[romans8]

I am almost 6 weeks post op. Aside from the first week of awful surgical pain I felt really good weeks two and three. Then I started physical therapy and do not feel nearly as well. The PT itself does not hurt as it is simple range of motion stuff. However I hurt a lot later that day and into the next day. It's frustrating because the pain is different than the awful scapular pain I experienced pre-surgery but it is very uncomfortable nonetheless. It's mostly neck pain and shoulder pain running above the scapular spine and into the arm. This also happens when I do any form of light exercise such as riding a stationary bike or walking 20 - 30 minutes.

I am wondering is this normal? Does it just take time to get everything to calm down? I had to go back to the narcotics tonight for the first time in a while.

For those who have been through this should I continue the PT, back off? Should I be doing some type of myofascial stuff or massage? I am asking myself how important the PT is versus giving it more time to rest. However I have read about scar tissue build up and would hate to have that ruin a good outcome.

[ginnie]

Hi, and sorry you are in pain after your PT. My son is an OPT. As with my own therapy beginning after 4 weeks after surgery, if it hurts, back up a bit in the intensity. Also does your PT include massage? 60% of the therapy I got going twice per week was massage, after the range of motion stuff. That tends to relax the stressed muscles, and stops spasms before they happen. You may have muscle spasms. Ask you doc. for Soma, instead of narcotic, it might just be more effective. Just ask for some massage at the end of your routine. I know this will help you if it is done right. I got sore, but it was more the sore of a good workout, rather than unbearable, or needing more pain killers. I hope you get to feeling better soon. ginnie

[romans8]

Originally Posted by ginnie

Hi, and sorry you are in pain after your PT. My son is an OPT. As with my own therapy beginning after 4 weeks after surgery, if it hurts, back up a bit in the intensity. Also does your PT include massage? 60% of the therapy I got going twice per week was massage, after the range of motion stuff. That tends to relax the stressed muscles, and stops spasms before they happen. You may have muscle spasms. Ask you doc. for Soma, instead of narcotic, it might just be more effective. Just ask for some massage at the end of your routine. I know this will help you if it is done right. I got sore, but it was more the sore of a good workout, rather than unbearable, or needing more pain killers. I hope you get to feeling better soon. ginnie

Thanks so much for the response. I think I need to get a new physical therapist. I do not think he does much with massage. Occasionally he will give me a few minutes of the ultrasound or whatever that thing is they rub on you after putting on some gel. It does not feel like it does anything though. He does ice down my shoulder and puts heat on my neck. Most of his focus has been on shoulder range of motion and I have been doing the neck exercises on my own.

I have been on Baclofen for 8 months or so and it does not feel like it is effective any longer. Maybe I should switch to Soma as I have read where you can build up a resistance to a MR if taken too long. One doctor told me some MRs can give you depression and I don't need that right now but perhaps Soma is worth a try. I do think spasms are what is occuring and they in turn cause nerve pain for a little while. I know they are highly addictive but I wonder how a low dose of benzodiazipines would work until I get further along.

[LiveLoveandTrust]

From what I understand, once you are cleared for PT the proper course is scar management from 1 day after sutures are removed, gentle ROM, massage, and nerve glides for the first 3-4 weeks, then some very light and easy strengthening exercises from 6-7 weeks until 12 weeks gradually increasing reps and weight. You should never be in pain and the point should be to correct poor posture, to stabilize your shoulder blades, and to reset the pain cycle. Ultrasound or e-stim can be helpful for the pain cycle I've been told but it never really worked for me. It sounds like your PT doesn't really know what they're doing so they're treating you like most other post-op people. I've had two shoulder surgeries and they get into strengthening right away and that works for those types of surgeries but TOS is a whole other beast.

Originally Posted by romans8

Thanks so much for the response. I think I need to get a new physical therapist. I do not think he does much with massage. Occasionally he will give me a few minutes of the ultrasound or whatever that thing is they rub on you after putting on some gel. It does not feel like it does anything though. He does ice down my shoulder and puts heat on my neck. Most of his focus has been on shoulder range of motion and I have been doing the neck exercises on my own.

I have been on Baclofen for 8 months or so and it does not feel like it is effective any longer. Maybe I should switch to Soma as I have read where you can build up a resistance to a MR if taken too long. One doctor told me some MRs can give you depression and I don't need that right now but perhaps Soma is worth a try. I do think spasms are what is occuring and they in turn cause nerve pain for a little while. I know they are highly addictive but I wonder how a low dose of benzodiazipines would work until I get further along.

[Jomar]

[ However I hurt a lot later that day and into the next day.]

That's called delayed pain, the PT should be asking about how you are feeling before starting the session each time and then adjusting the PT sessions to reduce that pain response.

Something is triggering that pain and and whatever it is needs to be backed off of.

[ginnie]

Yes, back off if you hurt too much. Your PT should begin each time with the therapist asking how you did after your last session. That massage is more important after your range of motion. Mine lasted anywhere from 20 to 30 minutes at a time and was delightful, not terribly painfull at all. After the whole thing even at 4 weeks I felt better every session. I hope you get a new PT with more experience. ginnie