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Muscle "knot" in trapezius immediately after ACDF

CMCCM Posts: 100
edited 06/11/2012 - 8:28 AM in Back Surgery and Neck Surgery
I had ACDF on C5/C6 the day before yesterday. Before going into surgery, my main symptom/complaint was muscle tightness in my trazpezius (where my neck and shoulder meet) and upper back (thoracic area) - all on the RIGHT side.

The first thing I noticed when I woke up in the recovery room was muscle pain in my LEFT trapezius. I immediately told the nurse about it and she said that was normal after ACDF surgery because that was the side where the surgeon made the incision and where he retracted the muscles so he could work on my neck. When I told the doctor about the pain he said "that is not unexpected". "Not unexpected" for whom? I sure which he had warned me about it. In all the handouts I was given I never read anything about expecting this pain.

Aside from the sore throat (which hasn't been too bad), this muscle pain is my only complaint. Neither of the pain medicines (intravenous Fentanyl in the hospital, Darvacet pills now) seem to help much. The muscle just stays tight and I have this huge, sore "knot". Could someone else who has had ACDF please tell me if they had this problem immediately following ACDF surgery, and, if so, did it go away? I am worried it will not go away. What is ironic is that I had the exact same pain in the exact same spot before surgery, except on the RIGHT side, not the LEFT side! :| Incidentally, the pain I had on my right side prior to surgery is now gone. So, in that sense, the surgery was a success.


  • Bubblegum, thank you for replying. It is encouraging to hear that yours eased-up after about a week. Thanks.
  • Hi there, unfortunate your doc didn't warn you about this... mine said to expect muscle spasms after the op and that they can take awhile to settle down. part seemingly has to do with the operation itself, but apparently after the op the "space" internally is physically different and the muscles need to realign - which takes time... My op is in a couple of weeks... must say i'm not looking forward to that part of the recovery.

    Best of luck with the best of your recovery and hope its a speedy one!
    L4-L5 fusion 1998; ACDF C4-6 2008; DDD
  • I had severe muscle knots in my shoulders and neck after my ACDF. I was told to expect this from the weird positioning and soft tissue trauma during the surgery. The narcotics really didn't help. I did get a little relief from muscle relaxers (methocarbabol and valium), but the best was heat, ice and massage. I just treated it like any other muscle spasm. A nice hot shower followed by someone massaging those tight muscles really helped. Don't worry, it gets better.
  • Rivertime, thanks for letting me know yours got better over time. That is encouraging. I think I will call my surgeon's office Monday and ask for a muscle relaxer. I tried an ice pack today, but I did not notice a difference in the pain. I wish my surgeon had warned me about this.
  • Initially I alternated ice and heat several times a day. (ice for the soft tissue inflammation from surgery and heat for the tight muscles). After about a week I just used heat several times a day. A soft, microwavable heat bag works great. If you don't already have one, you can make one by filling a tube sock with rice, sealing one end and heat it in the microwave for about 2 minutes. And don't forget the massage....recruit a significant other or a friend to work on the knots at least once a day after applying heat. I learned that this helped the first day I was still in the hospital.
  • Hi,

    I'm surprised I didn't see this post before. I never had pain anywhere other than in my neck (except headaches) before any of my surgeries. After my ACDF surgery in December of 2008 I have not been able to get rid of this excruciating pain that I have been told is my Trapezius muscle. My OS kept saying it was normal, similar to whiplash and that it would go away. He said it was caused by the muscle being pulled when he opened up the area to remove the disk. I have never felt constant pain like this before and if I would have known about this, I would have NEVER had that surgery done. My OS finally referred me to a PM doctor. I am unable to take most of the stronger pain medicines because of the side effects so I am constantly suffering with this pain. Tomorrow will be my second time trying the SNRB and trigger point injections.

    Has anyone ever had this problem to this severity and does it ever go away?

    Any comments would be greatly appreciated.


  • i had the same knot and pain after surgery. i asked the surgeon when he came in why it hurt there and never did before.he explained to me that when they position you on the table, tip your head back as far as it will go and tape your shoulders down to the table in order to open the disc space to remove them.so after 2 hrs in that position the muscles will be traumatized in your neck.therefore the knots and pain.
  • I think mine is WAY more than just a knot. It is excruciating pain that just won't end. Did your doctor say how long it usually lasts?


  • i hope the muscle spasm knot lets up soon and you get relief..take care....m
  • Thank you.

