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Query about nerve blocks for shoulder surgery
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Query about nerve blocks for shoulder surgery

Hello,

  two years ago I was hit by a crane and messed up my right shoulder. I had a Laderjet procedure, a bone transplant, some muscles had to be reattached and seven bone fragments were removed.

This surgery did not give me the results the doctor thought it might. I was left with a lot of pain and limited range of motion in my right arm.

Two months ago, I went in for a total shoulder replacement. The doctor said this would fix all my problems and to an extent, it did help. BUT  I was given a nerve block in my neck before surgery, to help with the pain after the surgery. The block did the job for sure BUT now I am having some problems.

1. I experience a numbness in my 3.4 and 5 finger, as well as my palm. This happens several times a day; more so when I lay down or recline in a chair to watch TV.

2. I have a spot on my shoulder blade that hurts to the touch, but is controlable when standing or not touching it. It also seems to flare up when I am in bed, causing me anoght pain to keep me up all night.

3. when I recline or lay down, I experience a deep heavy pain in my neck (in the area of the nerve block) that seems to start down by my shoulder and run almost to my ear.

I have searched for information that directly talks about side effects from nerve block but can't find anything that directly shows the kids of things I am experiencing.

My question to all of you is this:
have any of you experienced these problems?
do you know anything about the side effects from a nerve block?
can you direct me to any information that clearly states the side effects of a nerve block in the neck?

Any and all advice is needed and I thank you in advance.
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16 Comments Post a Comment
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547368_tn?1332173665
Hello Sean,

Welcome to the Pain Management Forum. I am sorry to hear about your painful shoulder and complications.

It sounds like you have had extensive damage done to your shoulder area including the bones, muscles, ligaments and tendons. I beleive it is near impossible to return the shoulder to pre-injury condition after such an extensive injury. It stands to reason that you will continue to have some degree of long term pain with some type of functioning problems of the effected limb.

There are many types of nerve blocks used for surgical purposes. The one most commonly used for shoulder surgery is called ISB.  Interscalene brachial plexus block (ISB). It is widely used as an adjuvant regional pain therapy in patients undergoing major shoulder surgery. Was an ISB used in your surgery?

I gather that you are contributing much of your current pain to the nerve block. I did some reading on it and found this study regarding an IBS (nerve block)....

..."An incidence (in ISB) of short- and severe long-term complications of 0.4%. In case of persistent paresthesia, dysesthesia, or pain not related to surgery after ISB, sulcus ulnaris syndrome, carpal tunnel syndrome, or complex regional pain syndrome should be excluded since specific treatment may be required..."

In other sites I found similar information regarding cervical nerve blocks used for surgery and the IBS. The percentage of ppl experiencing the symptoms you report are very small but they do exist. Most sites claim that these side effects will resolve on their own in time and without treatment but obviously some can be repaired and will require intervention.

What does your surgeon or physician have to say about these lingering side effects? If he/she is dismissing your symptoms I would seek another opinion.  If the nerve is damaged it may heal in time...but in my personal opinion the underlying cause needs to be determined.  

Our members may have better information and suggestions. I have been fortunate in that I have been able to avoid or refuse nerve blocks.  Please keep us updated and let us know how you are doing. I wish you the very best.

Take Care,
~Tuck
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Avatar_m_tn
I'm not sure what kind of nerve block it was.

The IC picked the surgen and I felt more like an outsider to my own surgery.
I am going to see him this week and I will ask questions. Maybe he will have answers, maybe he won't but I will follow up here and let you know what I do find out.

Thank you for all the information you provided in your reply.

Take Care,
Sean
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Avatar_m_tn
I have recently had the Interscalene block for shoulder surgery. After surgery I had a very sharp burning pain in my left leg when I would roll onto it or upon rising in the morning and constant numbness throughout the front thigh of my left leg. My rt shoulder had the repair. When I mentioned this to the Dr. he suggested that it was due to an existing back injury.
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Avatar_n_tn
Hello- I hope you are, by this time finding some relief!

I am five weeks post-op from a type four tear of the labrum and a 50% rotator cuff tear. I had the injury for three months before my surgery- it was work related.

At five weeks post-op, my shoulder is still extremely painful, even to light touch. I am also having some thumb and pointer finger pain.

I found your post when I did a search on the Interscalene Nerve Block. When I saw your below reference statements- I thought, okay- someone who can related to what I am going through!

"2. I have a spot on my shoulder blade that hurts to the touch, but is controlable when standing or not touching it. It also seems to flare up when I am in bed, causing me anoght pain to keep me up all night.

3. when I recline or lay down, I experience a deep heavy pain in my neck (in the area of the nerve block) that seems to start down by my shoulder and run almost to my ear.
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82861_tn?1333457511
I've had two surgeries on my left shoulder.  The first was rotator cuff repair that only made things worse.  A year later, a second surgeon did a Mumford procedure that should have been done at the time of the first surgery.  Basically, the end of my clavicle had to be removed because it was impinging a nerve in the shoulder and doing further damage to the soft tissues of the joint, making another tear a near certainty.  

I had the block for the 2nd surgery and it made a world of difference in post-op pain.  I was able to complete two months of dedicated rehab without too much trouble.  It hurt, but it's supposed to hurt.  Can't get away with a full recovery without it.

Having been through all that, I think the lingering nerve pain that people experience post-op is probably due to the C7 nerve in the joint itself rather than in the area of the blocking injection.  There may be damage from the original injury, from the surgery, lingering swelling and inflammation that impinges the nerve - any of which can result in arm, shoulder, neck and shoulder blade pain and numbness.  

