Torn rotator cuff and herniated disc in neck with upper back pain

Resolved question:
I have pain in my upper right back right below my neck. I was in a car accident 2 years ago that gave me a torn rotator cuff and herniated disc in my neck and resulted in physical therapy and rotator cuff impingement surgery. I was recovered until I had another car accident in February. Since then I've been in physical therapy with little progress. What else can I do?

Submitted: 4 Days
Category: Orthopedic Surgeon

Expert:  Dr. Mukesh Tiwari replied 4 Days.

Hello,

Thank you for asking your query at DoctorSpring. Looks like my previouse reply has disappeared !

I would like to know what are your current symptoms ?(after the second accident) - Neck pain ? shoulder pain ? Radiating pain ? Any pain while coughing ? Pain to the arms ?

Also are the current symptoms different from your previous set of symptoms ?

Was an MRI done ? If so what is the result ? (Or what is your Doctor's opinon about your current injury?)

Please reply as a followup
Thank you

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Patient replied :

Hi, thank you for answering. I have shoulder weakness that makes every day activities difficult, to the point I have modified or stopped doing certain activities that will increase the pain. Things like: driving, reading in bed, playing on the phone, cooking, lifting, putting on make up, getting dressed. I had an MRI a few days after the second car accident, but none since then so I don't know if there has been more damage since February. I am currently in physical therapy and am considering going back to the orthopedic surgeon. The pain is not as severe as the first car accident, but there is weakness that has not gotten better and makes daily life activities difficult. I have been icing and using a tens unit in addition to my physical therapy.


Expert:  Dr. Mukesh Tiwari replied 3 Days.

Hello,

Physical therapy might not be the best option for you now. You may need it later, but before that this 'weakness' you are experiencing should be evaluated. You might need an MRI (Since I do not have access to the previous MRIs, I assume there could be new changes).

Any compression / pinching of the nerve at the neck level or Brachial plexus in shoulder level needs to be considered. Weakness means nerves are involved. And if there is compression it needs to be relieved to prevent any further damage or weakness. TENS or icing will only help the symptoms, and it will not help the weakness or nerve damage.

So I recommend these measures :

1. Get in touch with your Orthopedic Surgeon
2. You may pause the physical therapy
3. Analyse the MRI to find the cause of weakness, if needed a new MRI
4. Nerve conduction studies
5. Forming a treatment plan.

A nerve compression at the neck or the shoulder level (plexus) is most possible.

Hope this helps
Please DO feel free to ask followup questions/ clarifications

Thank you

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