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Cervical fusion and Shoulder Pain why does it happen?

tonya42ttonya42 Posts: 810
edited 06/11/2012 - 8:27 AM in Back Surgery and Neck Surgery
I have read practically every post and what I can't understand from anywhere is it seems that most everyone has shoulder issues after ACDF surgery. Has anyone ever asked their doctor? I know it's one of those questions that is always on my list when I see him but then I get distracted by describing my pain and it just seems to get dropped. I understand the muscles and their connections but why does it have to create such dramatic pain? I've read people who have had their shoulders dislocated. Ligaments or tendons torn. I just wish I could be a fly on the wall during this surgery so I could see what is wrong with the way that they do this. Can't they find a better way? I wasn't counting on trading one pain for another. And I'm also seeking a second opinion about my shoulder because I've been through most all of the conservative treatments and don't know what else to do. Any ideas? Comments? Theories?
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Comments

  • Hi Tonya..I think we spoke about this a while ago as I have shoulder pain as well. I just had arthroscopic shoulder surgery yesterday..not (saying you will need that!) My cervical doctor said that when neck pain remains after a certain point and mri, etc are ok..he begins to spread out and look further for "connected" issues. He didn't have to look too far with me as I could not lift my right arm above shoulder height. His exam indicated AC shoulder issue. He gave me a shot and in a few minutes I had alot of relief! MRI showed issues (see my description below). Went to shoulder doctor who sent me for PT..and second shot 6 weeks later. returning to work as a special ed teacher, I was in un-imaginable pain (shoulder pain radiated to my neck) he told me something about 80% if neck people have shoulder problem or vice versa...don't remember.
    I had the surgery yesterday...which was a piece of cake compared to my neck!!!! In and out the same day.
    Has your doctor sent you for any additional testing? I guess it can't hurt!
    Feel better and let me know how you make out!
    Donna
  • Hi darlin,
    I dont' know why. Muscles and nerves being messed around with I guess and the degree of injury itself to begin with.
    I don't think there ever will be the "perfect" answer to that question as we all have so many different types of pains after surgery.
    My burning lasted forever for my cervical and spinal. The burning from my cervical in my shoulders down into my back was OUCHIE.
    Now I still 2nd lumbar fusion later still have the burning feeling in my lower back.

    You just keep on going girl like you tell me. Remember you were in a traumatic accident. Some of us well either just our pain built up over time or one day we woke up like myself and could not move my neck. So you had other things to contend with.
    Plus your only at 3 months post op going on 4.. And you went back to work early also.

    Ok back to the orginal question!! I'v never heard of shoulder dislocations to me that would be very rare and on the drs part.
    The ligaments being torn??? That to I would think and also would go along with the orginal injury.
    I mean your either cutting through the front or the back of the neck. So how in the heck could your shoulder get dislocated unless they flop you around that "hard" or ligmants getting torn in the shoulder would be a TUFF one also. Mabye the patient doing to much or not getting up the correct way after surgery???
    I really wish I had a answer for you..
    Mabye some people will pop in that have had this happen to them and describe to us how they got that way.....
    I'm very curious..
    Oh I don't know here we go again with me rambling on.
    Only cause hubby blocks me out I figured someone will read this AHAHAHAHAHAHAHA.

    K catch a later my guardian angel
    love yas!
    Terri
  • I'm just trying to figure out if there isn't some other way. I just don't know very many people who don't have shoulder pain of some sort after ACDF.
    Donna, He has had me do all of the conservative treatments and now we're trying deep tissue massage. That works for about 2 hours and then the knots and pains are back. I just can't work like this. So yesterday I figured I was entitled to a second opinion so I scheduled one with an ortho that I have seen before at another hospital. Shoulders are his specialty. I know that I have a trapped nerve somewhere in my shoulder because if I can ever get that muscle to relax it stops shocking my thumb. Oh which leads me to he said that my nerve study and EMG were normal. I looked him dead in the eye and told him there was no way on the face of God's green earth that it was normal. Wrong maybe but not normal. I just want a new set of eyes on the problem. He just keeps changing my muscle relaxers and granted they work for a while but I'm not one to take pills. I just want the problem fixed or for someone to tell me that it is what it is and learn how to deal with it. I'm glad to hear that your surgery seems to have gone well and wasn't as painful as your neck surgery. But I just can't imagine any conservative treatment that we haven't tried already. So I don't know what else to do.
    Terri, You know me. I'm so impatient. I can't stand this anymore. Maybe given more time it will go away on it's own but for today I just don't know how much more I can take. I don't know how to make it better. And I am sick of living on a heating pad.
    But I still want to know if there isn't a better way to do this surgery. They refine surgeries all the time. Why can't this be one of them? I just wish I had been a fly on the wall during my surgery to actually see what they do to a patient's shoulders while operating. Luv you girlfriend! I hope your pain is getting much better too.
  • Has you doctor looked into thoracic outlet syndrome? Since our accidents were both so violent and there was such extreme whiplash it's something that I hope that they would rule out.

