Member Comments are provided by individuals and reflect their personal opinions only. Under NO circumstances should you act on any advice or opinion posted in this forum.  ALWAYS check with your personal physician before taking any action regarding your health! MedHelp International and our partners, sponsors and affiliates have no obligation to monitor any comments posted on this site, or the content and/or accuracy of such exchanges. MedHelp International does not endorse the views of any user.
Neurology  (Expert Forum)
 | 
Arm Pain
This forum is for questions and support regarding neurology issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Fibromyalgia, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury
Post a Question Back to Forum
MedHelp Member's Question

Arm Pain

by sjb, Jun 22, 2000 12:00AM
I hope maybe there is someone out there who can offer me advice.

I will try to be brief. I am a 29 yr old a mother of 4 children, and had a fall at work in Dec banging my head on the floor hard.

was ok, just a mild concussion and sore neck the following day.

2 months later I woke up with excruciating pain in my right arm, the doc gave me pain pills and said it sounds like a radiculopathy. I saw a chiro 3X a week for 2 months, and he helped my pain decrease alot. I have other symptoms also, pins and needles in my hand, cold numb hand and again, upper arm pain, and sometimes wrist pain.

The past month I have pain now in my left arm, same pain as right and its daily. Had an EMG test done, which came back perfectly fine, and the neurologist said 'your fine' I told him of my daily pain, he said Im sorry  for your pain but your nerves are fine.

he had no advise, nothing, just goodbye. I was quite dissapointed to say the least.

I am a health care Aide in a nursing home, I lift every single day, I have been on modified duties for 4 months now, and see no progress, and no end to the daily pain in my arms.

My Dr has discussed the possibiliy of a herniated disc (C5-6) or stenosis (sp?) my question is, if the EMG was ok...could either of these still be a possibiliy.

I just want a diagnosis desparatly, I feel now perhaps the medical field is looking at me thinking its in my head...yet this pain in my arms is so real, yet some days I wonder...

Can anyone advise me as what to try next?

I believe I will be having an MRI (is it worth it if the emg was fine???) Its been 4 months...and all i get from my GP is percocet, which obviously isnt  a great solution as I have children to look after and cant be drugged up.

any advise, or thoughts would be so greatly appreciated!!!!

Thank-you in advance,

SJB
Doctor's Answer

by CCF Neuro[P] MD, RPS, Jun 22, 2000 12:00AM
Dear SJB:



Sorry to hear about your pain.  I would suggest the MRI be done on your cervical spine.  The EMG would detect changes in the nerve from the root distally (from the ganglion to the finger tips).  If it was done early in the process, it might not detect a root evulsion.  I don't think this is the problem as you describe no loss of function.  In addition, the time course of the pain would not really fit with a root evulsion.  You might have done something else though and an MRI might detect something in your cervical spine.  I would think it was the latter, maybe in your sleep (we do see this sort of thing).  Shooting pain is one of the symptoms of a radiculopathy.



I am sorry that I am not much help.  One really needs to examine the arm and do a good neurological exam on the arm to know for sure.  



Sincerely,



CCF Neuro MD
Member Comments (10)

by cs, Jun 22, 2000 12:00AM
I apologize for adding this onto another post but I have been trying to post a question for weeks.  This is a long but complete history of my husbands problems.  Thanks in advance for any comments you have, especially since I had to post on another question!  We are desperate.

  My husband is a 30 yr. old male who has shown multiple syptoms and seen several doctors with a

diagnosis at one point of monosymptomatic demyelinating disease.  Early in 1999 he began feeling

generally fatigued and ran a mild fever for a few days (came and went).  He didn't think much of this and

did not see a doctor for it.  Also, in early January he went to a local optometrist for a general eye exam for

his glasses and the optometrist noticed a hemorrhage in the left eye.  He referred my husband to an

ophthalmologist nearby who confirmed a retinal hemorrhage due to multiple venous occlusions of the

vessels which were described as being telangiectatic.  He suggested that we wait to see if it would resolve

on its own.  After he was rechecked the hemorrhage had not resolved and he suggest we see an

ophthalmologist at the University of Iowa that he knew.  The visit to the Univ. of Iowa occurred after the

following events.  

