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Old 12-19-2009, 12:41 AM   #1
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Anyone had frozen shoulder type symptoms Post ACDF?

I saw my consultant for a 10 month review post ACDF. I explained to him that I had again developed referred pain along my shoulder blades with pain, numbness and tingling down my left arm into my thumb, index and middle finger. This sometimes happens down my right arm as well but with less severity and less often.

I am also very stiff and get severe cramping/shooting pains in my left arm if I reach out for something. It is like that cramp you get in your leg at night sometimes if you have slept in a funny position. I also have difficulty getting my hand back to put on my coat and cannot do up my bra or wash my back.

My consultant did not seem too worried and discharged me for PT. My PT said she was having difficulty getting any reflex from the back of my left elbow and that my left thumb showed a decrease in strength. She also said that I was 60 per cent restricted in my left arm movement. I can reach slightly above shoulder level but cannot get my arm vertical.

She said I was showing frozen shoulder type symptoms - has anyone else developed anything similar, especially post ACDF, and what was the outcome?

Bobbyboo x
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Surgery: ACDF C6/7 5th February 2009 with plastic cage & BMP (No collar)

 
Old 12-19-2009, 11:26 PM   #2
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Re: Anyone had frozen shoulder type symptoms Post ACDF?

I have had problems with Neural tension and also some problems with the thoracic outlet, from 1) the new aligment/posture of my body after surgeries, and 2) from my own postures of how I hold and protect/guard my arms/shoulders.

Neural tension happens when the nerves cannot glide properly, and also get stuck in grooves, from being pinched, and also from scar tissue. Sometimes it is common after surgery to happen to some people who might be prone to this condition. What you describe sounds like some component of it in that you have a limited lift on your arm (I assume it provokes pain). These can generate pain just like the pain that originationed from your neck etc originally. there are PT maneuvers that they use to try to free up and encourage the nerve movement. It can be painful to break them free. Mine is permament now - we just work and making sure it doesn't get worse.

One piece of advice is that I do not think I would allow too much manipulation without a new set of xrays and MRI since you are having new symptoms that sound serious.

I am sorry you are still having difficulty - I hope you can make some progress here soon! Regards, NP

 
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Old 12-24-2009, 07:47 AM   #3
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Re: Anyone had frozen shoulder type symptoms Post ACDF?

when you mentioned that you 'again" had these symptoms, does that mean that these are indeed the very same symptoms you had pre op or are they different? do you actually 'hear' anything from your neck when you move it like bone grinding against bone sounds or snapping or popping sounds? did you have ANY actual hardware placement? do your symptoms become triggered upon neck movement or are they kind of a 'constant'?

what NP suggested about getting the repeat MRI done really is a great idea just to see how things actually look right now in the surgical area. there is always a possiblity too here that you never fully fused either. that shows up the very best with a simple flexion and extension type of x ray. even better than an MRI or CT can pretty much. it was that particular type of x ray(ONLY) that showed what an MRI could not see and what an actual radiologist stated about the CT? that i WAS actually fused but was not at both endplates, only one? that stupid CT really killed me as far as getting my NS to actually believe me. that one x ray just proved to my NS what i had been telling him all along, i did not feel like i was actually fused. but i was having intermittant types of symptoms like yours are? but after my hardware was placed and the stupid NS actually somehow impinged my c 7 nerve root with the stupid hardware, everything got ten times worse and almost a constant then. these are just some possibles here for what could be happening that really does need further more in depth types of real testing. another really great test,espescially given the lack of the elbow reflex would be to just have an EMG/NCV done too? this would just help alot to really show ANY true nerve flow loss or impairment/impingement?

just one more area that really should at least be looked into too would e the rotator cuff/shoulder area? loss of ROM can also stem from that as well. you would really be amazed at how many people who have c spine problems also have some level of rotator too or vice versa? just one other place to look at depending upon just what an EMG would show and of course the MRI. there IS something that just is NOT 'right' up there that really needs to be found out and tracked back to the source. unfortunetly that does just require alot of ongoing testing too. you just really do need to truely find out exactly where your nerves are being compromised and why that reflex is so diminished as well. how was that reflex pre op? the same or was it appearing to be normal then? marcia
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3-22-01,herniated C-6-7
11-20-01,placement of hardware for failed fusion
9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.

 
Old 12-24-2009, 06:41 PM   #4
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Re: Anyone had frozen shoulder type symptoms Post ACDF?

I did have an encapsulated shoulder about 6 years after my C5-7 repair and plating. I went to PT for a few weeks and it resolved. I still have some nagging pain in that shoulder at times, but nothing I can't live with. I do still do some stretching exercises to keep the joint from freezing again.

 
Old 12-27-2009, 01:55 AM   #5
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Re: Anyone had frozen shoulder type symptoms Post ACDF?

Hi everyone and thanks for the replies which, as ever, I do appreciate.

