Severe muscle spasms following labral repair – orthopedics forum – ehealthforum how long does hip replacement surgery take to heal

I initially dislocated my shoulder at age 14 after a blow to the shoulder. Its dislocated about 10 times since. Usually swimming or sleeping. I am a healthy 38 year old female. I had always been able to either put it back in myself or talk someone through it. About 1 month ago, it popped out while I was sleeping, and locked out. This was the first time I ever sought medical attention for it (always felt better in a day or so). My shoulder was out about an hour before they were able to get it back in. When I was still experiencing moderate pain a week later, I went to ortho doc. After x-rays, mri and ct scans, doc suggests day surgery for labral repair. Diagnosis was Bankart and Hill Sachs Legions. I am at 3 days post op and still having SEVERE shoulder spasms (they started about 3 hours after surgery).

I’m talking sudden sharp intake of breath followed by involuntary squeals, yelling, and words that would make a sailor blush! I am still taking Lortab, Ibuprofen, and Flexeril. Icing often, trying heat right now. Anybody know why this is happening? And what will make it stop?

The first things that has to be determined is if the sensation you are having is true spasms or just sudden sharp pain. Is there actual involuntary muscle contraction, which would cause movement by that muscle, if you were not in a sling or brace? Or is it just significant intense pain in the area, without actual balling up of the muscle?

You are on a muscle relaxant, but they actually do not work directly on skeletal muscle. I know, then why to they call them muscle relaxants? Their mechanism of action is still not known, but it IS known that they do not have any effects on skeletal muscle fibers. They basically work because they are very sedating, thus the person gets some sleep and feels a little better.

These pains and spasms are just the body’s way of dealing with the trauma from surgery. Again, the exact mechanism of action, or reason, is not known. But, in the immediate post-operative period, there is periodic, isolated firing of random nerves. If the nerve goes to the muscles, it causes spasms and pain. If the nerve is a sensory nerve, then there will not be any spasm. Is it because of injury to the tissues during the surgery, possibly temporary ischemia? It’s not known yet, but it does occur, which is why the surgeon put you on the Flexeril. Which, in most cases takes care of the problem. But, it seems that you may need a little something more.

It probably doesn’t really matter that much, as the result is the same, it hurts. The surgeon’s correct, of course, that you can’t sublux the joint in one of these episodes. It would probably take a grand mal seizure to produce enough muscle force to pull the humeral head out of the glenoid.

Just try to advise the nurse that you are having significant spasms in the muscles around the shoulder. These are causing the pain to be severe enough that you can’t rest. The opioid and Flexeril combination is just not taking care of the problem. The opioids are okay, but is there something that could be prescribed in place of the flexeril for the spasm? You have read that Valium has much better anti-spasmodic properties than the Flexeril, is there are possibility that you could give it a try?

Just be forewarned, in today’s war on drugs mentality, sometimes the surgeon’s ancillary staff will take any request from a patient for a controlled medication (by name) as a sign of drug seeking. It’s not right, but it happens. So, if you start to get the well, I don’t know if the doctor can do that, or well, that is a really powerful medicine (it isn’t really, it’s a Schedule IV medicine), don’t argue or get upset. Just politely ask that your message be relayed to the surgeon and when can you expect an answer. If you are not called back by the time they say, call again. Be persistent until your problem is addressed.

Okay, here’s the latest. I’ve been doing physical therapy for 2 hours a day, 3 days a week for almost 3 months now. I don’t know the actual degrees, but, actively, my arm will now get about eye level in front. Almost straight out beside me sideways. Midback right above my rear behind me. External rotation (like arm wrestling position) it’s stuck at 0/neutral. Pain is pretty much gone, just hurts when aggravated or if a strong cold front comes through. There has been virtually no change in the last month and my boss has had about enough of me missing work. So, I quit pt this week. My therapist said she understood my decision and explained that we were working against months of complete immobilization, the fact that the surgeon had to tighten the capsule ALOT to sew it back together, and adhesions. She said that my shoulder worked like a hinge instead of a ball joint (it just lifts instead of rolls). I have NO inferior rotation and a firm end feel. She said to keep up my pulley and bar/weight stretches. Even showed me a new trick, to put a weight a weight in a bag hanging on my shoulder with my arm propped up to mimic her pushing on it. Is it realistic to hope that I might still gain some rom? That I might not look so weird when I try to use my left arm? Any suggestions? I would sure like to be able to fix my hair again some day too!