Question
Last Feb 2008, I had my 4th out of 5 surgeries on my right shoulder. It was a manipulation surgery. A couple days after that I was back up to the doc with horrible pain in my shoulder blade, (it was flipped). Shortly after that, I had severe neck pain it hurt in my neck and everything on my right side. My doc ask work comp for an MRI on my neck, they said No, he did x-ray's they looked good, and it was pretty much dropped, neck pain eventually went away. Just recently I stretched and the same think happened again, everything on my right side (shoulder area) and my neck, I could barely move. Per another doc's request, I used my own insurance and got a MRI, it showed a herniated disk in my 6/7 disk (on the right side). I know this is somehow associated with my shoulder injury, or I was wondering if a shoulder manipulation surgery could resulted in this?? I have been on restriction for like 3 1/2 years, I didn't do anything that would have caused this, I'm working on getting a w.comp approval, but as they did a year ago, I'm sure it will be denied. Just wondering what you thought about the manipulation surgery being a cause or the injury itself. Initial injury partial torn rotor cuff, surgery 1: scrape out scar tissue and bone spurs. Surgery 2: same thing. Surgery 3: Repair of rotor cuff, scrape out scar tissue, Surgery 4: Manipulation because I couldn't get an approval from work comp for therapy after surgery 3, so by the time I got approval, I had "frozen shoulder", work comp has paid for all medical and they are paying compensation benefits, however I know this herniated disk is associated with my injury, I just don't know how, wondering if you have heard of it before? Thanks for any help at all or any web sites or information.

Answer
new york manipulation under anesthesia, staten island manipulation under anesthesia, shoulder manipulation under anesthesia,



Hello Jerri,

Sorry to hear of your long history of aches, pains, surgeries.

You have had 5 surgeries on your right shoulder ! ? !
How did this happen?,  What type of job or athletic competition do you do that requires repeated surgeries.  Usually one surgery is enough to repair the problem(s).  Did you return to your injurious activities?

I am not sure what a 'manipulation surgery' is.  Did you have a 'frozen shoulder' (adhesive capsulitis) with an MUA (manipulation under anesthesia) shoulder procedure?- this is not 'surgery', but it is a 'procedure'.

Then we talk about the neck (cervical spine) and a "....disk in my 6/7 disk (on the right side). ...." MRI result.  With this disk herniation in this location,,,, was this the cause of the shoulder pain all along?  A herniated disk in this region can cause pain into the shoulder.  Perhaps all of the shoulder surgeries were because of a missed diagnosis in the cervical spine?

"""...Shoulder pain is caused by rotator cuff tear, impingement syndrome, frozen shoulder, subacromial bursitis, shoulder instability, supraspinatus nerve injury or associated nerve lesion, *****cervical spine pathology with referred pain*****,
brachial plexitis, either by direct invasion or the acute brachial neuropathy of unknown etiology, crystalline disease, avascular necrosis of the humeral head, occult fractures and metastases, arthritis (inflammatory and degenerative), and visceral pain referred from various organs. A conscientious exam aided by special tests such as arthrography, bone scan, or MRI should reveal which disease process is causing the patient's symptoms. ..."  http://www.pain.com/sections/categories_of_pain/musculoskeletal/resources/librar...


"...I have been on restriction for like 3 1/2 years, I didn't do anything that would have caused this, I'm working on getting a w.comp approval, but as they did a year ago, I'm sure it will be denied. ..."
I do not know your locale, but I would think with 5 surgeries upon your shoulder, an MRI that shows cervical disk pathology; I do not think you will be returning to work anytime soon, let alone return to work at all.

"...however I know this herniated disk is associated with my injury, I just don't know how, wondering if you have heard of it before?...",
Cervical spine pathology, 'pinched nerves', radiculitis, radiculopathy, vertebral subluxation, herniated disk- these problems can mimic shoulder problems, radiate to the shoulder, or in the chiropractic experience; cause shoulder problems.  Perhaps you have had a long term cervical problem which caused or radiated your shoulder complaints.  In chiropractic school we were taught the relationship between C4, C5, C6, C7 and the shoulder.  Often a problem in the C-spine will precede a shoulder condition.

"...It was a manipulation surgery
( http://www.youtube.com/watch?v=mLpYrqMDzSw ). A couple days after that I was back up to the doc with horrible pain in my shoulder blade, (it was flipped). Shortly after that, I had severe neck pain it hurt in my neck and everything on my right side. ...",  'shoulder blade flipped'- I am sorry, I am not sure what this means.
              Could this procedure have caused a herniated disk?
I still need further information.  Were you awake for the shoulder manipulation (local anesthesia)?  Were you asleep for the shoulder manipulation?  

I was the first Chief of Chiropractic in a Hospital in New York State, the NYS Governor honored me, NYS Senate (http://www.chiroweb.com/mpacms/dc/article.php?id=38576 ), NYC Council, and even our congressman recognized me (http://www.chiroweb.com/mpacms/dc/article.php?id=37186 ).  As Chief of Chiropractic (http://www.chiroweb.com/mpacms/dc/article.php?id=31768 ), I incorporated SPINAL manipulation under anesthesia into our hospital privileges.  While under anesthesia (more technically correct= under twilight sedation), the patient has to be moved, or assisted to move by the staff.  While under sedation or anesthesia, the utmost care is provided with the patient lifted or moved by professional personnel.

When I do Spinal MUA, we are very cautious, gentle, tender in moving the patient about.  I am sure, if you were 'under', while you were under anesthesia the maneuvers and movement of you were cautious and proper.  It would be very unusual for you to 'wake up' with a herniated disk from a shoulder MUA.

IF, if something happened to cause a herniated disc, somewhere in the record- something should be reflected; a drop, sudden movement; whatever was traumatic enough to cause the injury.

I do not think the manipulative procedure could have caused your disk herniation (unless some trauma occurred, and that should be documented).  Your cervical problems could possibly pre-date the shoulder problems.  Your cervical problems may have been aggravated by an aggressive procedure, but,,, without a trauma,,, I do not think the procedure caused the C-spine problems.

With these neuro-musculo-skeletal problems, I hope you are seeing your local Doctor of Chiropractic.  Now with a cervical spine condition, you definitely should visit a local DC for evaluation. If this was all initiated by an injury at work, workers compensation should cover your exam/ treatment.

Traditional in-office, standard conscious Chiropractic could be very helpful to your spine complaints.  IF these treatments are appropriate after evaluation, but only provide transient relief, then a SPINAL mua
( http://www.youtube.com/watch?v=_ZgJFigsdZc&feature=related ) may be appropriate for you.


You sound like you have endured a lot of pain and surgery.  I hope you get to the cause of your pains and treat it safely, effectively, quickly.

I hope I have given you some good information.  If you need further, do not hesitate to re-contact me here at AllExperts.com :
http://allexperts.com/ep/965-100794/Chiropractors/Victor-Dolan-DC-DACBSP.htm

Thank you,
your Staten Island Chiropractic friend signing off,

Dr. Victor Dolan, DC
http://drvictordolan.chiroweb.com     (Email NewsLetter)
http://www.SIworkComp.com




Further info you may wish to read:

http://www.chiroweb.com/find/tellmeabout/shoulder.html

http://en.allexperts.com/q/Chiropractors-965/2008/7/Drooping-shoulder.htm