Shoulder Pain After Fracture Surgery: Causes and Relief

Regarding shoulder bone healing issues?

Hello, Doctor.
First, I wish you a Happy New Year.
I was involved in a car accident on December 14th last year, which resulted in a fracture of my right shoulder bone, and I underwent surgery to have a bone screw inserted.
It has now been a month, and all the screws have been removed and the wound has healed.
However, recently, whenever I wake up (lying flat) and get out of bed, my right shoulder experiences pain that lasts for a while before subsiding.
Additionally, when I lie flat before going to bed, my shoulder also experiences some pain (though not as severe as when I get up).
I would like to ask the doctor: 1.
Is this considered normal? Could there be an issue with the bone? 2.
What can be done to alleviate the pain in such cases? Thank you for your patient response!

Kuxuan, 20~29 year old female. Ask Date: 2020/01/25

Dr. Shi Guozheng reply Orthopedics

1.
This is still considered normal.
If you're concerned, you should return to the hospital for another X-ray.

2.
You can take some pain relievers to alleviate the discomfort.
If it doesn't improve, you should see a doctor for further evaluation.

Reply Date: 2020/01/25

More Info

Shoulder pain after a fracture surgery, particularly in the context of a recent accident and subsequent surgical intervention, can be a common issue. It’s important to understand the potential causes of this pain and the strategies for relief.

1. Is this pain normal? Could there be an issue with the bone?
After a shoulder fracture and subsequent surgery, it is not uncommon to experience pain, especially during the recovery phase. The pain you are experiencing upon waking and after lying down may be attributed to several factors:
- Soft Tissue Healing: The shoulder joint is surrounded by muscles, tendons, and ligaments, which may have been strained or injured during the accident or surgery. As these tissues heal, they can cause discomfort, especially when you change positions after resting.

- Post-Surgical Changes: After surgery, the body undergoes a healing process that can lead to inflammation around the surgical site. This inflammation can result in pain, particularly after periods of inactivity, such as sleeping.

- Adhesive Capsulitis (Frozen Shoulder): This condition can develop after shoulder surgery or injury, leading to stiffness and pain. It is characterized by a gradual loss of range of motion and can be exacerbated by inactivity.

- Nerve Irritation: If there was any nerve involvement during the injury or surgery, it could lead to pain radiating from the shoulder, especially when certain positions are held for extended periods.

- Bone Healing: While the removal of hardware (like screws or plates) typically indicates that the bone has healed, there can still be residual pain as the bone remodels itself. If there are concerns about the integrity of the bone, follow-up imaging (like X-rays) may be warranted.

2. What can be done to relieve this pain?
There are several strategies you can employ to manage and alleviate shoulder pain post-surgery:
- Physical Therapy: Engaging in a structured physical therapy program can be beneficial. A physical therapist can guide you through exercises designed to improve range of motion, strengthen the shoulder, and reduce pain. They may also employ modalities such as ultrasound or electrical stimulation to help manage pain.

- Pain Management: Over-the-counter pain relievers such as ibuprofen or acetaminophen can help manage pain and reduce inflammation. If the pain is severe, your doctor may prescribe stronger medications.

- Ice Therapy: Applying ice packs to the shoulder for 15-20 minutes several times a day can help reduce swelling and numb the area, providing temporary relief from pain.

- Activity Modification: Avoiding activities that exacerbate the pain, especially those that require lifting or reaching overhead, can help prevent further irritation.
- Sleep Positioning: Adjusting your sleep position may also help. Consider using pillows to support your arm and shoulder, which can alleviate pressure on the joint while you sleep.

- Follow-Up Care: Regular follow-ups with your orthopedic surgeon or healthcare provider are crucial. They can monitor your recovery, assess any ongoing issues, and adjust your treatment plan as necessary.

In conclusion, while experiencing pain after shoulder fracture surgery can be concerning, it is often a normal part of the healing process. However, if the pain persists or worsens, it is essential to consult with your healthcare provider to rule out any complications and to discuss further management options. Your recovery is a priority, and addressing these concerns early can lead to better outcomes in the long run.

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