    Just a thought,

    Griff
  • Maybe the shoulder dislocations you remember reading about were mine? My neck/shoulder pain was so confusing to me before and it was more confusing to me because the pain is in my left shoulder.This just happens to be the shoulder that I had dislocated several times,so I was unsure when my pain suddenly got worse-if this was something new,a coincidence,or something to do with my neck.

    I've had problems getting good answers/any answers actually,and I've also had the nerve study done(at the hospital).It took quite awhile,but came back normal.Now normal means that I don't have carpel tunnel-because that's what they were looking for.

    I have a lump now that sits on top of my..between my neck and shoulder.It's been there since the 19th when I had my last injections,and though it's gone down a little,it's not changing in the past week.I feel that it's a muscle-maybe entwined with a nerve even.Hell,I don't know,but I do know muscle pain,and this is more than just that.My theory is that the shoulder pain is coming from the nerves (and muscles) leading away from my neck into my shoulder/arm.That would explain the tingling in my fingers-which I don't mind really,it's the pain that gets tiring.Numbness & tingling are a symptom I can handle..but has me believing from all that I've read that this is nerve and muscle related.

    Of course I'm only guessing because the Drs don't tell me much,and to be honest I'm sick of asking them.I think it's ridiculous to ask a question of your Dr and not get a straight answer.What are they afraid of..it's not Jeopardy-?
  • has the shoulder doctor done an mri to "see" what is going on? I had impingement from bone spurs (calcifications pressing on tendons. I didn't have an emg done after my neck surgery..did have abnormal one before..though. anyway, I was getting exact same symptoms from the shoulder that I got with the neck. this surgery, the shoulder guy removed all the bone spurs that were pressing on the tendons and also removed a small section of my collar bone. two days post op: no neck pain, no arm pain/numbness (except post surgical of course!)
    Maybe ask about an mri...just a thought.
  • Hi Tonya,

    Without going into my life story, I wanted to tell you what my doctor said about my shoulder pain which goes all the way down my left side. I did not have this problem with my two previous ACDF surgeries only the last one for C6-C7. When I asked the doctor about this new pain, he said it's perfectly normal as it happened when he had to open up the area to remove the bad disk. He said it pulled the muscles which caused a "whiplash like" effect. It is an awful pain and heat or cold treatments don't appear to help. I see him again on 2/4/09 and I am going to ask him again since it doesn't seem to be going away. I am finally supposed to return to work on 2/17 and I do not know how I am supposed to function like this. I wish you the best!

    Laurie
  • At this point he hasn't really said much of anything. He doesn't say he thinks it will get better or that he expected it or anything. He just keeps giving me different muscle relaxers and that's about it. Oh he did suggest the deep tissue massage since it's pretty much the last thing to try. Maybe he is just trying not to make it such a big deal since he's done 100's of these surgeries and knows something I don't. But he doesn't seem willing to share. I am going to for a second opinion Monday just to see what someone else thinks. Lord. I felt so bad for you when I heard you say TOS. I hope it isn't anything like that. I'm too busy praying for you. :)
  • I guess it was your post I was reading. I just remembered reading about a dislocated shoulder. Sounds like we're in the same boat. My doctor just comes in says how great everything looks and then writes me a new presciption for a muscle relaxer. How can everything be great if I need a muscle relaxer?! I know for a fact there is a nerve tangled up in my shoulder spasm but I DON'T know how to get to him to even entertain the idea. I love this doctor. He has such a great bedside manner but he aint the only good doc in town. I am ready to meet the doctor again on Monday and get his opinion.
  • I would have thought he would have done an MRI by now. Maybe it's just too soon for him to consider it but he's not the one in pain. That would be me. I'll let you guys know on Monday what my new doctor says.
  • Let us know what your doctor has to say. Maybe yours will have better answers than the rest of our docs have to say. I know how they have to move the muscles around and everything but I had surgery in early Oct. and I'm just really looking for some permanent relief. I can't keep living like this. It's amazing how much you use your shoulders. I'd never really given it much thought until now.
  • My NS warned me about the immediate post-op shoulder and neck pain and explained a lot was due to positioning for the surgery. They put weights on your head to pull it up and back and then weight your shoulders to pull them down. I read my operative report and the exact positioning and weights used were all described. Now imagine being in that position for several hours (although my surgery was only about an hour and a half, so I got off lucky). All of your soft tissues in your neck/shoulder region will be very stressed.

