Post-Clavicle Screw Removal: Managing Shoulder Discomfort After Surgery

About five months after the removal of the clavicle plate, there may be discomfort in the shoulder?

Hello, doctor.
I had the clavicle fixation plate removed in early February this year, and it has been almost five months since then.
I returned for a follow-up appointment and had an X-ray, which showed that the small holes from the plate have healed.
Currently, after about five months, my general mobility is normal, and I can raise my left arm without issues, but I do experience some symptoms.
When I raise my arm, I feel tightness in the upper part of my left pectoralis major near the clavicle, with a persistent sensation of tension.
My left arm feels tight against the pectoralis major, and it feels like the muscles are stuck together.
Additionally, my left shoulder and neck still feel relatively weak, and the skin around the surgical area near the clavicle is more sensitive, causing a prickling pain when touched.
I am unsure if I need to see a doctor for an examination, and if so, which specialty I should consult.
Should I continue with heat therapy, electrical stimulation, and stretching? Will these symptoms gradually resolve? Thank you.

Liu Xiansheng, 30~39 year old female. Ask Date: 2016/07/05

Dr. Shi Guozheng reply Orthopedics

It is advisable to see a rehabilitation specialist.
After the healing of a clavicle fracture, there should be no issues.
It is normal to feel tightness in the local area after surgery, and sometimes there may be a slight tingling sensation.

Reply Date: 2016/07/05

More Info

Post-surgical discomfort, particularly after a clavicle screw removal, can be a complex issue that requires careful management. Based on your description, it seems that you are experiencing tightness and discomfort in the area surrounding the clavicle, as well as sensitivity in the skin near the surgical site. These symptoms can be quite common after such procedures, especially if there has been a significant amount of trauma to the muscles and nerves in the area.

Firstly, it’s important to understand that after surgery, the body goes through a healing process that can take time. The tightness you are feeling in the pectoral region and the sensation of the muscles being "stuck" together could be indicative of scar tissue formation or muscle tightness due to disuse during the recovery period. Scar tissue can develop as the body heals, and this can sometimes lead to a feeling of tightness or restriction in movement.
The sensitivity of the skin around the surgical site is also not uncommon. This can be due to nerve endings being affected during the surgery, leading to heightened sensitivity or even neuropathic pain in some cases. This sensation may improve over time as the nerves heal and adapt.

In terms of managing your symptoms, there are several strategies you can consider:
1. Physical Therapy: Consulting a physical therapist would be beneficial. They can provide you with a tailored rehabilitation program that includes stretching and strengthening exercises to improve your range of motion and reduce tightness. They can also use modalities such as ultrasound or electrical stimulation to help alleviate pain and promote healing.

2. Heat Therapy: Applying heat to the affected area can help relax tight muscles and improve blood flow, which may alleviate some of the discomfort. You can use a warm compress or a heating pad for this purpose.

3. Gentle Stretching: Incorporating gentle stretching exercises into your routine can help improve flexibility and reduce the feeling of tightness. Focus on stretches that target the chest, shoulders, and neck areas.

4. Pain Management: If you are experiencing significant discomfort, over-the-counter pain relievers such as ibuprofen or acetaminophen may help. However, it’s essential to follow the recommended dosages and consult with your healthcare provider if you have any concerns.

5. Monitoring Symptoms: Keep track of your symptoms. If you notice any worsening of pain, swelling, or new symptoms, it would be prudent to return to your healthcare provider for further evaluation.
6. Follow-Up Appointments: Since you mentioned having had an X-ray that showed healing, it’s still a good idea to have regular follow-ups with your orthopedic surgeon or the physician who performed the surgery. They can assess your recovery and determine if any further interventions are necessary.

In conclusion, while some discomfort and tightness after clavicle screw removal can be expected, it’s crucial to actively manage these symptoms through physical therapy, heat application, and gentle stretching. If your symptoms persist or worsen, do not hesitate to seek medical advice. Your healthcare provider can guide you on the best course of action and determine if any additional treatments are needed. Remember, recovery is a process, and with the right approach, you can improve your shoulder function and reduce discomfort over time.

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