Shoulder Pain After Previous Surgery: What to Do Next

Q: Shoulder Pain After Previous Surgery: What to Do Next

Hello： Thank you for providing more detailed information. <br>Ten years ago, you had a labral tear that resulted in recurrent shoulder dislocations, which was treated with arthroscopic surgery and anchor fixation. <br>Recently, you have experienced discomfort unexpectedly. <br>Co

Shoulder issues

Hello, doctor.
I would like to ask about my condition.
About 10 years ago, I underwent arthroscopic surgery on my shoulder due to habitual dislocation of my left shoulder, which involved the placement of screws and repair of the labrum and bursa.
Recently, I have been experiencing significant discomfort in my shoulder.
Certain unintentional positions during daily activities cause such severe pain that I am unable to exert any strength.
This only occurs in unexpected situations.
Could you please advise me on how to handle this situation? (I apologize for not explaining my condition clearly at the beginning!) Thank you!

Rick, 30~39 year old female. Ask Date: 2018/11/21

Dr. You Dianqi reply Orthopedics

Hello: Thank you for providing more detailed information.
Ten years ago, you had a labral tear that resulted in recurrent shoulder dislocations, which was treated with arthroscopic surgery and anchor fixation.
Recently, you have experienced discomfort unexpectedly.
Could you clarify whether the discomfort is pain or if you are experiencing instability again? If it is instability, there may be concern about potential re-injury to the labrum (although you did not mention any recent accidents or sports injuries).
If it is pain, there could be various causes, including inflammation of the rotator cuff.
It may be advisable for you to return to your surgeon's office for a more precise in-person consultation and physical examination, supplemented by imaging studies, to ensure the best protection for your health.
Thank you, and I wish you a speedy recovery.

Reply Date: 2018/11/21

More Info

Shoulder pain after previous surgery, especially after a procedure like arthroscopy for recurrent dislocation, can be concerning and frustrating. Given that you had surgery about ten years ago to address issues such as labral tears and bursal repair, it is not uncommon to experience discomfort or pain later on, particularly if there have been changes in your shoulder mechanics or if there is underlying degeneration.

Understanding Your Symptoms
1. Pain Triggered by Movement: The fact that your shoulder pain is triggered by certain movements or positions suggests that there may be an issue with the soft tissues surrounding the shoulder joint, such as the rotator cuff, biceps tendon, or even the joint capsule itself. This could be due to inflammation, tendinitis, or even a re-tear of the rotator cuff.

2. Loss of Strength: The inability to exert force or lift your arm without pain can indicate weakness in the muscles that stabilize and move the shoulder. This could be due to disuse, muscle atrophy, or ongoing inflammation.

3. Chronic Pain: Chronic pain after shoulder surgery can sometimes be attributed to conditions like adhesive capsulitis (frozen shoulder), which can develop after surgery or injury, leading to stiffness and pain.

Recommended Actions
1. Consult a Specialist: It is crucial to revisit an orthopedic specialist, preferably one who specializes in shoulder injuries. They can perform a thorough physical examination and may recommend imaging studies, such as an MRI, to assess the soft tissues around your shoulder joint. This will help identify any tears, inflammation, or other issues that may not have been present or detectable during your previous evaluations.

2. Physical Therapy: Engaging in a structured physical therapy program can be beneficial. A physical therapist can help you with exercises designed to improve strength, flexibility, and range of motion in your shoulder. They can also provide modalities like ultrasound or electrical stimulation to help reduce pain and inflammation.

3. Pain Management: Over-the-counter anti-inflammatory medications (like ibuprofen or naproxen) can help manage pain and reduce inflammation. If your pain is severe, your doctor may prescribe stronger medications or corticosteroid injections to provide relief.

4. Activity Modification: Pay attention to your daily activities and try to avoid positions or movements that exacerbate your pain. Modifying your activities can prevent further irritation of the shoulder.

5. Consideration of Further Imaging: If symptoms persist despite conservative management, further imaging may be warranted to assess for any new injuries or complications related to your previous surgery.

6. Surgical Options: If conservative treatments fail and your quality of life is significantly affected, discussing surgical options with your orthopedic surgeon may be necessary. This could involve arthroscopic evaluation and potential repair of any identified issues.

Conclusion
Shoulder pain following surgery can be multifactorial, and it is essential to approach it with a comprehensive plan. Early intervention can often lead to better outcomes, so do not hesitate to seek medical advice. Your symptoms are valid, and addressing them promptly can help you regain function and reduce discomfort in your daily life. Remember, communication with your healthcare provider is key to finding the right treatment plan for your specific situation.

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