Tuesday, July 29, 2014

Monday, June 15, 2009 MISERABLE, Community Member, asks

Q: IS STIFF FINGERS NORMAL AFTER ROTATOR CUFF SURGERY

I HAD ROTATOR CUFF SURGERY 4 MONTHS AGO. I HAD OPEN SURGERY WITH 3 ANCHORS AND SUBACROMION DECOMPRESSION. I WAS IMMOBILIZED FOR 6 WEEKS.  I'VE BEEN

IN PHYSICAL THERAPY FOR 8 WEEKS NOW AND AM STILL EXPERIENCING PAIN REQUIRING

VICODIN, THE SHOULDER IS STILL VERY STIFF IF I DO NOT KEEP IT MOVING. WHICH I CAN SOMEWHAT UNDERSTAND BUT IS IT NORMAL FOR MY HAND TO BECOME STIFF IF I AM NOT MOVING MY ARM ESPECIALLY IN THE MORNING. EVERYONE TELLS ME TO KEEP IT

ELEVATED, WHICH I DO BUT IT DOESNT HELP. I SEE THE DOCTOR IN 2 WEEKS. IS THIS

SOMETHING I SHOULD BE CONCERNED ABOUT

WOULD APPRECIATE ANY HELP OR ADVICE SOMEONE CAN GIVE ME

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Answers (1)
6/18/09 11:52pm

You did not mention whether or not you have swelling in your arm and hands. Swelling with stiffness could be associated with a condition called lymphedema. After surgery in the shoulder or breast region, the lymph system can be effected. This system is vital for the return of fluids to the vascular system by collecting the fluid from the tissues. For example, women who have had a mastectomy are at high risk of developing lymphedema.

 

If you had just had surgery, then the stiffness could just be associated with positioning during the surgery. Patients are put into percarious positions for the surgeon to access the region sometimes. In fact, positioning can be very problematic and even cause temporary nerve damage. Maybe your brachial plexus (nerve center in the shoulder region) was mildly injured during the surgery, leading to nerve irritation and muscle spasms. It is possible and will mend with time.

 

Even plain old pain in the shoulder will cause stiffness in the entire extermity because the muscles shut down as a mode of protection.

 

All and all, I would need a more specific description and examination to be able to determine the cause of your stiffness. I would not say that it is common for the fingers to be stiff after rotator cuff surgery, but it is possible.

 

Talk it over with your surgeon.

 

Dr. Christina Lasich, MD

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erik, Community Member
9/25/10 4:00pm

I have a similar issue, but I am in my 15th week of recovery from rotator cuff surgery (a small tear).  I had a nerve conduction study done, which came back normal.  However, I still have slight swelling in my surgery-side hand both day and night, and if I wake up in the night, I cannot close my hand due to the fact that it is swollen/stiff.  It does not seem to matter if I sleep with it elevated or not.  Any advice would be appreciated.

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9/25/10 6:33pm

You might want to try wearing compression gloves like the ones made by Isotoner. These gloves help the fluid to return to the heart and not pool in the hands. I'd try wearing such gloves at night only to start with and see how it goes.

 

Dr. Christina Lasich, MD

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erik, Community Member
9/25/10 6:59pm

I know you are probably not comfortable giving a diagnosis, but it sounds to me like you do not think lymphedema is an issue in my case.  Or, if it is, are the gloves a way of treating the symptoms?  Either way, thank you for the advice... I will definitely give the glove a try!

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9/26/10 4:23pm

Well, you are right. I cannot give a diagnosis, but can say that the edema is either due to a nervous system problem (nerves manage fluid homeostasis within the tissues) or a mechanical fluid flow problem isolated to that particular limb.

 

The gloves just represent a possible solution either way without getting too hung-up on a diagnosis or a name.

 

A thorough examination of the limb would be in order just to make sure that a more serious problem (unconnected to the shoulder surgery; vascular? lymph?) is not lurking. I would hope that your doctor surgeon has already done that and is aware of this on going problem. I would want to know if I were your doctor.

 

Dr. Christina Lasich, MD

Reply
erik, Community Member
11/23/10 10:37am

This is part of a series of questions you have responded to... it is now 5 and 1/2 months after my rotator cuff surgery, and I am still having slight swelling in the surgery-side hand (it is more obvious after exercise and in the heat, I believe).  My surgeon is now saying that the swelling may never go away.  I am wearing the gloves you recommended at night, which seem to help, but the swelling never totally subsides.  Do you have any further thoughts on this matter?  Thank you for all the help/advice you have had to offer to this point. 

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erik, Community Member
11/26/10 3:45pm

This is part of a series of questions you have responded to... it is now 5 and 1/2 months after my rotator cuff surgery, and I am still having slight swelling in the surgery-side hand and "tightness" or soreness when I make a fist (it is more obvious after exercise and in the heat, I believe).  My surgeon is now saying that the swelling may never go away.  I am wearing the gloves you recommended at night, which seem to help, but the swelling never totally subsides.  Do you have any further thoughts on this matter?  Thank you for all the help/advice you have had to offer to this point. 

 

P.S.  He has finally said he might have my hand X-rayed, but I don't know what this is supposed to accomplish.

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By MISERABLE, Community Member— Last Modified: 05/20/13, First Published: 06/15/09