question about first rib swelling and pain

[capricorn]

Hi all....Just got back from PT. Not doingmuch because I can't. the pain and swelling in different areas is no better than it was 6 weeks ago. Here' my question as I have heard it mentioned here before but don't remember by whom. After the aggressive PT pulled my arm to far out I have aquired alot of swelling right on top of my collar bone that gives me alot of pain and limits movement of my arm and neck. Tired everything to get the welling down. Asked my PT today what it is and he said the first rib and it appears that there is alot of muscle swelling around it. Can someone explain to me what causes this and what I can do to help it get better? I had no problem in this area before the shoulder surgery. Any and all help will be appreciated. It will be 7 weeks this Friday and I feel as if I am getting nowhere.

CAP

[Bad Boy Bad Boy]

Capricorn, I'm one that has the first rib movement that hits a nerve. Called TOS, Thoraic Outlet Sydrome, you should do web searches on it. Medical searches you will find so very interesting.

Thoraic Outlet Sydrome;

http://www.tos-syndrome.com/

[Pooh]

Cap

Badboy is way correct and you don't have to have an extra first rib either. Most doctors will like to say it is because of an extra first rib - in my case it isn't because of an extra first rib. And to tell you the truth - PT has inflammed the TOS and made it worse even though my rom is still there - the pain has increased along with the spasms.

We did find out I do have one muscle that is no longer working properly at all - so not sure what that means and not sure why it took til week 6 to figure that out.

[capricorn]

Morning badboy and pooh.....If i had a WC check I would have bet that it was the 2 of you that had TOS but wasn't positive. badboy , thanks for the link. It appears that I am in Pooh's shoes. Didn't have this before surgery or before the PT yanked my arm. I guess this is one more thing that will be time consuming to get under control . PT is aware of it and IF I'm still swollen I will be sure that he makes the surgeon aware on the 3rd when I see him again. I haven't seen the spine specialist who has bee the teating Dr. since the end of April as the shoulder surgeon took over treatment until the shoulder issue is resolved. I think it's time I saw both. Thanks for the help

CAP

[Bad Boy Bad Boy]

Capricorn, my Doctor can Pop mine back into place, in fact had been doing that since my first injury of the cervical neck. Then in the area of Nov 2004 I told him why pop it back in place, for it hurts like heck to do it, only for it to pop back out when I get home the same day, and when that happens, the pain would send me to my knee's. It was apparent the bone found a new home I told him. So they left it alone since. I could of had it removed, but elected not too, and just leave it alone. It moves every now and then with that pain that will send me to my knee's, but that's only the top rib hitting a nerve is all. I got use to it, so why bother with more surgeies, I had enough of them.

[capricorn]

Badboy....I am actually wondering at this point if this is from my neck or shoulder. I am still in alot of pain 7 weeks post-surgery on the shoulder., PT is making matters worse. Never had this bulge above my collar bone until after the surgery and PT started. I had been through 2 months of cervical PT with no problems. I am really starting to wonder. Surgeon and PT all tell me this happens, looks normal, will hopefully go away BUT I am not happy with these answers or the way things are progressing or should I say regressing. I feel worse than I did before the surgery. Stil having stomach problems. No pain meds. Just plain old disgusted and have no idea what to do about feeling better. I am wiped out after a shower and getting dressed. The pain is there 24/7. sometimes it eases up a little but is always there. Don't know what to expect next. Maybe I should follow up with the shoulder sugeon and the spine specialist.?????????

CAP

[Pooh]

Cap

If I remember correctly - your shoulder popped when she did the last treatment to you - so I have been thinking - wonderful thing PT gives me time to do.  lol

When I first got injured that is what my shoulder did and it also had the swelling and the bump on top of the collar bone area.  I think it took mine about 2 months before the bump went down and that was with PT.  Did any of the WC PT write that in their reports - NOPE - so make sure it's wrote in your reports - as far as the swelling - the wrote it was just tendonitis and bursitis.

As Badboy wrote - first ribs can pop out of place - it's called rib dysfunction. (See I do learn things at PT.)  But I also learned it's not just the first rib that can pop out of place - like in my case - almost all of mine on the right side are out of alignment.  I think one way they can tell is from x-rays of the chest.

You should see the surgeon if you feel you are regressing at this time.  What did he tell you on the 12th when you seen him?  or was that when he said things were normal?  did he take x-rays of it? or do anything at all

I have just finished my 6 weeks of PT and although I have some strength - at least a little more than before I went - the pain is still worse than when I started.  There are some movements I can make and some that just hurt no matter how much I try.  So not sure what is next but with TOS not much can be done since I don't have an extra first rib ...... so it's something I have to live with.

