This is a very overdue blog… and as usual, it takes someone’s misery to spur me to the keyboard.
The privilege of being in practice for 26 years is that you see patient’s through multiple milestones of their general health journey in the background of their chiropractic care. And some of the milestones involve surgeries with general anesthesia.
It took me several years to connect the dots between patients presenting with sudden new onset of neck shoulder and arm pain and recent history of full anesthesia surgery. Coming out of surgery with pain in the shoulder, regardless of where you had surgery is not uncommon. This is the result of air from the abdominal cavity trapped under the diaphragm and referring to the shoulder. It is typically not related to any trunk, neck, or arm position and disappears within 7 days. However the patients I was dealing with were still very much having pain after weeks or months and were unable to turn their head or lift their arm.
General safe anesthesia requires that airways are maintained open and ventilated at all times. In order to achieve this, the upper body has to be propped up in a way that allows the attending anesthetist to properly insert an intubation tube down the throat. The body positioning happens when the patient is sedated or already under, so you may not be aware of what sort of positional strain is applied to your neck and arm. If you were awake, you would ask the team to stop and reposition you. But you are not.
The picture I have attached comes from a manufacturer of foam wedges that are used for surgical positioning. You can see that the intubation positioning requires the patient to be able to tolerate a certain amount of lower cervical extension and posterior shifting for prolonged periods of time. This may, or may not be the case depending upon your individual spinal anatomy and cervical curve. I have especially noted that patients with short neck, with rounded upper back and a history of cervical degenerative disc disease, scoliosis or stenosis are more likely to develop a neck and shoulder positional injury .
If you or a loved one continues to struggle with pain in the neck, upper back, shoulder or arm following a surgery that involved total anesthesia, consider getting evaluated.