I had a lumpectomy last week. While I was in recovery my blood pressure dropped and also had a minor temperature. The next day I had terrible muscle pain, my neck, my rib cage, my lower back and both calves were tight that I felt like I had been in a car accident. Over the next few days, the pain subsided, one area at a time and no more muscle pain and tightness. But now I occasionally feel light-headed and dizzy. I`m 61 and in good health. Could all of this be effects from the anesthesia? 

Most likely you were given a drug called succinylcholine as part of your anesthetic. This is a topic on which I've written before.ﾠﾠAlthough muscle pain sometimes occurs after other muscle relaxant drugs, and even without muscle relaxants being given at all, the pain you've described is fairly typical of the major discomfort that occurs in some people after succinylcholine. Fortunately, as you've discovered, the pain does eventually go away. The low blood pressure, slight temperature, light-headedness and dizziness can't really be explained based on anything you've told me. All these symptoms can occur after general anesthesia and surgery, in association with all the different anesthetic and pain medications and the mental and physical trauma of the operation itself. This is not a diagnostic service however, and you should be sure to check with your doctor if your symptoms continue to bother you. 

I am a 40 year old male. When I was 21, I had a surgery (varicocelectomy) and I have had chronic pain in my muscles and tendons throughout my body ever since, but I managed to live with it. Most the time it is like sore muscles, but sometimes it is fairly painful. The pain developed as I was recovering from the surgery. I had been seen by a couple of rheumatologists. They ruled out diseases like lupus and rheumatoid arthritis, etc, but they could not give me an answer other than maybe some kind of "reactive arthritis". They gave me NSAIDs, but the medication did not help much, if at all. This last year I just had another surgery (double hernia repair). The chronic muscle and tendon pain has worsened following the surgery. I think the pain condition is a result from the general anesthesia chemicals. Has this been documented with others that have had surgery? What is causing the pain? Is there anything I can do to help relieve the pain (NSAIDs do not help much)? Thank you for any information you can provide. 

I am not familiar with any link between general anesthesia and the type of pain condition that you describe. I believe your best option is to consult an expert in chronic pain. You may have a condition related to fibromyalgia which may worsen with various kinds of stress, including the stress associated with anesthesia and surgery. 

I had a laposcopic hysterectomy one week ago today. I am on pain meds: mortron, milk of mag. daily. I have a history of high blood pressure and ashma. Currently, I continue to have bloating and gas pains. My concern is why do I continue to have light headedness, light sensitivity, and a pulse rate of 102 upon ambulation? I also have pain in shoulders, neck, upper back, and very fatigued. Any answers will relieve anxiety. Thank-You. 

ﾠProlonged fatigue after such a major surgery is not uncommon. It is also possible for pain in the shoulders, bloating and "gas pains" to continue, although for the majority of people this sort of pain is much reduced after 2-3 days. Your light-headedness, light sensitivity and high pulse rate are NOT features associated with recovery 1 week after abdominal surgery so you should call and/or see your doctors for attention to this set of problems. 

A 48 year old male had back surgery for herniated discs on his lower back. 4 weeks after surgery he developed problems with swelling in hands arms and feet with pain. They seem to migrate to different parts of the body. A doctor told him it was angioedema and told him to quit taking his accupril he has not taken any for ten days and sees no improvement. Could this be also caused by the medication used at the time of surgery? We are looking for some type of answer to make of this sinceﾠit did happen after surgery and has been causing him great pain. Please help Thanks. 

I don't know quite what to make of the symptoms you describe. Angioedema is a rare condition in which various parts of the body swell (edema). In its most serious form this affects the tissues of the airway, leading to closing of the airway and requiring emergency treatment. Accupril and related medicines ("ACE inhibitors") are among the most common causes of angioedema. I don't believe that pain is a prominent symptom of angioedema, and you have not described any effect on the airway (lips, throat) so there might be something else causing the problem. There is a long list of causes of edema that includes liver problems, malnutrition, obstruction of blood vessels and lymphatics, allergy, and heart failure. You need to see your doctor and be fully evaluated. I seriously doubt that any of the anesthetic agents given a month ago would have anything to do with the current problems. I do wonder whether there were any materials left implanted in the spine to which a reaction might be occurring but that is entirely a speculation. 