    Tonya, as for your long-term persistent pain, I think a lot of it may be due to your accident. I had a minor MVA 15 years ago and I suffered with severe neck and shoulder pain from the whiplash. I saw PT's, chiropractors and massage therapists for over 2 years until I reached "maximum medical improvement" from that injury. So you are not only dealing with the fusion surgery, but also the accident itself. My post-accident shoulder pain was much worse and lasted much longer than my post-ACDF pain.
  • I never put the two of them together until Griff and now you mentioned the accident. Maybe I should talk to the new shoulder doctor tomorrow about that. Maybe I've been so focused on my neck pain for so long and now that it is gone the shoulder pain has become more noticeable. I'm sure the combination of my car hitting a rock wall and my surgery couldn't have been good for my shoulders or any other muscle in my body for that matter. I did read my operative notes about the surgery. Interesting reading I must say. I found out that they used a 30 lb bag of sand to hold my head back. I thought to myself "Geez I only weigh 96 lbs did it really take 30 lbs to hold my head back?" I'm sure that didn't help. But I like you River was only in surgery for an hour and a half so I could definitely understand the discomfort afterward just not this kind of pain.
  • I know you are talking about after surgery shoulder pain but I thought it was worth mentioning that I have not had my neck fusion yet (C6/7,cancelled it) and shoulder pain/severe muscle spasm, is my biggest complaint. It has brought me to tears before & landed me in the ER from the pain. Pain meds barely touch it when it flares.

    Did you have the shoulder pain pre surgery also?
  • After my accident I had so much pain coming from everywhere that I really don't remember specifically having shoulder pain. Before my accident I didn't have any pain anywhere and hadn't even been to the doctor in 3 years. So to answer your question I'm not sure. Like Griff said I had severe whiplash so every symptom that I had I just attributed to that until my Ortho told me I'd be having surgery. I couldn't move my neck for 3 weeks until after surgery. It seems though that the shoulder pain has been there every day since surgery. I have knots that you can actually see and feel. It hurts to stand. Hurts to sit. Hurts to move. It just flat out hurts. :''(
  • OK~I haven't had surgey on my neck though...my neck hurt pretty bad,then one day..I mean literally -allofasudden- my shoulder pain started.It was *severe for about 4,6,8 ? weeks before it subsided.I say subsided because the pain is still there,but not near as bad as it was.

    *The reason I'm not certain how long it was severe is because of the other things going on in my life at the time.

    Tonya~do you find yourself trying to put your arm into really odd positions to lessen the pain,but whenever you move it in the slightest-or even bump it easy-it's terribly abnormal pain?

  • I have tried every position known to God and man to try to get relief for my arm. My arm is getting weaker and it hurts now to even write my name on a piece of paper. I've tried sleeping with it propped up on pillows just to take sure I don't sleep with it under my head (which I used to do before my surgery). I've tried keeping it straight by my side. Everything and not one position changes the symptoms. I even slept in my soft collar the other night thinking that if it was coming from my neck that might help in keeping it from bending while I slept. Even that didn't work. Yes most of the time the pain just gets worse. Reaching up makes it the ABSOLUTE worst. Anything above my shoulder.
  • hopefully you can keep detailed information concerning your pain! my arm and neck were terrible; just like before me neck surgery. but what gave the doctor the "clue" was when i said it was unbearable to lift my arm over my shoulder! Sorry for the pain; I understand!
    Donna
  • When my shoulder pain was at its worst, the doc sent me to PT and they would run ultrasound over it & then massage. There is also a little trick they can do to get the spasm to release its grip, a certain way they pressed a trigger point, I think. The PT gal could find the knots right away.

    They would work on me daily for 45 minutes & it finally calmed down...this is the only thing that has given me any relief. I had horrible migraines with it also.

    You have my sympathy, that muscle group is very painful when it spasms.
    Have you tried Bio Freeze?
  • I saw a new Ortho today that specializes in shoulders. Since we've already done all of the practical PT since my surgery and I have gotten zero relief he is going to start on a brand new therapy. Myofascial release therapy. I hear great things about it around here so I hope they are right. Tatiyana I didn't use that particular product but found one product that gives me some relief from the nerve pain down my right arm. He's also calling in his "neck guy" because even though my surgeon doesn't think the pain is coming from my neck he does. So we'll see. He did mention doing a myelogram which I hope it doesn't come to that as I understand that's painful. If this therapy works I will send this guy catered lunches for the next year! I would be so grateful. Just for the record he's the first doctor I've seen who didn't just write me a prescription and send me on my way. Thank goodness he is really taking this as seriously as I am.
  • After my neck surgery, I was having muscle spasms and pain in my right shoulder. The doctor sent me to PT. They noticed when I was doing some of the exercises (especially those with my arms and hands over my head) that my hands would turn pale white and they wouldn't be able to get a pulse in my wrist.
    My doctor sent me to a different doctor to check on the thoracic outlet (or whatever it is called). He said that it was probably what was causing me the problem, but that he would not recommend the surgery for it because it is seldom successful.
    I still have the pain in my shoulder. I try not to lift my arm or hand up...lol...which doesn't happen often when you teach and have to write on the board or when you are a photographer and are trying to take pictures.
  • A friend of ours on here Griff actually had a procedure on Monday for her TOS and she is scheduled for surgery. She's really loved around here and we will miss her while she recovers. She did however ask me about whether or not the doctor had considered TOS. He hadn't and I don't think this doctor does either. After doing some homework when she mentioned it I went and looked it up and found the tests that they do. The raised hand thing and holding your arms out to the side. Well needless to say I had to try it out. So I stood in front of the mirror with my palms out and made my son check my pulse. No loss of pulse with either position so I don't think that's it thank goodness. :D