    I just had my second SNRB and trigger point injections a few hours ago and I am hoping that they do some good. The injection site pain is quite bad so I don't know if it's helping yet. I asked the PM doctor why I never had this happen with my two prior ACDF surgeries and he just said that it had to do with the positioning during each surgery. Lucky me. I honestly thought that more people would have had this problem but maybe I am wrong.

  • On Feb 18th, 2009 I have ACDF at C4-5 level..The history is kind of long so I can try to summerize. I was injured at work in Oct/08 lifting a 10lb box, 2 days later they finally decided to send me to a dr. I was examined, finding numbness in my upper arm/shoulder area. X-ray and MRI showed a large protrusion at C4-5 to the right side. Was referred to a neuro-surgeon. He said no surgery was needed and prescribed PT. A month later, no improvement, said still no surgery, goet trigger point injections. Did that...nothing. Two weeks later i receieved my first spinal epidural..nothing, 2 more weeks, another...nothing...Finally I was passed my 90 days and was able to get my own 2nd opinion instead of the panel of drs for work. 5 minutes with him he said "when do you want to have your surgery?"...Few weeks later ( Feb 19th/09 ) I was having my operation, all went fine, pain was gone. When I came off of the meds post op i had horrible muscle spasms in the right side of my neck and shoulder, along with horrible headaches. 4 months later I am still having the same intensity of spasms and headaches. No prescription to help ease them other than PT. Just saw the surgeon 2 weeks ago, said the fusion is healed after 4 months ( ive seen the x-rays to compare and i believe him ) He said he has no clue what is causing the spasms and released me back to limited work next week...PT says it just takes "time" I have done my at home excercises and everything that I was told...nothing....starting to get tingling in my upper back between my shoulder blades and the muscles feel tighter after a month of PT...anyone have any ideas of what I can do or how I can get to the root of this problem? I am only 26 yrs old....I am way too young for this to go on forever...thank you
  • I can only say when I woke up from that surgery, I had horrible surgery pain, and severe back spasms everywhere I had an acdf c4-6, I always had knots before the surgery, but after it was all over my back kept knotting up The doc and nurse had to press all different spots of my back it was horrible, I never slept the first 3 nights. that was 7 months ago, after 2 months I felt good, and that lasted for about 3 months, then it all returned. that surgery did not work for me. now, 7 months later, I am worse than before surgery, I cannot live like this. It took me 5 yrs to decide on the surgery. never again.
  • The knot in my trapezius did finally go away. I don't remember how long it took, but it wasn't very long. If I had continued to have the same pain for months on end, I would have strongly suspected either a problem with the surgery or maybe another disc had herniated or something, and I would have insisted on an MRI or some other imaging test.
  • MeME77MMeME77 Conyers GaPosts: 2

    How do you deal with the constant pain. I have a mental disorder and its seems to slowly be driving me insane. I'm in so much pain when I wake up most days unless I have pain meds I can't function I'm only 38years old i dont want to live with this forever I'm scared for myself because I hurt so bad some days I just shut myself away from everyone my fiance has to be starting to think he can't even deal with this anymore. I don't know that I could its been 16 months since my surgery and I've had the spinal injection, selective never root block , nothing has helped me. 
  • MeME77MMeME77 Conyers GaPosts: 2
    Hey there I had my cervical fusion done may 28 2015. I had severe pain afterwards in the opposite side where it was before surgery also I get severe headaches now that leave me in bed all day even with migraine meds. I am a very strong willed person and I've always worked hard however I can only maintain a job about two months at a time now due to chronic pain. I myself just started having the knots in my trapisus muscle the knot forms and runs all the way from my shoulder to the backside of my scalp where it attaches to my scalp
     I have been put back on the pain meds and muscle relaxers yet I can function  when on the pain meds it still hurts and I get very bad headaches however I can function but after working 4/5 days I'm done I only get enough pain meds to last 6 days and I'm in bed crying for two days rotating ice and heat. I resigned from a position due to my constant health issues last week I worked this week Tuesday and I've been in bed for two days with no pain meds a huge knot with swollen lymph nodes inside the knot but this year it's different its on the right side and severe pain in my right shoulder and chest. I had a new MRI recently and the primary doctor sent me to a new neurosurgeon I see them tomorrow however I need some relief I have three children to help raise my father and my father in law whom is both sick and need my care how do I do this in this much pain I'm literally vomiting from the pain.
  • LizLiz Posts: 7,832
    This is a very old discussion the member that created it has not been on the forum  for more than 2 years. For support i suggest you create a new discussion.
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    Liz, Spine-health Moderator

    Spinal stenosis since 1995
    Lumber decompression surgery S1 L5-L3[1996]
    Cervical stenosis, so far avoided surgery
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