammation may cause swelling and pain around the biceps tendon, and over time it can lead to the development of damage to the tendon, including tears. Tears within the biceps tendon can lead to persistent pain that sometimes requires surgical treatment.

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    Intraperitoneal Gas Pain Relief

    Intraperitoneal gas pain results when gas becomes trapped in the abdominal cavity and is usually the result of laparoscopic surgery. While this kind of gas pain may be unpleasant, laparoscopic surgery is a minimally invasive surgical procedure that typically has a shorter recovery time with less overall pain.

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    What Do I Do If My Tendon Has Not Healed

    The reality of rotator cuff surgery is that while most tendons heal back to the bone after surgery, not all repaired tendons heal completely, and some do not heal at all. There are many reasons for this lack of healing with surgery. The first is that the rotator cuff tendons are large tendons which may have too extensive damage to heal. The rotator cuff tendons are big, and there are four of them. Each rotator cuff tendon is as thick as your little finger and as wide as two to three fingers. The chance that the tendons will heal with surgery is directly related to how large the tear in the tendons was before surgery. How to determine the size of the rotator cuff tendon tear will be discussed below.

    The second reason that the tendons may not have healed with surgery is that these tendons begin to wear out in most humans beginning around the age of 30, and the amount of wear and tear varies from person to person for reasons we do not understand. This wear of the tendons occurs in some people but not in others. By the age of 50, many people have some wear of their rotator cuff tendons.

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