I had a D&C close to 2 weeks ago. I had general anesthesia. I was also to have a hysteroscopy, but I was too tight, so that was not done. Since the procedure, I have experienced a rather sharp and ongoing pain at the side of the left breast very close to the armpit area. I had checked with my gyn to see if it was hormonal, which he`d indicated that it was not. It was not tested however. Not having had this in the past, I`m concerned as to why this is happening. I did read about muscle pain after surgery or postoperative myalgia which I understand is fairly common. And is referred to a "scoline pain" from the drug "succinylcholine. I understand that anesthesia can stay in the body for up to 6 months, and I would not want to look forward to having this uncomfortable pain that long. Would this pain be from a side affect of the anesthesia? Please help. 

ﾠNo, I do not think that the pain you are describing has anything to do with scoline pain, or with any other anesthesia medications. Scoline pain is generalized, not localized. In other words, the pain involves muscles throughout the body, not just one particular part of the body. Postoperative myalgia from succinylcholine is an interesting condition. Although there have been a lot of studies, it is still not clear what the cause is or how to eliminate the problem, short of avoiding the use of this drug. Succinylcholine causes muscles to contract briefly before it paralyses them. It was commonly assumed that these muscle twitches ("fasciculations") caused the myalgia but the studies have shown that they don't seem to correlate with muscle pain. Also, the incidence of muscle pain varies widely. One recent Michigan study looking at a variety of anesthesia outcomes found fewer than 0.1% of patients had myalgia, whereas other studies have shown that around 50% of patients have it! Surprisingly, higher doses of succinylcholine seem to reduce the amount of myalgia. 

I had breast surgery 11 days ago and still suffer from severe muscle pain in my right shoulder and arm. Could this be due to postoperative myalgia and how can I treat the pain. Nurofen and Ibrufen seems to work only for 2-3 hours. How long can I expect the pain to last? 

Thanks for your question.ﾠPostoperative myalgia does not normally go on for quite as long are you've been suffering. Nor is it likely to affect only your right shoulder and arm. Moreﾠusually it is symmetrical and affects muscles throughout the body.ﾠIs that the side of your surgery? Your pain may have something to do with the surgery itself as the breast is in close proximity to the shoulder. I think you need to call your breast surgeon and ask about an alternative cause for the pain. In the mean time, Nurofen and ibuprofen are not unreasonable medications to use to control the symptoms. The duration of pain relief you are getting is about average for those particular medications. 

My father had a hernia repair done approx 3 months ago and an eye surgery about a month ago. He is in severe pain (never had arthritic pain before). He went to see a bone doc here in our small town and he said it had to do with the anesthesia he had for the two surgeries. He is now in physical therapy for the pain. He looks awful and is normally not a complainer. I have never heard of this before. Is it more common than we know or is this just a strange occurence? My father also drinks heavily and I wasn`t sure if that had something to do with it. Thank you. 

You haven't provided much detail about the pain your father is experiencing so its hard to form any opinion about what might be causing it. There is no connection I am aware of between "arthritic pain" and previous anesthesia. 

My daughter who is 25 yrs old had a tubal ligation today. She is now complaining of chest and shoulder pain. What could be causing this? Her stomach is not bothering her and she is in good health. Thanks 

Chest pain can be a symptom of serious illness and your daughter should consult your physician as soon as possible to be properly evaluated. With that warning in mind, I will offer one possible explanation for your daughter`s symptoms. Tubal ligations are generally done using a "laparoscopic" technique. During laparoscopic procedures, the abdomen is inflated with carbon dioxide to allow the abdominal organs to be seen and instruments to be maneuvered around the belly. The distension caused by the gas inside the belly can irritate the diaphragm (the large breathing muscle under the lungs). This can cause chest pain and also "referred" pain at the tip of the shoulder after the surgery. This kind of pain should go away within a short time. This is a possible explanation for your daughter`s symptoms, but as I mentioned initially, she should contact her physician to make sure that the pain is not resulting from something more threatening. 

