What amount of pain, nerve pain and muscle spasm is normal 5 wks posto

Posted by servicedogmom @servicedogmom, Sep 10 10:20pm

Hi! I’m new here and hoping for reassurance and guidance.
My background history is…I was an EMT for 20 yrs, worked on an ambulance and in an ER. Total of 45 yrs in the medical field. Over the years I had several surgeries on my shoulders and elbows. I’ve had a torn rotator cuff, severe osteoarthritis bone on bone with significant spurs. I’ve had previous labrum and bursa repairs, injections, PT, rest etc…. I finally needed a replacement. I’m 5 weeks post-op left total reverse shoulder. According to my surgeon, my surgery went well, he had some difficulty with my muscles because they were “tight”. (I’m a 60 yr old woman who is active and in decent shape for my age.) He wasn’t expecting that and “had to work for his money” per his PA. At my 14 day post-op for staple removal, I was taken out of my brace with orders of no weightbearing for 6 weeks per his PA. I asked for a refill of my pain meds, “I’ll refill them but people are usually turning the corner with their pain by now ‘. I’m thinking to myself, it’s only 2 weeks! He gave me a refill of 20. I was only taking them at night to sleep. I was very careful at home, still wore the sling when my arm needed a rest and at night for comfort. Was icing at normal intervals. At three weeks I started PT with passive exercises. I had and still am experiencing significant nerve pain with movement and muscle spasms. My hand becomes numb and tingles, my upper arm stays numb. At 4 weeks I started having popping/grinding of the joint. I mentioned this to my PT, he was concerned and held off on exercises. I too was concerned. I sent my Dr/PA a message regarding this, still haven’t heard from them. This week, 5th; I’m still having more pain than I feel I should, the nerve issues, muscles spasms and not sleeping well because of pain. I’m frustrated and worried something is wrong. I have my 6 week post Op on Monday. Definitely going to discuss this at that time!

How much of this is normal at 5 weeks? I’m frustrated, tired of being in pain (which I have a fairly high tolerance) and not receiving answers. Am I expecting to much to soon? Any advice from someone who has been through a reverse total shoulder?

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ddsack | @ddsack | Sep 11 9:46am

I don't think you are expecting too much too soon. Each patient's levels of pain will vary depending on your unique body's reaction to any surgical trauma and types of procedures used by the doctor during the surgery. However, it sounds like the surgeon had to deviate from his normal work because of "tight muscles" - (can they still be tight while under anesthesia? Or did he mean a small area to work in because you are a small person?). It's possible he affected unexpected areas, nerves etc that will take longer to heal.

Since the surgeon and his staff know your procedure was not his normal quick work, I would think they would be extra accommodating to pain medication and following your progress in healing. By 5 weeks, you should be feeling better, not worse. Definitely speak up firmly at your upcoming appointment. Maybe ask for an MRI along with the Xray they normally do at a re-check. Good luck, I hope you can find answers and start a true healing process.

Sue, Volunteer Mentor | @sueinmn | Sep 11 10:22am

@servicedogmom No reverse shoulder replacement here, but complx rotator cuff repair with torn biceps (and numerous other ortho surgeries) Nerve pain, numbness and spasms are common, especially if the surgery is more complex than anticipated. Muscles take a couple months to heal, nerves can take longer to regenerate. Numbness, pain and tingling are common complaints, and can change day to day, sometimes even minute by minute.

I think you are experiencing normal recovery issues and need to be kinder to yourself. Also, consider using the ice up to several times a day to ease symptoms.

Have you tried alternating ibuprofen and acetaminophen every 4 hours in place of stronger pain meds? The key is to take them on a regular schedule, not wait for pain to remind.

Sorry the doc is not responding. I would pester them by phone as often as necessary to get a reply.

steve161 | @steve161 | Sep 11 12:15pm

...first, I agree with the previous comments with one note, your dr/pa said "no weight bearing for 6 weeks". I'm assuming that was after the first 2 weeks, so now your needing to take it easy for 8 weeks...from your history you've had a lot of medical work done and after 2 decades of my guess very intense work as an EMT (thank you for your service!) and another 2 decades in the medical field your body has taken a beating and maybe my guess is that it's taking longer to recover from hard work. When you add in all of the medical procedures you've endured you also probably know just how your body feels when it's time to rest or when it's OK to get out there and live your life. So my advice is to listen to your healthcare team and especially your body, you know it better than anyone, give it some time and stay positive. Your dr/pa said the surgery went great, so use that as permission to think of who you were "before" and work on your to do list and develop an exercise plan and stick to it, to get back to normal.
I'm 80 and a year ago I had an accident causing me to fall backwards from a 30" high platform landing on the back of my neck crushing the C4 disk and my left wrist not working the same. A week in the hospital, 6 weeks in a rehab facility and several weeks at home all while in a neck brace before corrective ACDF surgery. The week after the accident the cast on my left arm/wrist was removed after x-ray's indicated nothing was wrong except no strength in the wrist when picking up anything with a little weight. Then 2 weeks after ACDF surgery the neurologist told me the plate in my neck has made that portion of the neck very tough, with range of motion being my only issue. Have to admit there were some low spots then I remembered a phrase "And this to will pass" made a difference and I started looking at the things that worked and the stuff I had to work on. Specifically I had to build up my left arm/wrist/hand strength. Today the arm/wrist/hand are all back about 80%. Nerve damage from the left shoulder to the hand has subsided a lot with some small spikes and lingering discomfort. I was able to ween myself off of Gabapentin (nerve pain meds) and have added CBD cream for hands before bed to take the edge off while sleeping. Bottom line I'll be a few steps slower going forward, but that's OK with me, could have been worse...I hope some of what I've said helps...and if there are any questions I can answer just ask away...