Brief Answer:
Neck pain following shoulder repair surgery and nerve block

Detailed Answer:
Good morning and many thanks for your question. The incidence of neck and limb pains following nerve block injections for orthopedic repair procedures is not uncommon at all and is generally self limited meaning that pain/numbness/tingling symptoms (if they occur) usually go away on their own within several weeks. In some cases it could take several months and in very unfortunate cases pain can be virtually permanent though it generally gets better.

Often times the anesthetic compound is mixed with other chemical agents that are necessary in order to allow for the injection to be given in that form directly into the joint or muscle area where the procedure is to be performed. These substances can be toxic to tissues and this can be especially true in some folks with respect to nerve or nerve root irritation.

In your particular case the radiation of your pain makes it seem as if the nerve roots at the base of your neck were probably affected and this has resulted in the radiating pain or in more medical terms RADICULITIS that is occurring. Since it involves the neck then, we would refer to it as a CERVICAL RADICULITIS. The fact that this same thing happened to you last year on the opposite side is even more evidence that the chemical content of the injection is the likely culprit of this pain which is the way the nerve reacts in your case to this sort of injection.

Perhaps, you should make mention of this phenomenon to your surgeon so that they analyze what they're giving you and try to avoid this sort of medication in the future. Or they may try a different form of anesthesia or block procedure less likely to cause such irritation.

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I sincerely hope you start to feel a bit better sooner rather than later and recommend you speak to your doctor about avoiding these injections in the future as they seem prone to causing this sort of adverse reaction.

This query has utilized a total of 15 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.

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Brief Answer:
Neurological Examination highly recommended

Detailed Answer:
Since I don't have the advantage of performing an actual physical examination on you and getting the same type of details from you as a doctor would that you were directly in front of....I would have little to counter your surgeon's remarks with except to say that in my experience as a neurologist, I've seen this picture on a variety of occasions and therefore, my belief is that there is a relationship between the injection blocks and developing radiculitis. But again, having you in front of me to examine (as your surgeon does) makes a huge difference when it comes to drawing medical conclusions.

My recommendation is that you ask your GP for a neurological assessment and referral. Pain in these circumstances can be a tricky thing to resolve if in fact, it is due to irritation of the cervical root nerves but in such instances I've found that medications such as gabapentin (Neurontin) or pregabalin (Lyrica) can be quite helpful. I don't think that any type of scan of the shoulder is necessary unless a neurological deficit in either motor or sensory pathways is encountered in which case, not only might an imaging study of the NECK be useful (not the shoulder...but the neck) but I might even have an EMG/NCV study done as well in order to rule out a RADICULOPATHY or NEUROPATHY of some sort.

I do not endorse chiropractic involvement for such cases due to the risk they may wish to perform cervical manipulations which I believe are potentially dangerous to patients because of head thrust maneuvers they perform which can cause arterial dissections. I like the idea of acupuncture for pain management but again, diagnosis is more important at this point than anything else since depending on what you have the treatment will be derived from that fact.

I hope you get to see the proper specialist and will continue to stand by the recommendation that further injection blocks using the same medication regimen are not advisable.

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Many thanks.

This query has utilized a total of 29 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.

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