My neighbor had this procedure and suggested if I wanted to be aware of everything, to request fentanyl. My question is how much fentanyl is usually given and what is `in` to request to be pain-free? Thank you 

ﾠAll drugs given for anesthesia and sedation are best given in a "titrated" fashion. This means that a small amount is given, the response assessed, then additional amounts given until the desired effects is achieved. An average initial dose of fentanyl in an average adult is between 50 and 100 micrograms. If you don't want Versed (midazolam) tell your doctor. Alternative agents include propofol, which is sedative, and other drugs similar to fentanyl such as meperidine, alfentanil, sufentanil and remifentanil, which are pain-killers. These drugs have potential side-effects too - including nausea and suppression of breathing. 

I am having surgery on bunions and hammer toes. I will be undergoing the MAC procedure. I am very concerned that I might feel pain if I am not completely asleep. Is this procedure suitable for my type of surgery? thank you 

You may wish to browse this site for other questions I've answered covering the issue of "MAC" and its suitability for various surgical procedures. In brief, MAC (Monitored Anesthesia Care) is another term for mild or moderate sedation. The level of comfort (or discomfort) you experience during the operation on your feet will relate to the effectiveness of the local anesthetic administered by your surgeon (or anesthesiologist), and to the amount of sedative medication you are given. You should be pretty comfortable. Sometimes the hardest part of these kinds of procedures to tolerate is the injection of local anesthetic itself. For a brief period you may given an amount of sedative medication that is enough to make you unconscious for a minute or two, then the rest is plain sailing. 

I recently underwent an incomplete colonoscopy under "moderate sedation." Although I had two previous incomplete sigmoidoscopies due to intolerence to pain, I was not given any information on the sedation--just that it would be much better than a sigmoidoscopy. Only after the failed prcedure was I told that the sedation was not meant to relieve pain. The doctor claimed not to know why a person would fail under mild/moderate sedation. Am I some unusual case? Can you tell me what % of colonscopies have to be done over under heavier sedation? Since the chart notes stated the previous sigmoidoscopy was incomplete, shouldn"t the doctor have known the average amount of sedation might not be enough? Any good reason why the doctor automatically used mild/moderate sedation? I have a $2000 bill and no cancer screening. 

It sounds as though you have had a very difficult time with your colonoscopy, but it is hard to comment specifically on your experience without knowing more details. Who was responsible for administering the sedation? What drugs were given? Nevertheless, even without knowing the specifics, I can assure you that your unpleasant colonoscopy experience is entirely avoidable and should not happen again. The fact is, with proper anesthesia care almost anyone should be able to undergo a colonoscopy in comfort and safety. In most cases, mild/moderate sedation produces acceptable results in patients undergoing colonoscopy. Unfortunately there are always going to be individuals for whom an arbitrary amount of sedative medication is inadequate, and does not in fact take them to the appropriate level of sedation. The trouble is, in many cases, that sedation is given based on a preset protocol, which allows for a certain amount of medication to be given over time. By contrast, anesthesiologists giving sedation for colonoscopy will provide mild, moderate or deep sedation, or even general anesthesia if warranted, based on the needs of the patient and of the practitioner doing the procedure. There is no preset maximum, and everything is done based on the response of the individual patient. One reason why an anesthesiologist can do this is that she is trained to ﾓrescueﾔ patients from the effects of excess sedation and is therefore not bound by any theoretical maximum dose of medication. In addition, anesthesiologists may use a full array of drugs and techniques, under careful monitoring, to ensure comfort. This includes a particularly useful drug called propofol. The really critical thing about sedation for this type of procedure is that, if successful, it allows the doctor doing the colonoscopy to focus entirely on his main job, which is to methodically examine the entire colon and take whatever other action is necessary to diagnose or treat disease. Ideally, the doctor should not have to worry about the sedation. When this task of sedation is delegated to a qualified expert in sedation ﾖ i.e. an anesthesiologist - the doctor can perform the colonoscopy in ideal conditions. In fact, recent studies have shown that more polyps can be detected when excellent sedation is offered. If your insurance plan does not cover the cost of an anesthesiologist it may be worth pursuing this directly with the insurance company. Your gastroenterologist may be able to help. After all, he was unable to perform the procedure you need, presumably for cancer screening, and there needs to be another attempt to do it, this time in a way that you can tolerate, and in safe hands. Good luck next time! 