I hope you can get a hold of someone and explain to them what is going on so that they understand that this happened after the therapists went haywire on your arm where before you were progressing.

Pooh

[capricorn]

Morning Pooh.....I have PT at 8:00 this morning. I really like this guy. He listens. When I saw the surgeon he said shoulder is great , moves smoothly with great ROM. All pain seems to be muscluar at this point, except the constant stinging in my shoulder. Never having joint surfery before doesn't help as I have no idea what I should and shouldn't feel at this point in time. I see the surgeon on July 3rd again and atart more aggressive PT next week. I have full confidence in this PT that if I need to still go slowly he will. I'll remind him the week before I see the surgeon to please make sure he has his notes and all is in there. When the aggressive PT yanked my arm I felt a slight snap in my chest muscle, shoulder is in tact, no dislocations BUT that is when I noticed the sweeling above my collar bone. One tells me it's lymph nodes that aren't flushing the fluid, another tells me it's a pulled muscle, another tells me it's the first rib. All the surgeon said was that he has seen this happen before with too aggressive PT too soon and didn't seem to be worried. I am starting to wake in the morning with less pain but as the day goes on it's the same. HORRIBLE! whether I have PT or not. I called the surgeon adn left a message yesterday to please prescribe something. I need a relief once in awhile. He felt the last time I saw him that I needed a round of anti-inflammatories which I agree with but since I have LPR he didn't think it wisw to take anymore. Can't even take advil now, my stomach is such a mess. PT started to work on my neck a little the other day. Maybe with him onmy neck AND shoulder some of this swelling will go down. I ice off and on all day until I'm frozen. Fall asleep everytime I have th eice on since it's the only time I am totally pain free. Pooh, I'm just plain old tired of being in constant pain. This stinging iin my shoulder 24/7 gets to me even though I know it's probably the nerves coming back to life and a good sign, all in all I'm still disgusted and starting to wonder if the surgery was a good idea. Hubby keeps telling me that with that 2 inch tear and all teh bone spurs I would have ended up really in trouble someday. I agree but it doesn't make anything easier. Sorry your PT didn't help but i truly understand.

You know pooh,,, I don't even know what I shoulde be doing at home. Surgeon tells me to rest it and ice it for a couple of weeks. Did that. Now i just do my simple strretches after heating, then I ice it. The PT who pulled it told me 2 weeks after surgery I should be doing housework and using it all day. I am so confused. Going to talk to my PT this morning and hopefully will get some help.



CAP

[Pooh]

Cap

I can't answer about after surgery since I still haven't had surgery. What I was told was that I can do what I want to at home as long as it doesn't hurt to much. If the pain starts in - then stop. Like I can stop in the middle of cooking dinner - yeah right.

Any way - there is only so much one can do - but have you tried seeing if they can prescribe you something that is coated to help protect your stomach?

I think we must be a nightmare for doctors since they can't prescribe much for us ........... but at the same time we also would like some pain relief. My doctor has me doing lots of alternative pain relief since the narcotic knock me on my butt - but that is the best that I can do on some days. I think my hubby can see that all the pain is getting to me and would like that something be done about it so that I am in less pain at this time. He's even getting to the point of telling me to take a pain pill knowing that I will be out most of the day. He so hates seeing me in pain and when he's home I really hate to take them because it's our time together ya know.

[capricorn]

I do know what you mean Pooh...... Sadly but I do. I'm not much of a pill popper BUT talked to the surgeon's asst. this morning and he said he was calling a prescription in . I have no idea for what yet. Even if I have to take something on my PT days, or just at night when it's at it's worse. I am even willing to take a steroid round even knowing it will whack my diabetes, BP and stomach up just to get some relief. I am still really swollen. Bicep, tricep, colloar bone, pec muscles and hand so I know that's part of the problem. I can't ice anymore than I do already. I'm trying to do a little more around the house within reason so I don't stiffen. Some of my worst pain is still in my armpit when my arm is raised. I think fear has stepped in at this point and makes me afraid to move. Oh dear, what are we going to do. You're so right. I think most Dr.s and my PT want to run when they see me coming. You know "Oh God , here she comes. All sorts of problems. Can't take this, can't take that" We certainly make them have to think and do their jobs don't we? Not the easy ones of just prescribing what they normally do. My next stop is going to be my PCP who has offered me all the help I need. Maybe he can come up with something to get some of the inflammation down. Glad your here Pooh.


CAP