Dr Chen Weighs In "Shoulder Soreness & The Phrenic Nerve" By Edmund B. Chen on November 29, 2022

shoulder pain after bariatric surgery phrenic nerve dr joe cribbins Did you know it is not uncommon for the right shoulder to be sore after bariatric surgery?  This is because of the connection between the diaphragm and right shoulder via the phrenic nerve.


Bariatric surgery requires a surgeon to insufflate the abdomen with gas to create room to perform surgery.  Essentially this means putting carbon dioxide into the abdomen to allow it to stretch out like a balloon.  This stretching is only possible when a patient is asleep under anesthesia. 


The stretching of the abdomen allows a surgeon to perform surgery through small incisions.  One of the muscles that is stretched in this process is the diaphragm, which is the muscle that separates the chest cavity from the abdomen.  The diaphragm plays a key role in breathing. 


After surgery, the carbon dioxide gas is released, just like air is released from a balloon. The abdominal wall muscles then bounce back to their original form.  However, these muscles, including the diaphragm, can sometimes feel that they have been stretched and can be sore.


Interestingly, the nerve that connects the brain and the diaphragm, the phrenic nerve, also has branches to the right shoulder. 


So, if the diaphragm is sore, it sends this signal via the phrenic nerve, which then manifests itself as right shoulder soreness. This soreness goes away by itself, generally by a couple of days. Tylenol also works great for the soreness.


Avoid taking any NSAIDS (Motrin, Aleve, Advil) because that can cause problems with bariatric surgery.

Stay tuned for the next "Dr Chen Weighs In"

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