I had oral surgery exactly a month ago, and IV anesthesia was used. About a week after surgery I noticed pain in my forearm distal to the insertion site (but no pain at the site). There was also a bruise running up my bicep proximal to the insertion site. It hurt (in my forearm) to extend my elbow and there were was an odd lump in my upper forearm. The pain lessened for a few days then came back only this time it was more distal and extended into my thumb. The pain is along my radius to about half way up my forearm and fairly superficial. The skin in the area is painful to light touch, and that pain is similar to that of a burn. Also, there is still a small lump and a vein seems to be protruding--though it is hard to tell if the lump is just part of the vein. I went back to my surgeon and they looked at it, but the nurse seemed like she had no idea what was wrong. Can you help me? 

Thanks for the very detailed description of your problem.ﾠ It sounds as though you may have some irritation of a vein together with thrombosis (clot), a condition called venous thrombophlebitis.ﾠ This is a relatively common condition resulting from the presence of an intravenous cannula ("IV") and/or the effects of drugs injected through the IV.ﾠ Thrombophlebitis is not usually associated with infection, is not life-threatening, and does not usually require treatment except to relieve the symptoms.ﾠ Is it getting better?ﾠ This is a condition that does get better over time and is treated with mild analgesics.ﾠ In the early stages of thrombophlebitis there is inflammation, which is seen as redness and warmth at the insertion site and along the course of the vein in which the IV has been placed.ﾠ Later, there may be a hardened area corresponding to where a clot was formed in the vein.ﾠ Although this diagnosis probably accounts for your symptoms, some aspects of your description don't correspond entirely.ﾠ The pain distal to the insertion site (further along your arm) would not be typical of venous thrombophlebitis.ﾠ Despite your excellent description you don't say exactly where in your forearm the IV was located.ﾠ Some locations would be close to nerves that supply the forearm.ﾠ It is possible that during insertion of the IV cannula a small peripheral nerve was injured.ﾠ Such an injury can cause heightened sensitivity to touch or pain from a stimulus which is not normally painful (allodynia).ﾠ Again, this type of nerve injury normally recovers over time (a few weeks or months) without treatment.ﾠ Was the insertion of the IV cannula very painful? - this would happen if the nerve was stuck directly by the needle.ﾠ A nerve injury resulting from the insertion of an IV cannula is uncommon but is probably something not entirely preventable.ﾠ Although your surgeon's nurse was not helpful, if you continue to have problems you should ask to see the surgeon directly, or perhaps the anesthesiologist or nurse anesthetist who took care of you during your oral surgery procedure.ﾠ These are the professionals responsible for your ongoing care in this situation, who are aware of the details of your medical history, which may contribute to a diagnosis or therapy, and who can conduct an appropriate, detailed physical examination. 

Three years ago I had surgery for removal of a large ovarian cyst. An epidural was planned, and when I was prepped and on the OR table, leaning over as the needle was being inserted, I felt an electrical-like jolt of pain-(severe!!!!!), and I remember falling over on my side onto the table but that`s all. Next thing I remember I was waking up in recovery. Apparently after this happened a general anesthetic was administered instead, but next day there were large bruises on my left upper arm almost in the shape of fingerprints, as if I was grabbed to prevent falling off the table. My question is, is this common and what likely happened during the epidural? 

ﾠThe best way to establish what happened while you were in the operating room is to ask the doctors who took care of you. Failing that, you could ask to review the hospital records, which is your right. (Some institutions may charge for the cost of copying those records, which is their right!) 

One possibility is that the epidural needle went somewhere it was not intended to go. A very sharp, severe pain might have been due to contact between the needle, and a nerve. In such circumstances, the anesthesiologist would promptly withdraw the needle and he or she might very well choose to abandon the epidural and not subject the patient to further unintended pain or trauma. A general anesthetic is then a satisfactory alternative. 

How common is this? Unfortunately even in the best hands, regional anesthesia (including spinal and epidural) is occasionally unsuccessful. That's why there is always a "Plan B". 

The exact incidence of nerve injury in association with spinals or epidurals is of the order of one in every several thousand, with almost all of those recovering over a period of weeks to months. Epidurals are almost always done in awake patients. You might be able to guess why. Had you been asleep during the insertion of the needle you would not have reacted to the needle. Pain, and the reaction to pain allow the anesthesiologist to recognize the possibility of imminent injury to a nerve or other structure, withdraw the needle, and avoid serious harm. 

