Shoulder Pain Pumps: A Lifetime of Pain for a Few Days of Relief

Baltimore, MDPatients who have developed postarthroscopic glenohumeral chondrolysis (PAGCL) following shoulder surgery would likely warn people that the pain they will feel for a lifetime is not worth the two or three days of relief they get from using shoulder pain pumps.

The pumps, which are inserted to help patients manage pain following arthroscopic shoulder surgery, are only used for two to three days following the surgery. Pain pumps are used because oral pain relievers do not adequately treat the pain many patients feel and have adverse side effects. However, shoulder pain pumps that deliver medications directly to the surgery site have now been linked to PAGCL, a painful condition with no consistent treatment.

Shoulder pain pumps linked to PAGCL generally infuse pain relievers including bupivacaine, lidocaine and/or epinephrine into the affected shoulder. Bupivacaine is a local anesthetic that blocks the conduction of nerve impulses. A doctor inserts the pain pump following arthroscopy. Essentially, a pain pump consists of a small catheter that is inserted at the site of surgery and is attached to a container, outside the patient's body, that contains a pain reliever. The pump then slowly and continuously releases the medication into the patient's body.

PAGCL is a fairly new condition, so not a lot is known about it or how to treat it. Patients who develop PAGCL can suffer severe pain and permanent problems with shoulder mobility. Furthermore, some patients require shoulder replacement surgery to treat the problem. This is because the shoulder joint requires cartilage in order to move properly. In patients with PAGCL, the cartilage is broken down, resulting in pain and limited mobility.

Patients who develop PAGCL may not show symptoms of the disorder for a few months after arthroscopy. In fact, although most cases appear within five months of surgery, in some cases PAGCL has not developed for 12 months or more following surgery. This may be because the shoulder joint is not used significantly in the months after surgery, which delays people noticing that they are having problems with their shoulder.

Symptoms of PAGCL include shoulder stiffness, weakness and pain, clicking, popping or grinding in the shoulder, and a decreased range of motion in the shoulder. If you have had shoulder arthroscopy and notice any of these symptoms in the months following surgery, contact a doctor to discuss your options.

Some patients report that the symptoms of PAGCL are worse than the symptoms of the condition they initially sought surgery for. Lawsuits are being filed against the makers of pain pumps alleging the manufacturers did not properly warn patients about the risks of PAGCL.