I have been having shoulder blade/shoulder and nerve pain (which I recognise from before) running moderately down my left arm, elbow and hand and sometimes, mildly, my right. I have some numbness in thumb and index fingers. I had a plastic cage with BMP fitted at the time of my ACDF for C6/7. X-rays at the 6 month mark showed excellent fusion. When I turn my neck there is a crunching and grinding sound although this was also happening pre-op.

I initially thought that all these problems, started around 2 months ago, were coming from my neck but I now suspect a lot of them (but not all) are coming from my left and (to a much lesser degree) right shoulders. My PT now suspects this as well. I have also now read up online and both cervical surgery and cervical radiculopathy can set off a frozen shoulder or frozen shoulder type symptoms.

I am pleased about this. From my research a frozen shoulder, although painful and debilitating, is not as serious as another disc becoming severely herniated in my neck and that the symptoms will subside in due course but that it can take up to 2 years.

I know that I am having some disc problems (I suspect C5/6 - there was some disc space narrowing there on the MRI and the surgery at C6/7 has probably put a bit of extra pressure on it) but if I subtract the pain coming from my shoulder, it is nowhere near as severe.

However, as you suggested, it would be pertinent to have some extra tests to confirm/eliminate. However, since my surgeon did not think there was any real problem, I will have to continue just with my PT as my health insurance will not pay out unless a consultant refers me for extra tests. My PT says that if my symptoms do not improve soon, she will refer me on for extra testing. I will keep you posted.

Hope everyone is feeling comfortable at this holiday period.

Bobbyboo x
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Surgery: ACDF C6/7 5th February 2009 with plastic cage & BMP (No collar)

Last edited by Bobbyboo; 12-27-2009 at 02:02 AM.

 
Old 12-27-2009, 06:21 AM   #6
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Re: Anyone had frozen shoulder type symptoms Post ACDF?

Hi Bobby, I had something very much like your describing before my fusion. I ended up with shoulder decompression, this was almost 1yr. exactly before my fusion. My problems started very much like yours but became much worse so I could not lift my arm at all. It would send spasms all through the shoulder area, chest & ribs. It was partly resolved though the decompression, but not fully. That is when it was discovered it was coming from the cervical.
It can be very confusing. I had bursitis, tendonitis & arthritis along with a bone spur.
So many things going on it was hard to tell. I was checked for TOS as NP mentioned also. I still have some pain in that area but I have most ROM back. I cant do any over head lifting without pain & spasms though. Thats the one thing Ive never been able to do since the shoulder & the fusion.

I also get it in both shoulder areas. Although recently my neck pain is increasing so Im guessing its more the cervical. Ive always had a problem with muscle spasms to.

If no real progress comes from your PT now I would definantly get more testing done before any aggressive therapy is allowed. Better to be on the safe side.

I wanted to tell you I had pain the left thumb area & that was the C5-6, thats one thing that went away with my fusion. I have some problems but not in the exact same area.
Im wondering if your pain encompasses all the way down to your scapulas & between your shoulder blades at all?
Sammy

Last edited by sammyo1; 12-27-2009 at 06:23 AM.

 
Old 12-28-2009, 08:14 AM   #7
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Re: Anyone had frozen shoulder type symptoms Post ACDF?

hey bobby. if your surgeon wont refer you for the shoulder/rotator cuff MRI(and this is not at all suprising), just speak with your actual primary doc about it. they are the ones who are in charge of co-ordinating your overall care. most surgeons wont simply take on any 'new' problem areas, espescially if they just do not noramlly specialize in that particular area? but at any rate, getting that whole rotator cuff area really does need to be done soon. i had the same types of issues you are right now in the very same sequence while sammys kinda went the opposite with her rotator needing surgery, THEN her c spine went crazy on her?

my top tendon(the supraspinatus and also the most commonly torn of all the tendons since it runs across the very top from the base of the neck out to the top of the actual shoulder area?) actually tore right in half before i really even realized just how much of my continuing symptoms were not stemming from spinal but the rotator cuff problems. i also had a partial tear in the tendon right under the full tear and like sammy had tendonitis ,bursitis and ALOT bone spurring going on in alot of places that all just needed clearing.

while i still do think that at least some of your issues here are indeed stemming from the c spine in some way, since all those spinal nerves from about c 5 also run thru at least down to just above the elbow(c 5) with the rest of the c 6-t 1 reaching the fingers) you can have alot of symptoms that simply mimic each other to a degree? so getting that one MRI done really would kind of show much more of what actually IS the rotator cuff or the c spine. its just a matter of what you have already been kind of dealing with here, testing and ruling in or out that will hopefully show where any real impact is occuring. just speak to youyr primary doc since referring you for anything just IS part of their job. once any surgeon does a surgery and you get beyond that like 6 weerk mark, they just want you off their little 'assembly line" trust me there. good luck BB, marcia
__________________
3-22-01,herniated C-6-7
11-20-01,placement of hardware for failed fusion
9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.