Although the marks on your upper arm might have resembled fingerprints, they were more likely due to the imprint of the blood pressure cuff. During a surgical procedure you will have your blood pressure measured repeatedly every 2-5 minutes. This sometimes causes bruising. 

Is there pain during the c-section with anesthesia being used? Why do some women say they feel pain during the actual c-section? 

C-Sections are usually done with spinal or epidural anesthesia, not general anesthesia. This has been shown to be safer for both mother and baby. Unfortunately, neither spinal nor epidural can GUARANTEE a cesarean section that is completely without discomfort. Why is this so? Sometimes is is a matter of time. The baby must be delivered quickly (e.g. fetal distress) and not enough time is available to ensure that the spinal or epidural has "set up" to provide complete lack of sensation. 

Sometimes it is a matter of dose - not enough anesthetic has been given. In the case of epidural anesthesia, medication is added bit by bit, to make sure that the block does not spread too high. With spinal anesthesia, a single dose is given, based on various factors including the particular anesthetic drug given, the type of patient, and the expected duration of the procedure. That standard dose might be insufficient for the occasional person. 

Sometimes, the epidural or spinal, for a variety of reasons. is "patchy" - that is, the person is quite numb in one area, but not throughout the area where the surgeon is operating. When these problems occur, there are are various methods available to treat the pain. Intravenous medication can be given to treat the pain. Local anesthetic can be injected by the surgeon. Finally, a general anesthetic can be given. 

I should add, that even with a successful spinal or epidural anesthetic, the patient can expect to feel some minor discomfort. When the baby is delivered pressure is applied to the abdomen, which can hurt. When the uterus is manipulated as it is sewn up there can also be some discomfort or nausea. 

In addition, spinals and epidurals do not block every kind of sensation. Pressure and touching very often continue to be felt as the surgery proceeds, and some people will find this uncomfortable or even painful. The vast majority of patients are easily able to tolerate these sensations if they are forewarned and have a sympathetic medical team and a birth companion. There is a reward for the effort! 

My daughter had an epidural/spinal anesthetic for her C-Section 12 days ago. Immediately when positioned on the surgery table she noted right shoulder pain that increased to severe neck and bilateral shoulder pain by the 2nd post op day. This required 2 Percocet every 4 hours to merely dull the pain. This treatment continues today to manage the pain to this same `dull` level. Since her 3rd post op day the right shoulder has been free of pain but her left shoulder, neck and around her shoulder blade (medial edge and under) continue to be extremely painful (a 10 on the 1-10 pain scale) without the 2 Percocet every 4-5 hours. She cannot tolerate even the lightest tough to her shoulder without the analgesics in effect. She also found that Rx Motrin was not effective. 

The pain is now progressing to a radiation of aching down her left arm and hand. She is normally very sensitive to any medication. Before the C-Section, she required only 1 tablet of Tylenol or Advil, occasionally, to manage other types of pain. She has been evaluated by anesthesia, who prescribed the Percocet and Motrin, without a diagnosis; her OB Dr, without a diagnosis, who referred her to an Orthopedic MD who ruled out a rotator cuff problem, who prescribed Physical Therapy also without a diagnosis. She will start Physical Therapy next week. Chiropractic and acupuncture have provided a bit of short term relief but not lasting. The extensive medication is a concern for this breast feeding mother as is her ability to care for her baby while severe pain or in a medicated state. Any insight and suggestions are appreciated. Thank You. 

Your daughter's history is a complicated and puzzling one. It seems very unlikely that her epidural or spinal anesthetic had anything to do with the pain she is now experiencing. I certainly have not encountered or read about anything resembling this in relation to a regional anesthetic. If there were a direct nerve injury from the anesthetic we would expect a history of pain at the time of insertion of the needle, and we would expect symptoms to be limited to the lower part of the body. Headache is a well-known complication of epidural or spinal anesthetic (about 1 in 100-200 cases) but you do not mention headache as part of the problem. Your daughter needs a proper evaluation by an expert clinician - perhaps a neurologist - to establish a diagnosis. The clinician will need to know a lot more than what you've told me, including whether there was any previous history of pain, of muscular or skeletal problems, vascular disorders, neuropathy, trauma, etc. A careful physical examination is also needed. 

