Several ? about the recovery process..muscle spasms

[am99gt]

I had a TBPI in Jan, I lost all use of my arm at the time but it is now fully back as far as movement goes. I also broke my arm were it goes into the socket.
My strength still needs improving mostly in my hand and fingers.I am able to carry bags of gro. with my arm and lift heavier things. But what I'm trying if figure
out is if its normal to have all this movement and strength back but still be in a great deal of pain. I'm not having the shooting pains down my arm (the nerve type pain)the only
meds I'm on is the zanaflex. Stopped the Neurontin the end of March.

1. I have pain in my shoulder when I move or raise my arm, it feels like I'm the tin man and need oil. If I happen to roll over on that shoulder at night it feels like something is stabbing me.
Is this normal, and if so does the pain go away with time?

2. There are nights that I wake up and my arm is asleep I'm unable to lift or move it like it felt after our wreck but after 30 mins or so its back to normal. Anyone else experience something like this?

3. Muscle spasms & electric shock like feeling in my arm, neck, face,head and back. Increases 5-6 hours after getting up from sleep. I've been on zanaflex since wreck but
I try just to take it at night because it knocks me out but the spasm/shock feelings seem to be increasing by early afternoon. I don't know how to explain the feelings but days that
I'm having a lot in my head/neck area I will not drive it makes me feel like I'm gonna pass out. Is this symptom something caused by a TBPI?

4. My fingers & wrist get very painful and feel like they are drawing up, its not constant it just comes and goes. From the tip of my thumb running down to my wrist will get painful and very swollen usually 2-3
times a week. It almost feels like it gets out of socket and needs back in. What might cause this?

Please excuse my long rambling questions I feel like I must be crazy to be having this much problems since I have my movement back. I'm just trying to find out it there are others who are going to through something similar.
I had to reschedule my last 2 dr. appointments in April & May (no insurance/low on $) but I am going the end of this month. I would love to hear if anyone knows of any treatments...procedures...or meds I should talk to him about.
I've got to get these problems under control.

[Its1105]

Sorry to hear about your pain. I had my injury in December 2008 and repair a little over a week after that. I have similar symptoms. I have received some movement back, although not complete ROM. My biggest problem has been pain. I have nerve pain as well though. My Occupational THerapist has said that a lot of my pain is the muscle spasms though. I get it all over my shoulder blade and neck area as well as my bicep and shoulder joint area. My arm also goes "to sleep" and feels numb like I cannot move it at times - particularly if I am sitting in a certain position or if I am doing ROM and am holding it up.

I have been seeing a pain management specialist as well as my BPI doctor and my OT... none have been able to really figure it out. My OT think some of it might be swelling that I have had since the injury - pushing against the nerves. Also, there was talk that my body might be trying compensate and so some muscles that dont normally work are working much harder causing the spasms.

I dont know if that was much help, but I would def talk to a doctor or pain specialist about it all. I hope you feel better soon!

[troy]

Hello,
Sorry to hear about your situation but I am stoked you got movement back. I am keen to know a little more about your recovery because I have quite a few of the things you mentioned with no recovery of arm movement.

I am six months post injury and about to have nerve transfer surgery and exploratory surgery. I have recovered a very little tricep but no bicep. I had bad shoulder sublaxing but have noticed over the last three weeks that this has improved to the point where there is no sublaxing pain and my shoulder has visibly improved.

My arm really feels apart of me now and especially over the last two weeks the upper arm and shoulder areas have become very sensitive to tap and touch. This sends pins and needles to different parts of my hand depending on where i tap. My arm really feels like it is coming back but not sure if this is just wishful thinking because i want it so bad. I really i wish i could give it another six months but do not want to miss my best window of opportunity for the nerves to graft on.

Just keen to know what sort of things you felt before your arm came back.

Cheers mate, look forward to hearing from you or anyone else.

[Its1105]

Have you had a nerve repair surgery yet? I had a repair done approximately 9 days after my injury. Although I must say, my injury occurred during a surgery - the doctor accidentally cut two nerves (C5-C6 at Erbs point) which is how I got my BPI. So I really started out in a better situation since the nerves were cut pretty clean. Having the surgery so soon after the incident was also helpful for me to gain the movement back so quickly.

It is a loooong process though and I was told that it would take 12 months to get majority recovery back - and my majority recovery could range from 50-90%

I still have a good portion of my bicep area that is completely numb to touch on the skin, but I can feel deep nerve pain below it. I have been told by my OT and BPI doc that it is odd though becuase generally feeling/sensation comes back before movement (which it didn't for me). So if you are beginning to get sensitive to touch that might be a good sign. I have also been wanred many times that pain is good for this injury to an extent becuase it you have the nerve pain it means it is healing. no pain would be a bad sign.

If your nerves were ripped apart, then you need to get the nerve graft surgery in ASAP. If they were torn then the chances of recovery are not good unless you have the surgery from what I hear. The surgery will reconnect them and you will be in a sling for some time to let it heal. I was in a sling for 5 weeks - no moving my shoulder at all otherwise it would risk tearing the stitches holding it all together. Once it is healed though, I still didn't get movement back for another 2.5 months and then only slightly. Definitely get the nerve graft surgery if you can.

I didn't really feel anything in particular when my arm came back. I just noticed one day that I was able to move my shoulder a bit. I remembered my doctor asking me if I could do something previously and I couldn't and then suddenly noticed that I was doing it then and there. It started more with my shoulder blade being able to move so I could maneuver around a bit and then i could raise my should about 3 degrees and eventually and currently I am at 10 degrees. I have developed much more pain though since the movement came back. Mainly cause it irritates the nerves and etc.

Feel free to email me at its1105@yahoo.com if you want. Or I check here frequently too! I hope some of that info helps

[troy]

ive had no surgery yet i have`a stretch injury and they hope it would come back within 6 months. since i have had no bicep and very little tricep they will have to do surgery. its just that my shoulders is strong and feels good. i thought i would throw some questions out there before the op.

[shaunnb]

Hey Troy,
im from australia too..
i had nerve graft surgeries... seral nerve left leg to my c5 & c6..this initial suregry was done within 3 months of my accident...then distall bypass surgery twice.. i think get ur surgeries done asap..
as my window of opportunity has just closed, but the last surgery looks to have worked.so i might regain my deltoid,,
when my bicep/brachiallis came back...well initially.. i found it started twitching.. just as a normal muscle would if it is tired.
shaun

[troy]

Yep i am booked in for the end of the month at the Royal North Shore by Dr Biggs and Prof Tomkin.

Glad to hear your news is good. Just wondering who did your op and where in Aust are you from?

[racerboy]

Hi Troy-
I'm just curious whether they are planning on doing grafts or nerve transfers? It seems that grafts have fallen out of favor a bit, at least here in the US, unless the nerve injury itself is relatively small.

Best of luck. I am just about 3 months post-op from multiple nerve transfers and the waiting is the hardest part!

Frank

[shaunnb]

Hi Troy, Dr Phillip Griffin..
Im from S.A

[troy]

yea mate not sure its more exploritory and they will just do what they need to depending on what they find but he said i will be on the op table for around 18 hours.