Ask:
arthroscopy surgery
Hi, I have been experiencing a lot of pain and aches. My present complaint is my right shoulder. I took an MRI about 2 years ago when my pain became bad. The pain is mostly in my shoulder blade is a very sharp burning sensation and is also very tender to touch. The MRI revealed effusion and nothing else. The pain left for a while but now is been back for over two months and is constantly there. I take celebrex, lyrica, ultracet, use the lidoderm patches and attended physical therapy but the pain still there and I cannot even sleep. My doctor told me that my last resort will be an arthroscopy surgery. He explained all the risks and benefits and I am considering it. I also have a lot of problems with my left shoulder which I took an MRI also. That came back with a whole bunch of things like tendinosis and bursitis. Can you explain to me a little more the surgery itself and do you think I should wait?
Answer:
arthroscopy surgery
I had my shoulder scoped last year because it was chronically dislocating. I was put under general anethesia and three incisions were made in the shoulder. One in front (anterior) one on the outside (lateral) and one in the back (posterior). Through these portals, my surgeon was able to insert his camera and do all the work he needed to tighten up the capsule. I don't think I was under for very long (maybe 2 hours?). Anyway, once I woke up and got beyond the discomfort from the anethesia, it was pretty much smooth sailing. There was minimal pain (though this is relatively speaking as I had just had reconstructive surgery on my elbow six months prior). I used an ice machine for the first couple of days and I believe I was supposed to be in a sling for six weeks, but I think I only made it a week and a half, though I continued to wear it at night the whole time because there was the risk of my arm ending up in an awkward position when I was sleeping. I was given percocet to take on an as needed basis, but I don't think I needed it more than a week. I don't remember how long it took me to return to normal activity (though it was winter break, and "normal" activity wasn't that extensive, anyway) My doctor was the same doctor who worked on my elbow and he saw how quickly I made progress and he knew I had trouble sitting still (I believe I went one-handed rock climbing a week after my elbow was fixed) so he kept me out of PT for awhile because he knew I was going to be doing enough (maybe too much) with my shoulder anyway. The day after the surgery, I remember going out with my friends (actually I wanted to go to a school function the day of, but that got vetoed) and I was able to be fairly active soon afterwards (going for walks, etc.) By the time I started PT about a month later, I nearly had a full range of motion which I fully acheived shortly thereafter. Within 3 months I was playing baseball, so I was fully recovered at that point. My case is more complicated in that I also have a problem with my shoulder being significantly (grade 3) seperated. In order to fix that surgically, it certainly wouldn't have been anthroscopic, and I either would have had a part of my collar bone removed or another really nasty operation, which I didn't feel was necessary at point. It may still need to occur sometime later in the future. So while I would consider my surgery a success (my shoulder hasn't dislocated since the operation) I still have significant pain, weakness, and disability in that shoulder (which is probably worse since the operation, since I can do a lot more with that arm without it dislocating which puts a lot more stress on my A-C joint). But knowing what I know now, I would probably go through with the operation again. In my case, the procedure was completely elective. As an athlete, my main reason for going through with the surgery was I was sick of the limitations it was putting on my athletic career. While pain also factored in, I was sick of running around the soccer field looking like Napoleon. By the time I had my operation, my shoulder was loose enough that it was difficult for my arm to stay reduced for any significant period of time. Only you can decide where you want to draw the line about how much pain you're willing to tolerate before you'll go through the discomfort and the risks associated with surgery. I would always suggest conservative treatment first, which it looks like you have, before going through with surgery. Beyond that, its really a personal choice about what you're willing to live with. As an athlete, I had a high standard for my shoulder functionality, but if you're not going to spend your time throwing things you may not need your shoulder to function at such a high level. For you, it may just be a matter of how much pain you're willing to tolerate. Of course, there is no gaurantee your surgery would be anything like mine. It seems yours would be more diagnostic, so your recovery and other variables will depend on what they find. There is even a chance that they might have to open up the shoulder if the damage is extensive, in which case your surgery would be a lot different than mine. Good luck with making this decision and let me know if you have any further questions.