I recently had a spinal tap because I had an emergency c-section. I was wandering if the pain I`m feeling around the injection site has anything to do with the spinal? 

A certain amount of discomfort around the injection site of a spinal anesthetic is quite common, but should improve quickly over a few days. The pain should be localized, with perhaps a bit of tenderness. If the anesthesiologist had to insert the needle in more than one site, or had more than one attempt to insert it, you may have more pain than usual. If the pain increases or is accompanied by redness, warmth, swelling, or a discharge you should immediately seek attention. These are signs of inflammation or infection. 

Back pain during pregnancy and after delivery is extremely common, occurring in at least 50% of cases. Sometimes the backache is attributed to the spinal anesthetic, but it is likely that in most cases there is no relation between the two. Such a backache would not be limited to the injection site of course. 

6mths ago I had a C-Section in which they administered a spinal. Since then, the part of my spine where the needle went into has been very tender, it is painful to touch, and extremely painful when I am in certain positions (e.g. I am no longer able to be in certain yoga positions I could previously do without a problem). Is this a normal side effect of a spinal? If so, how long will it last? If not, is this something I should see a general practitioner, chiropractor, etc. about? What is the pain from? 

A small amount of tenderness at the site that the spinal needle was inserted is fairly normal. This might last a few days or so. Also, about 50% of women have back pain after labor and delivery. This occurs with or without an epidural or spinal. 

Your pain is unusual and I am not sure how to explain it. Is it getting worse or better? Is it right in the center of your back? Is the area of tenderness warm or red? The first thing would be to rule out a serious problem such as an abscess (infection). You would be probably be feeling unwell, the tenderness would be worsening and there might be signs of inflammation (warmth and redness). 

If the pain is related to movement there might be a problem with a spinal ligament or a small joint in the spine. There may have been a bit of bleeding caused by the passage of the needle and now a hematoma (blood clot) that is taking a long time to get absorbed. Or perhaps there were repeated attempts to insert the spinal needle and hence more than the usual amount of damage to the muscle through which the needle was inserted. 

You should see your general practitioner. Let her assess the problem with the benefit of a full history, and a physical examination. If the problem is musculoskeletal your GP can help you decide whether to see a chiropractor. 

I gave birth six and a half years ago. The doctor began to give me an injection into my spine and I jumped away from the needle. The doctor pulled the needle back out and then reinserted the needle. I started having problems right after I gave birth. I woke at night every night with my arms completly numb for about a year and a half. It still happens though not as frequent. My left arm after a few weeks began to hurt and over the years the pain is continuous and has intensified. I have pain in my right leg that the doctor says is sciatica. I have pain in my upper and lower back. I get very bad head aches and my memory seems to be deteriorating. I have problems with my right hand as well. Could any or all of this be related and how can I get proper help and immediate releif. 

I doubt very much that the problems you have described have anything to do with your spinal or epidural anesthesia so many years ago. Although neurological problems can occur after spinals or epidurals, these problems usually take the form of either headache, or nerve injury. The headache occurs after about 1 in 200 epidurals, and usually goes away within days. Nerve injury is pretty uncommon and will affect nerves at the level of the needle insertion. That means the lower limbs may be affected. When a nerve injury does occur it fortunately will also usually get better but may take a few months. 

I think you need to seek the help of a neurologist to try to identify what is affecting you so badly. It may be a combination of things. Some of the diagnoses that spring to mind include disc herniation in the lower back and neck, carpal tunnel syndrome andﾠfibromyalgia. Psychological illnesses such as depression might also be involved. Please talk with your doctor. 

It has been almost 3 weeks since my section and i am still experiencing pain in my neck which eventually leads to a bad headache. The neck pain is very tender to the touch and very annoying. It seems to get worse if I lie down, especially on my back. It almost feels like a sinus headache at the base of my head. During my operation I had shoulder pain. Then later in the day it moved to the side of my neck and now at the base of my head. My doctor thinks it is referred pain from the operation. I just want to know that this will go away, he said it could last 2 weeks but it has been 3. I have been taking advil but stopped about 4 days ago because the pain is still there. What do you think? 

