When does the shoulder pain stop?

Why shoulder pain?

During the laparoscopic surgery, C0₂ (Carbon Dioxide) gas is injected through a special needle inserted just below the navel. This is done in order to inflate the pelvic cavity and allow the surgeon to have a better view of the organs.  After the lap, many people experience shoulder pain, ranging from mild to severe.  But if the work was done in the pelvis, why the shoulder pain?

The diaphragm and the shoulder share some of the same nerves - when the C0₂ gas irritates the diaphragmatic nerves, that pain is then sent upwards through the nerve connections, eventually landing in - and aggravating - the shoulder.

Why does the gas irritate the nerves, if it's just inflating the diaphragm?  Because the gas does more than just inflate the abdominal cavity: it also effects the physiology of the surrounding peritoneal tissue.  The whole thing is very complex but has to do with the temperature change of the Carbon Dioxide and the drying effect of the gas which ultimately causes the nerve irritation in the shoulder.

AND IT SUCKS!

Are you walking as much as you're able? That helps to dissipate the gas. You might also want to try a ho****er bottle or heating pad (or even those heat stick on things) right under your ribcage where your diaphragm stretches over the stomach. It might help at least a little.  A hot bath also seemed to help me when the pain was at its worst.

I had the left shoulder pain the whole 2 years I had my band. I still have it to a lesser degree occasionally due to diaphragmatic damage. 

Hope you feel better soon.

 you really went through hell with that band didn't you???? :(  I'm glad that part is over for you. 

It was truly horrific. Thank you for your support. I really wanted it to work. I chose a REALLY bad surgeon. I mean, he wasn't just negligent,he was pretty malicious.

Thursday and Friday I had a hard time doing more than a few laps around the house but Saturday I spent 3 hours roaming downtown Annapolis and then went to visit my horse, Sunday I walked through DC for 1/2 hour then took an epic 2 hour walmart trip. So I don't think walking is the issue I wi**** were so easy an answer. Tried a heating pad last night but not allowed to take a bath for another 10 days probably (due to my stitches.)

LUCKILY no shoulder pain this morning as of yet - knocking on wood. But thanks for the idea of putting it under the ribcage where the pain is likely originating from rather than at the shoulder. If/when it comes back, I'm going to try that.

The band literature reports this shoulder pain can last up to 6 months, although I don't know very many people who had trouble this long.
did your doc instruct the ways to prevent it??

This is not gas pain from inside the intestine, so walking will do nothing to help (but walking is good for other reasons, so move as much asyou can). similarly, things like Gas-x, which work IN the intestine, also will not hlp at all. THis pain is from diapgragm irritation (more on this in a minute).

First, an NSAID will be much more effective than Tylenol. you need the anti-inflammatory effect of NSAIDS. Most docs will now allow them for a couple days. Check with yours - and be sure to use the liquid, like liquid ADULT strength Motrin.  The Motrin will also help your surgical swelling and your incision pain.

second, do the "chicken flap". This is best done at the first incident of pin, hen it rarely lasts for more than a few days. sit upright in a straight chair. Place your fists together in the center of your chest. Raise your elbows to horizontal, and flap like a chicken. This interferes with the nerve pain transmission. do it for 30-60 seconds, and as often as needed. Sometimes it doesn't work too well when started so late, I'm afraid.

Also,  a warm heating pad to your CHEST will help. The pain is originating in your diaphragm, which is being irritated by the surgical swelling and new band - so place the heating pad on your chest , where the diaphragm is.

Please do NOT soak in a hot bath, as someone said - you have new surgical wounds begging to get infected. Most docs allow NO baths until the wounds are healed completely - 2-3 weeks minimum. a brief stand-up shower, washing the wounds briefly, is ok.

Hope this helps -

Sandy r,  BSN, MN
band educator
at goal 6+ yrs
banded 7 yrs

How funny, back in 2003 on Spotlight Health, you were one of the people who told me that it was "just gas." And you were quite condescending about it. 

I had a bad surgeon telling me that it was "all in my head" and then people like you telling me that he was right. After I found a different surgeon, it turned out that my stomach was twisted, my intestines kinked, I had a bowel obstruction and was filled with toxins and about to kick the bucket.  And my new surgeon told me that it was good that I hadn't listened to all the people telling me it was "just gas" because I would have died in a day or two.

I'm sorry for what you went through, but this feels kind of like bringing old baggage into a discussion that really wasn't about that.

I appreciate ALL suggestions about what to do for this type of pain (it seems to come more at night.) And I especially appreciate hearing that it shouldn't be ignored if it continues for a long time. I don't want you to think I'm knocking you, I just think that people should focus on giving helpful advice but leave personal gripes at the door. I'm an innocent bystander and don't want to read about what one person said to another years ago.

Thanks!

I don't care so much what other people think I should or should not post.  Good luck to you. I hope the pain goes away soon.