    Donna, You are right this hurts like the dickens. I'd rather have ACDF surgery again than to go through this. You know how hindsight is 20/20? Well that being what it is the ACDF post surgery pain was so minimal I barely remember it anymore.
  • I injured my elbow. Now my Dr. wants me to go to get myofascial release and showed how I can do some myself by pulling down my fist and pumping and massaging my elbow the same time but it's easier if physio does it! Anyway, I hope myofascial release helps that pain in your shoulder caused by the neck. Take care. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • I hope beyond hope this is the answer. I've taken so many pain pills and muscle relaxers that I could have afforded a nice vacation this year with the money I've spent on medication alone. Never mind all the copays that went with every one of the prescriptions. I have tremendous faith in this doctor and I am looking forward to Thursday and my new PT. This program does require that I do my part at home but I will spend a lot more time in PT than I did in the other office. Tatiyana, just so you know they spent about a half hour with me and that was it. In the words of Griff "Let the healing begin!"
  • Have they used ultrasound yet? I would request that they do. That really helped break up the knots. If I remember right, the first 10-15 min was ultrasound, then massage (sometimes moist heat) and then stretching & band work.

    My experience with PT is that aside from the Dr's specific instructions, the care plan & goals are at the PT's
    discretion so treatment can vary greatly, it doesn't hurt to ask..

    I hope you get relief soon
  • chefaubie,
    There are actually 3 types of Thoracic Outlet Syndrome. One kind is nervogenic, meaning the nerves in the thoracic outlet are compressed by either muscle or an extra rib. This type has no bearing on the pulses while positioning the arm. The second type is Arterial which does affect the pulses. I can't remember the thirs type- sorry! I actually have BOTH of the first two types but we only realized the arterial type a few days ago.

    My surgeon has had incredible success with TOS surgery and is a pioneer in many of the methods used. Please PM me if you'd like more information. I think most docs give up on this condition because it's HARD to take care of and most simply don't have the training. Most cases of nervogenic TOS can be resolved with PT and no surgery is required.

    I've had a short amount of time to learn a lot about this condition LOL. I don't have all the answers but will answer any who want to PM me with them. I don't want to hijack Tonya's thread about it (especially since she said such kind words about me).

    Griff
  • I have scar tissue wrapped around a nerve which is causing me all of this pain. Please someone reassure me that PT will take care of this. I am still seeing another Dr. next Monday for my neck because both my Physical Therapist and the Doc who looked at my shoulders are very concerned because I am holding my shoulders and neck in very ackward positions. I would have never even noticed. The doctor is most concerned about the fact that the nerve has to do with my neck and not my shoulders as I had thought all along. My new Physical Therapist is about to put me through the wringer for the next month. Three days a week. But I cannot begin to tell you how much I look forward to the relief that I hope to gain from all of the hard work. Why didn't my surgeon suggest any of this? I'm still of the mind set that surgeon's have the attitude that they fixed you so there just couldn't be anything else wrong. I'm glad I got a second opinion because my new PT explained that this nerve damage could have become permanent if not treated. Believe me, I've read enough posts around here to know how true that statement is. So hopefully I will get even better answers from the new doctor next Monday too.
  • We tried ultrasound before but I just think we didn't spend enough time with it. The new physical therapist is sort of starting over from scratch with me because my neck seems stiff again. So ultrasound may help more now. I loved the heat therapy and still live on a heating pad but I would love to put this thing in the closet once and for all.
  • I'm so glad that you have an answer! Now get to work!

    Getting another opinion is the best thing that you can do sometimes. You are right, most surgeons don't believe that it could possibly be anything that they have worked on. I'm so happy that you took the bull by the horns and are on the way to getting this taken care of.

    Hugs to you gal,

    Griff
  • I am so glad you finally have an answer to your pain! now you and the pt can figure out a treatment plan! Good luck to you! donna
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