Pain after shoulder surgery
Danielle R. Steilen, MMS, PA-C
Shoulder surgery as a cause of shoulder pain
We frequently see patients who have had surgery for shoulder pain, but are subsequently left with chronic pain after surgery. When you see what actually occurs during most surgeries, a legitimate question is, “how can they not still have pain?”
For instance, a surgery is called for after a traumatic injury in a motor vehicle accident where tendons, ligaments and/or bone are completely torn and broken. But most joint surgeries are performed for degenerative conditions that make the connective tissues such as tendons, ligaments and cartilage, weak and painful. We think, being regenerative injection specialists, that Prolotherapy is a better first choice to try to regenerate these damaged tissues. If it is viable to use simple techniques to speed the body’s own natural repair mechanisms why not do so instead of submitting oneself to surgical joint replacement, or what the orthopedists call “repair”? Prolotherapy is an injection treatment for lax, weak and injured connective tissues that gives the body the resources it needs to repair itself on its own.
Pain after shoulder surgery
Mark is a good example of a patient who had extensive shoulder surgery. Seemingly, the surgeon tried to “fix” everything he thought was damaged enough to cause pain. The surgery went as planned, no complications, and the surgeon accomplished everything he set out to do. But Mark came to our office two years after the procedure, still in pain. How could this be? Let’s look exactly what was done.
It was an arthroscopic procedure, and this is what was seen through the scope they placed in his joint: Partial thickness rotator cuff tear, Type I (least severe), a labral tear, grade III to IV (nearly most or most severe) chondromalacia of glenohumeral joint and subacromial bursitis. The labrum is a lip of cartilage that helps keep the end of the humerus in the shallow socket (glenoid). Chondromalacia is the degeneration of the cartilage inside the joint. Bursitis refers to the bursa, one of the fluid-filled sacks that provide cushioning in joints. After visualizing, the surgeon commenced his repair process. First, using a shaver, (like a miniature lawn mower), he debrided the labral tear and the rotator cuff tear. Then, where the chondromalacia was most severe, he performed a chondroplasty. This consists of scraping the damaged cartilage which covers the surface of the bone in hopes of having healthy cartilage grow back. He scraped both the humeral head and the glenoid. He then performed a bursectomy, removing the inflamed bursa. This is fairly typical what we see in an arthroscopy report of the shoulder. Mark wants to get back to playing tennis and surgery did not help him with this, and he was left with chronic pain. Only after he started Prolotherapy treatment with us did he get any better. Even after Mark’s first Prolotherapy treatment Mark experienced much less pain in his shoulder.
Avoid surgery before Prolotherapy
In regenerative injection techniques like Hackett-Hemwall dextrose Prolotherapy, Platelet Rich Plasma Therapy or stem cell Prolotherapy, the goal is always to preserve and regenerate these cushions and connective tissues rather than remove them. (See cartilage repair). It makes our job here at Caring Medical a little more difficult when treating a patient who has had an extensive procedure, but it is still possible to achieve healing after surgery. We do wish that before people sign up for any type of spine or joint surgery, they seek an opinion from an experienced Prolotherapist. In many instances, surgery can be avoided all together.
So if you have joint or spine pain and would like to see if it can be resolved without surgery, give us a call at 708-848-7789. Our staff would be glad to discuss your case, review your reports and let you know if you are a good candidate for Prolotherapy.