 
Old 12-30-2009, 07:31 AM   #8
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Re: Anyone had frozen shoulder type symptoms Post ACDF?

It could very well be a combination of the 2 things. Even doctors can get focused on looking for one cause when in fact it could be different problems causing all the symptoms & pain. This is what led to my prolonged diagnosis. I did have both but it confused the doctors. I had not real neck pain in the beginning. Most was in the shoulder, arm then chest & rib area. I lost movement in my arm very quickly though. It was so painful to move I would gag in the morning attempting to move it.

I believe my therapist mentioned something about the way we move or hold certain areas, such as the shoulders to accomadate a cervical problem can cause problems. Then following cervical surgery our necks & shoulders, etc.. can become weak.

I protected my left arm due to pain by not using it as much there for I lost some ROM. I was also holding my body/posture a certain way, the wrong way to accomadate my cervical symptoms & pain.

A good ortho would be able to rule in or out frozen shoulder. Your PT is right though, if no improvement is seen it usually indicates problems exist. My shoulder surgeon was a firm believer in setting a time limit for PT & noting progress. He said to many doctors beat the same dead horse, Attempting PT over & over or for long periods of time with no real results. As I said it can be confusing if there are muliple problems.

I had a good PT & during the rehab with my shoulder she swore there were spinal issues way before any doctor diagnosed. She was right of course. I learned to ask questions as you can learn alot from a good PT.
I hope this is the shoulder & it improves. I know it can be painful. Good luck & yes keep us informed. Sammy

 
Old 12-31-2009, 12:55 PM   #9
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Re: Anyone had frozen shoulder type symptoms Post ACDF?

Thanks Sammy and Feelbad

The pain got worse and my family doctor injected me in the shoulder with cortisone which has given me a lot of relief after a couple of days. I now realise that most of the problems must have been stemming from my shoulder. I still have some residual arm pain from elbows down to wrist but it is nowhere near as severe now and I can stay off the painkillers

Wishing everyone on this board a happy, healthy and pain free New Year.

Love, Bobbyboo x
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Surgery: ACDF C6/7 5th February 2009 with plastic cage & BMP (No collar)

Last edited by Bobbyboo; 12-31-2009 at 12:56 PM.

 
Old 01-01-2010, 09:52 AM   #10
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Re: Anyone had frozen shoulder type symptoms Post ACDF?

well that kind of showed alot considering the real relief you recieved from the injection? now all you need is to really 'see' what the tendons and the rest of that shoulder/rotator/joint area look like. i am willing to bet just based upon the relief you got from being injected into that joint area that like me and sammy, you more than likely among other possibles here also have some level of real true tendonitis or bursitus too. otherwise that injection would NOT have given you any real relief.

but i still would definitely push for the MRI. if you actually do have some level of real tearing that can simply occur over the years of wear and tear, you do NOT want it to completely tear on you like mine did? getting it fixed BEFORE that occurs is so much less painful and the healing time is also less. i do hope that injection lasts as long as possible. keep us posted BB, marcia
__________________
3-22-01,herniated C-6-7
11-20-01,placement of hardware for failed fusion
9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.

 
Old 04-10-2010, 07:14 AM   #11
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Re: Anyone had frozen shoulder type symptoms Post ACDF?

yes, I've had it in both shoulders. I first received a cortisone shot, very painful but it hasn't reoccured in over 5 years. the other shoulder I also received a shot along with therapy - not cortisone. However in this shoulder it begins again but the therapist suggested that as soon as i feel the pain, begin to do the stretching again. this does work and it will go away after several days of painful stretching. no surgery was ever suggested.

 
Old 07-04-2010, 10:39 AM   #12
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Re: Anyone had frozen shoulder type symptoms Post ACDF?

I also recently had a frozen shoulder. After reading online that I could have the condition for two or more years, I went straight to my chiropractor and had a therapeutic massage and adjustment. After a couple sessions, I am not having any more problems. I got some quick relief after even one session.




Quote:
Originally Posted by Bobbyboo View Post
I saw my consultant for a 10 month review post ACDF. I explained to him that I had again developed referred pain along my shoulder blades with pain, numbness and tingling down my left arm into my thumb, index and middle finger. This sometimes happens down my right arm as well but with less severity and less often.

I am also very stiff and get severe cramping/shooting pains in my left arm if I reach out for something. It is like that cramp you get in your leg at night sometimes if you have slept in a funny position. I also have difficulty getting my hand back to put on my coat and cannot do up my bra or wash my back.

My consultant did not seem too worried and discharged me for PT. My PT said she was having difficulty getting any reflex from the back of my left elbow and that my left thumb showed a decrease in strength. She also said that I was 60 per cent restricted in my left arm movement. I can reach slightly above shoulder level but cannot get my arm vertical.

She said I was showing frozen shoulder type symptoms - has anyone else developed anything similar, especially post ACDF, and what was the outcome?

Bobbyboo x

 
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