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Avatar universal

Shoulder injury

I am a nurse and was working in psych.....3 1/2 yrs. ago I was involved in a take down with a patient and tore the tendon in my right shoulder. I was sent to therapy which made it worse and after about 4 months I had an open surgery to repair the tendon. I was never free of pain and after the surgery the pain started going down my right arm into my hand with numbness and tingling in all the fingers. Approx. one year later I developed a lump on the top of my shoulder, which to me looked as if it was in the center the clavical. An MRI was done which showed osteophyte formation at the acromioclavicular joint with degeneration. My doctor referred me to another orthopedic surgeon. He did an EMG test which showed some problem in the bracial plexus area. A second surgery was performed via a scope to remove scar tissue and shave the bone.
The pain in the shoulder and down the arm still did not go away after approx. 9 months. A second EMG was performed and this one was negative. I was then refered to a surgeon for the hand, 3 months ago carpal tunnel release was performed. The dumbness and tingling is gone from the fingers but I continue to have pain up the outside of my hand near the wrist up to my elbow.
Within the past 3 months the lump in my shoulder has returned, which is approx. the same length of time it took for it to show up after the first surgery. I saw my doctor for the shoulder one month ago, he took xrays and said they were negative. He diagnoised me as chronic pain syndrome at that time.I have been in therapy for my wrist the past 2 months and the therapist today said the lump is getting bigger, which I feel it is too. I have never been pain free since the injury. At this point the pain in my shoulder is a constant aching going down the front to the breast area and underarm area, and the top of my shoulder is very tender to touch espically where the lump is.  Movement of my arm is pretty good but holding my arm up in front of me or above shoulder does cause more pain. I am very concerned about this lump forming again and wondering if it could be a tumor. I am just not sure how to talk to the doctor if he keeps saying nothing is wrong. The lump is visible and you can feel it, its feels hard with some swelling around it and it seems to be growing larger up towards the neck and down towards the front.
Any suggestions would be appricated very much.
1 Responses
Avatar universal
Dear Patti:
I am sorry to hear about your shoulder and the pain in the arm.  First, I think that carpal tunnel is likely the cause of some of your hand pain, but not related to your shoulder injury.  It is difficult to explain how a distal median nerve problem, with the EMG findings of carpal tunnel could be from a shoulder injury with no other EMG findings above the wrist in the median distribution but having a generalized distribution.  The other symptoms you describe are very compatible with a shoulder injury.  I can't tell you how to talk to your neurologist, if the lump is visable and tender, then it has to be recognized.  I might suggest seeing another neurologist, a second opinion.  Without examining you and seeing the MRI and EMG studies it is difficult to give to reasons for your pain.  The EMG does not pick up small fibers and these are the pain fibers so the EMG might not be the test for pain.  It might be that you will have to find methods to control the pain as it sounds like this might be be resolved with other methods.  Lumps are difficult to assess over the internet and you should know that when a bone heals, there is extra remodeling taking place and this can give rise to a lump.  The larger the area of healing and the more times an area has to undergo the healing process, the bigger the remodeling.  This may be why your lump is present.  

I am sorry that I can't help you more.

Sincerely,

CCF Neuro MD
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