It was over a year before I could even think about sleeping on my left side.  Eleven years later I still can't sleep on that side for more than a couple hours.  Other than that, I have no problems and can't complain.  

I know physical therapy is awful, but it really can get rid of a lot of these post-op problems if done religiously.  It doesn't make sense that doing something that causes more pain will make your pain better, but it's something we have to at least try.  The less you use that joint, the more your muscles atrophy and the less stable it becomes, making ongoing pain and eventual re-injury much more likely.  The surgeon can only do so much.  The real healing is up to us.
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Avatar_f_tn
Dear sean:
I think your shoulder pain is a myofacial pain due to your muscular trauma from your accident or probably muscular injection.If you have a trigger point injection by a pain specialist it may be help you.
regards
gharaee
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1943796_tn?1339432338
I am 4 1/2 weeks our for rotator cuff surgery on my left shoulder. I had the right shoulder done 6 years ago without a nerve block. This time they did the nerve block in the base of my neck & it seems like the shoulder is much more painful to the touch.  I also have lingering pain on the left side of my neck near the site of the nerve block.  If had the chance to do it again I would opt NOT to have the nerve block as when I awoke in recovery after the surgery I was in severe pain anyhow. Now I'm scheduled to begin PT in a few days & have no idea how I'm going to handle it - I'm still in a sling at this point. Does it ever get any easier?
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Avatar_f_tn
I had right rotator cuff repair surgery 10 days ago with an interscapular (?) nerve block and general anestesia. They repaired the tendons, removed calcification and did something with re-positioning the bones so they dont rub so much. My right ear and a growing area on my face are still totally numb. I have not been able to find any answers about this. Does anyone know how long it will take for this complete numbness to go away?
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Avatar_m_tn
I had the nerve block a year ago.  I do have a sensitive spot.  But, I had a concern that when I try to lift my arm up to high my heart beats fast and I have to stop.  Has anyone ever heard of this from the block.  It exhausts me.  I had echocardiogram and my heart is fine.  When I tried to get teh DR to answer this question he got indignant said it had nothing to do with his surgery and said he did not need to see me anymore
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Avatar_m_tn
I just called the doctor because I just had surgery December 26, 2012 and I am having numbness on my left ear also.  Did yours get better and if so what was happening and what did you do to get the feeling back
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Avatar_f_tn
I am about 15 days Post Ops from my Clevicle surgery.  I recieved a nerve block at the base of my left neck.  I'm still dealing with the numbness on my 2, 3,4 and 5th fingers and the palm of my hand.  It hurts to touch and I don't have much strength.  

I know you've posted this long ago and was wondering how long did this numbness last for you and what did you do to overcome this?  I tried to search on web, but it seems the answers are not out there.

I went in for my first checkup since the surgery and my doctor don't have an answer and said that I will need to be patience as my numbness will eventually go away.  BUT WHEN is the true question which it seems no one have an answer for.  

If you can share your end results story to the rest of us...I think it will help others and myself that perhaps this numbness will go away and it's not forever.  

Thank you and I look forward in hearing from you!
Linda
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Avatar_f_tn
I am about 15 days Post Ops from my Clevicle surgery.  I recieved a nerve block at the base of my left neck.  I'm still dealing with the numbness on my 2, 3,4 and 5th fingers and the palm of my hand.  It hurts to touch and I don't have much strength.  

I know you've posted this long ago and was wondering how long did this numbness last for you and what did you do to overcome this?  I tried to search on web, but it seems the answers are not out there.

I went in for my first checkup since the surgery and my doctor don't have an answer and said that I will need to be patience as my numbness will eventually go away.  BUT WHEN is the true question which it seems no one have an answer for.  

If you can share your end results story to the rest of us...I think it will help others and myself that perhaps this numbness will go away and it's not forever.  

Thank you and I look forward in hearing from you!
Linda
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Avatar_f_tn
I had Interscalene Nerve Block 6 weeks ago with shoulder surgery. I am experiencing tingling/numbness down my left arm into left hand and fingers with fingers being swollen. Increases with activity. Please help
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Avatar_m_tn
I have the same issue after my surgery just three weeks ago need help
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Avatar_m_tn
I have the same issue after my surgery just three weeks ago need help
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Avatar_m_tn
Dear Tanya426

I hope you are doing better, here is my story.

It is just 6 weeks today after rotator cuff surgery on my right side and I had an interscalene nerve block. After 4 weeks I began physical therapy and noticed my hand was quite swollen and could use my fingers very little. I have worked with squeezing the ball and getting my hand to function more and more, but as I do more my hand has a burning pain, I also have moderate to severe pain in my forearm and upper arm around the tricep.

When I told my doctor yesterday of these side effects he said he had not encountered this reaction before. He recommended sleeping in an upright position (which I find impossible) and to keep him informed. Last night the burning pain in my hand was so severe nothing would make it subside. I took Aleve, extra strength Tylenol, I applied cold, extreme heat, nothing helped.

I finally put my arm back in the sling (which helped slightly) and searched the internet. I found this to be a rare occurrence, but it often effects patients with a preexisting condition (I have moderate carpal tunnel syndrome in both hands). It seems from my reading that it could take from 6 months to 2 years for the nerves to repair from the nerve block. I don't know how to help it. I will speak to my physical therapist, and later my doctor, and perhaps a neurologist, but I think it is going to be a long haul. I may try supplementing my diet with B Complex and MSM.

Oh, I did find a way to sleep. I kept my sling on and sat on the floor and placed pillows on a chair in front of me and I leaned forward on that and could sleep. I had to adjust as my legs went numb, but it was better than trying to sleep upright on my back.
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