Good Afternoon, First off let me start by saying i had shoulder surgery on Dec 6th(almost 3 months ago) the dr cut part of my collar bone-Took out my bursa sac and removed some bone spurs off my ac joint... I started going to PT 10 days after surgery and still go 2 times a week. My problem in that now i have a frozen shoulder (at least thats what they say) and 2 days after my surgery my hand(fingers) swelled up and to this day they are still swollen up.(i have ROM of shoulder 40 outward and 130 up).I have been back to my surgeon and he has sent for for scans to make sure i dont have a blood clot(came back fine) and he took xrays of my hand and wrist and they came back fine also........ I have searched and searched the internet for a reason why my hand is still swollen and i have found nothing! I cant bend my fingers and sometimes my knuckles turn almost black... My surgeon wants to just send me to a pain managment dr and say it is RSD, Im not believing that at all! I have looked and although i do have some of the symptoms i dont have the pain that should be with it...I think its a nerve-circulation problem, I had called my dr 3 days ago and asked for a emg and i have heard nothing back yet.... UHGGG I need help, does anyone have any ideas on what might be going on?
Although my hand is swollen and i cant bend my fingers , you can also see that my whole right arm is bigger then my left.. I have been on anti imflammatorys for over a month and nothing, he put me on anti depressants and still no difference...
Can anyone help me?
sandy

Sandy, I am sorry to read about the ongoing problems with swelling and pain. One would think a doctor diagx and sets a surgery that yuou would improve.

Not be ing a doctor I can only guess from your symptoms that you may have had a TOS related compression and the shoulder problem was secondary.

The reason is what did the doctor state he was shaving the collar bone? This is typically for compression of the brachial plexus, less invasive then the typical first rib removal whish is done for TOS. The first rib lays rinder the collar bone.
This was a surgery proposed to my son at one point.

If you had surgery in this area in Dec. it is possible that you have had inflamation and swelling to the area, or an obstacle is compressing or you are developing adhisions and perhaps they are strangling the vascualr bundles that pass through this area. That could account to swelling. The blood can go down into the arm, but from compression it is not coming back out of the arm. Sounds like something is in a tight wad there.....

The vascular bundle is pictured in this picture...
http://neurotalk.psychcentral.com/sh...light=pictures



Or there may be a lymphatic problem too. BUT at this point I would see an agressive top TOS doctor to find out what it is instead of seeing three different doctors all with three different thoughts.

You may need a doctor to go in clean up the area, and remove the first rib.
Also after shoulder surgery did you return to the same job?
I hope that you find the answers and can get the swelling down.

Dianne

Hi Dianne, thanks for your reply...... The reason he trimmed the collar bone was to make more room in there? So things would not rub together and cause pain, I had alot of arthritis and bursitis going on....; You talk about compression not coming back up my arm.. Would that show up in a emg(nerve test) Because i called my surgeon today demanding one(waiting for him to call back now) As far as work, NO i have still not been back to work have never been well enough or should i say not been able to close my hand or lift my shoulder.. SO im without work which means without money..LOL I have up until april to go back or i loose my job
sandy

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I also forgot to add that at my last visit the dr said i should have been back to work last month (along with my PT_ my PT faxed him a letter saying i was not responding well to PT and that she thought i might have RSD well when i went for my appointment he took what she said and ran with it just sending me to a pain managment dr... I did not go!!!!!! I want to find out what the problem is before covering it up with shots,pills and such

EMGs are test for the larger nerves that make your arm work. tell it to bend, jerk, lift. The nerves involved in compressions are smaller sensory nerves the first affected. EMG may show nerve compression in its later stages...

But your symptoms sound like they are vascular not nerves, that testing on the circulation should be done.

The making room in there to clean up for shearing the collar bone, is typically the opposite side of where TOS surgery is. From the picture you can see the collar bone and first rib. TOS surgery removes the first rib, the cutting back collar bone is opening it up too without removing the rib.

In the picture do you see the subclavian vein? In doing the procedure, I wonder if something happened that compressed this vein and that is why you have the swelling?

Sonograms, veinograms, Doppler other test that are used to test for blood flow sound like you need.
I never had them, also if there is high resolution MRI/MRA that may show what is going on.

Also if you have a repetitive job and this is from the over use, just as carpal tunnel is, you would be covered under workers compensation.
Just a couple thoughts I had, others will be in to share their situations and symptoms too..

Hope it is resolved for you soon,
Dianne

Hi Sandy! I agree with Di...sounds more like a circulation issue than nerves. Not sure an EMG would help. Do you have any numbness in your hand? The claviculectomy (shaving of the collar bone) was probably done to relieve some impingement on the rotator cuff, possibly, due to your bursitis/arthritis. Do you have a lot of joint pain in that shoulder? Are you diabetic? The frozen shoulder dx is a bit puzzling...I think it's usually very painful in the early stages. Was your shoulder immobilized after the surgery? What does your physical therapist think?

Ha...guess I've got more questions than answers! A good PM doc may refer you to a vascular or neuro doc if he doesn't think it's RSD, so that might be a good place to start. I, too, hope you find some answers soon, so you can get better and get back to work!

Take care, and keep us posted!

Donna

I would offer that "pain management" docs are not really cover it uppers, my pain doc ia a neurologist and also the primary diagnosing and treating doctor for my TOS.

I think the best way to manage pain is to figure out the source, and since pain management docs are tryign to make you feel better, they can often help you try to find the source if you are not sure what it is.


I don't know anything about arthritis or burstits, really, but sweilling is a sign of vascular probelms, as Di said. If the blood comes in but can't get back out...well voila, swelling!