A few months after the initial feeling of fatigue and mild fever he was shingling the roof of a

house and during the night (he woke up with it in the morning) he noticed numbness in his right

fingertips.  He also noticed a large reddened area that appeared to be an insect bite or bruise on his left

arm, but he did not recall being bitten by anything or hitting his arm that day.  This was somewhat

concerning because he doesn't bruise easily.  The numbness in the right fingertips continued and he went

to see a general practitioner for it.  During the physical they discussed the retinal hemorrhage and the

doctor decided to run an ECG which was abnormal (I'm not exactly sure what abnormality was noted) and

the doctor said it could be from a possible mild heart attack at one time.  He sent my husband to a nearby

hospital to have an echocardiogram performed just to check everything.  The echo was normal and no

further tests were performed to double check the original abnormality.  He has been known to complain of

chest pains off and on (approx. every 2 months or so), not a pain like tightness but a sharp pain.  His

sternum will also 'pop' once in a while (a deep/loud 'thunk') and it will be really sore sometimes.  He does

smoke approx. 2 packs/day.  An MRI was also scheduled at the hospital due to the numbness and vascular

concerns.  The results showed 4-5 white matter lesions, some were located periventricular and I believe

most of them, if not all, were on the left side of the brain.  From here he went to a local neurologist who

performed an EMG on his right arm which was normal (tested for carpal tunnel).  Because of the wait

required before more tests could be done we decided to go to Mayo Clinic taking a chance at a walk in

appointment.  He got to see a neurologist there that day who performed another MRI with similar results

and also the following tests with their results:  Phospho/Cardiolipin AB - IgG phoslipid Ab = neg, IgM

phoslipid Ab = pos. 1:16;  L.P. Observation - Initial pressure = 190 mmH20, Interspace = L4 - 5, Quantity

= 10ml spinal;  CSF IgG Index = 1.09 index, IgG (CSF) = 9.55mg/dl, Albumin (CSF) = 40mg/dl, IgG (s)

= 982mg/dl, Albumin (s) = 4480mg/dl, IgG/Albumin (CSF) = 0.24 ratio, IgG/Albumin (s) = 0.22 ratio,

Synthesis rate (CSF) = 26.99mg/24hrs, unique CSF bands = 2;  CSF tests - Glucose (CSF) = 54mg/dl,

Protein Total (CSF) = 86mg/dl;  Body Fluid Cell Count - Fluid type = CSF, Gross Appear. = clear, Total

Nuc. Cells = 10/ul, Erythrocytes = 0/ul, lymphocytes = 92%, monocytes = 8%.  These were the test results

run.  The neurologist seemed unsure at this point of a diagnosis of multiple sclerosis or some sort of

vasculitis.  I believe he also did an estimated Sed. Rate which was normal.  We informed him of the

retinal hemorrhage and he seemed concerned so he set up an appt. with their ophthalmologist.  This

exam, I feel, was not very thorough compared to the exam performed by our local ophthalmologist,

however they did not see the retinal hemorrhage and, therefore, treated him as if there was not one.  This

was disturbing because we had it rechecked later at home and it was still present and later had to be

lasered.  I am concerned that the finding of the hemorrhage may have led the Mayo neurologist in another

direction.  The neurologist sent my husband to a different neurologist at Mayo who worked more

specifically with MS patients to get his opinion.  This doctor did not examine my husband, a doctor

visiting from Canada under supervision of the neurologist is the one who performed the exam.  The doctor

we were referred to did not even spend more than five minutes with us the whole time and then diagnosed

him with monosymptomatic demyelinating disease based on the MRI results and symptoms (at this time

the CSF results were not back).  He said we would need to wait and see if he has another 'episode' or

'attack'.  The only problem is his symptoms have never gone away and they do not get worse like people

describe with exacerbations.  His symtoms are there 95% of the time every day and he feels they are very

slowly progressing.  I don't physically see progression of his physical neurologic symptom (foot slapping

the ground after walking a while- not real obvious), but he feels more fatigued.  He has horrible mornings

where he doesn't want to get up and then at bedtime is wide awake and cannot sleep, which is likely

contributing to his fatigue.  He says the numbness comes and goes within the day and he will feel pretty

good one time and a few hours later feel like he won't make it through work.  His job involves operating

heavy equipment for a county road department.

While he was at the Univ. of  Iowa for his eye we decided to get a second opinion from a

neurologist there.  A thorough neurologic exam was performed and the test results from the CSF tap were

provided to them.  They ran several additional tests: CBC/chemistries, B12 w/ IFBA, Folate, Rapid

Plasmin Reagin, ESR, TSH w/ free T4