Pain upper bicep

Hi,

I had a rot. cuff repair in July 11 and a bicep tenotomy Nov. 11. Still have the same pain I had since July. It is upper bicep, front side above elbow but below shoulder. It hurts esp. lifting arm up and to side. ROM is gone and arm is weak. My Orth. Surg. says now I need a total shoulder that the arthritis is severe since July. I can't understand this. Arthritis takes a while to progress right? Esp. to the point of needing a new shoulder. Also this pain is severe in upper bicep. I was told by Doc that there would be no pain after the bicep was cut..the pain is as bad as ever. I am on Loratab everyday for it.

Any ideas Doctor?

Thanx.

Destiny

[Michael L Gross, MD]

If your pain is identical to the pain you had before the original rotator cuff repair, I would be concerned about failure of the repair, or a retear in the rotator cuff.  The best way to confirm, or rule out, this diagnosis is with an MRI arthrogram. It is crucial that an arthrogram be performed, and not simply a standard MRI.
Occasionally, biceps tenotomy, when not accompanied by reattachement of the tendon (tenodesis), canresult in cramping and pain in the upper arm. This does not sound like the symptoms you are describing, particularly the weakness, that sounds more like a cuff problem.
Finally, with regards to the arthritis, 6 months is rapid, but not unheard of, for arthritis to become symptomatic.  Was there evidence of arthritis on your original xrays, or at the time of your first surgery?

[Destinyjb]

Hi,

Thanx for answering. I have had some arthritis since the rot. cuff tear and surgery in July 2011 but I don't feel to the extent of needing a total shoulder now. I had a MRI and arthrogram post my bicep tenotomy and I am the 1 who couldn't lift my arm over my head for the last part of the MRI.
The first MRI and arthrogram before my rot. cuff tear and surgery I believe showed a labral tear. Would this cause all the severe pain I am having in my upper bicep area? I have had this pain before the rot. cuff surgery after..then Doc did a bicep ten. to no avail...the pain is the same and it interferes with my quality of life. My husband has to help with everything!

Is there anyway you could review my 2 MRI's if I email them to you? Just your expertise opinion Doctor Gross? Let me  know..my email is: ***@****.

Thanx.

Destiny

[Michael L Gross, MD]

Sorry. But MRI's alone are not enough to evaluate a patient. Face to face evaluation with a thorough examination is imperative.