10 Weeks Post Rotator Cuff Repair Surgery - Experiencing Heavy Arm Pain

Bones, joints and muscles
1

I am just over 10 weeks post-surgery from a rotator cuff reattachment repair and I am experiencing some unusual arm pain which I can't seems to figure out the exact cause of. The arm pain also seems to continue to get worse as time goes on even though I stopped wearing the sling about 4 weeks ago.

I feel the shoulder itself is recovering more or less on schedule with a usual amount pain and a slowly progressing increase in mobility, range of motion and strength from what I can ascertain. But the arm pain seems untypical and is in addition to the shoulder pain. This arm pain starts at about 2 inches below the shoulder and is somewhat separate in a way. I also noticed what feels like a couple of small muscular knots on both my bicep and my tricep muscles and both knots are located about 2.5" equidistant below the shoulder that was operated upon. The knots seem to have developed while I was wearing the sling.

The arm pain typically starts, and is at its worst in the morning when I wake up. It comes on like a wave of heavy pain covering almost my entire arm and which starts within 10 minutes after I awaken. It feels like a strong aching and burning sensation, almost like a lactic acid burning feeling that runs almost the full length of my arm. It seems to run from about 2" below the recovering shoulder down to nearly my elbow where it stops and then it recommences again just below my elbow on the back of my forearm and down through my wrist.

After a few weeks of trial and error I seem to have figured out at least how to relieve most of the pain by putting a hot water compress on my arm immediately after I wake up and moving it up and down my arm and applying the heat to various parts of the arm for about 20 minutes. This normally gets rid of 85%-95% of the pain, but if I don't use the hot water then the pain often persists most of the day. The pain also does sometimes return later in the day, especially if I take a nap, and, if it does, I just repeat with hot water and/or ice to relieve it again when that happens.

I don't think I have a DVT, but I guess I can't be 100% sure. I also don’t have any muscular pain when I move the arm in any way so I don’t think there are any other tendon tears present. I did also have a small lipoma removed from the back of my arm just below my tricep (during my rotator cuff surgery), but I doubt this has anything to do with the pain. Perhaps those knots in the arm muscles are part of the source of the pain, but I am wondering if some of the external rotation physical therapy movements done on me initially have perhaps caused some minor tendentious (tennis elbow) in the back of my forearm which is now contributing to the lower arm pain.

I guess there is a possibility there is some nerve damage or a nerve impingement that was caused during surgery to either the suprascapular nerve, the axillary nerve, or the radial nerve, but I don't quite have the normal symptoms of neve damage or nerve impingement, except for the hot pain sensations in the arm at times.

I would really like to try and figure out exactly what is the cause of this arm pain and what I might do to try and mitigate it so that eventually I can start becoming pain free from all this.

Thank you all in advance for any thoughts you may have on my issue.

2

You are only at 10 weeks. There will be pain. Gradually, there will be less pain. So nobody here is a doctor and can diagnose you. You should check with your surgeon or your physical therapist. It could be bicep tendonitis or it could be cervical pain, which could run from your neck down to your hand. I have had both of these things. I had to get a steroid shot in my small bicep around week 8. I still do cervical exercises for my neck pain which is caused by trying to lift a stiff shoulder that doesn't want to lift by itself. 

3

I am at 10 weeks and suffering from all of the above. Tough to no get discouraged. Wrist pain is pretty bad. Hang in there.

4

Thank you for your reply. I just checked my pre surgery MRI which indicated that I also have mild long head bicep tendinosis and infraspinatus, subscapularis, and teres minor tendinosis. So I have tendinosis in 4 muscles all around the supraspinatus tendon that was operated on.

What is surprising though is that I had no pain in my arm whatsoever before the surgery. Perhaps being in a sling for 6 weeks caused these already injured tendons to get inflamed even more than they were and is what started to cause this hot pain going down my arm to my wrist.

I have an appointment with my surgeon for Thursday. I will ask him more about all this when I see him.

 

5

Thank you Bill. As I wrote above, I discovered from my MRI report that I also have tendinosis in 4 other muscles surrounding the supraspinatus tendon that was reattached during the surgery. Not sure if this is the cause of all my arm pain, which has lessened a bit now thankfully, but I will ask my doctor about it when I see him Thursday.

Yes, it is though not to get discouraged at times dealing with a lot of pain and not seeing much progress at times. I have good days and bad days and I thought at nearly 3 months post-surgery now that I would be much further ahead in my recovery. Got to hang in there though as you said.

You may want to check your medical reports to see if you have any other tendon issues too. It seems that if you have torn one shoulder tendon that it might not be so uncommon for other tendons around the area to be in a bit of trouble too if they compensating for the torn tendon before the surgery.