I'm not sure what is causing your pain but I can comment on the known relationships between headache and epdiural and spinal anesthesia. About 1 in every 100 or 200 patients who have an epidural or spinal anesthetic - (I am assuming this is what you had) - end up with a headache. This headache has particular characteristics. It's often a really bad headache, but usually goes away after a week or so, although it can persist for longer. The most important, distinguishing feature of this particular headache is that the headache will go away when you lie down. Because your headache gets worse when you lie down, I really don't think this is what you have. 

Shoulder pain during cesarean section is quite common. It is, as you said, "referred" pain. Another example of referred pain is the discomfort felt in the arm or neck that some people get with heart pain (angina). This means that there isn't anything wrong with your shoulder. Rather, the pain is felt there as a result of physical trauma elsewhere. In the case of a cesarean section, the shoulder pain is probably due to irritation of the peritoneum. The strange phenomenon of referred pain is due to the way the nervous system is "wired". The referred shoulder pain from a cesarean section normally doesn't last more than a few days, and doesn't migrate to the neck or base of the head the way you've described. 

After 3 weeks, the pain from a cesarean section should be very manageable, although not entirely gone. It would be quite unusual to experience the pain you've described. Perhaps something else is going on - sinus headache, fibromyalgia, or some other muscular or skeletal problem. However it sounds as though the Advil wasn't helping you, which makes a muscular/skeletal problem a bit less likely. My recommendation, if the pain is not improving, is to go see your doctor again or seek a second opinion. 

During my first pregnancy I had an epidural and when the anesthesiologist inserted the needle or tube an excruciating pain went all the way down my leg like a lightening bolt. It went away suddenly but that was the worst pain that I have ever had in my life (worse than the labor itself). I ended up having a C-section and I am fine now. This time, I plan to have a VBAC and I may need an epidural but I am very concerned that this would happen again. I am worried that I am going to be so anxious about getting the epidural that it will make my labor pain worse so I will try to have a natural childbirth. What causes this and is there a high probability that it will happen again? 

ﾠDuring the insertion of an epidural, a tiny plastic catheter (tube) is inserted through a needle and into the epidural space. This is the space just outside the membrane - the dura - that covers the spinal cord and spinal nerves. The catheter is normally inserted a few centimeters beyond the needle tip and the needle is then withdrawn, leaving the catheter in place. Modern techniques of epidural analgesia for labor and childbirth have an excellent safety record. Permanent injury to the spinal cord or nerves is extremely rare. Occasionally however, during insertion of an epidural, the catheter will brush up against a nerve. This is a chance occurrence that can produce a transient sensation (feeling) almost like bumping one`s `funny bone`. Sometimes the sensation is painful and the pain can spread down one leg, as described in the question. 

The severe pain described above is unusual and unlikely to recur during a subsequent epidural. The majority of VBACs (Vaginal Birth After C-Section) do result in vaginal deliveries, but there may be a 40% or higher risk of needing a C-Section. As epidural or spinal anesthesia is the preferred anesthetic for C-Section (safer for both mother and baby), it would be unwise to avoid an epidural because of the fear of the type of problem described in the question. 

I had surgery 5 weeks ago on left knee. After 1 week had bad numbness in right knee. After 3 weeks had pins needles plus numbness. After 5 weeks it`s very painful, numbness, very bad pins needles. Also very bad muscle spasm. When I get out of bed there`s a very bad sharp pain like somebody is cutting me with a razor blade and it burns. 

ﾠFrom the title of your question I understand that you had your arthroscopy done under spinal block. You are concerned that your recent symptoms - pain, pins and needles, and muscle spasms - could be related to the spinal anesthesia. This is obviously causing you a great deal of pain so you should seek medical attention. You need to see your doctor as soon as possible to get a proper diagnosis. It sounds like you had a week or so in which you did not have any of the symptoms you describe. A nerve injury related to spinal blockade would be unlikely to present in the way you describe. A direct injury to nerves from needle insertion would be apparent soon after the anesthetic wore off. Later complications can occur - these include meningitis, hematoma (blood clot), and thrombosis (clotting) of arteries supplying the nerves or spinal cord. However the symptoms you describe are not typical of these serious problems, and could be linked to other diagnoses, including arthritis in the knee, spinal disc herniation, and the use of crutches, among others.