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Severe shoulder and arm pain
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MedHelp Member's Question

Severe shoulder and arm pain

by LKC, Dec 13, 2005 12:00AM
I am a nurse.  On October 23rd, after moving extremely heavy furniture I began experiencing severe pain in the (L) shoulder (like a continuous charlie horse is the best way I can describe it), arm with an INTENSE tingling sensation in my (L) thumb and index finger (feels like if I looked at my arm it would be vibrating). I felt that I had injured the rotator cuff.  Since that time the pain has gone from continuous to intermittent, with the use of physical therapy and cervical traction.  The Ortho. said he did not think it was my shoulder becasue I had full range of motion.  There is discomfort in the shoulder when I abduct.  I am still unable to lay down in bed due to the pain returns to continuous.  I did have a MRI; results are C3/4 diffuse disc bulge; C4/5 mild diffuse disc bulge.  Mild compromise of the anterior aspect of the spinal canal with moderate narrowing of the neural foramen.  Same at C5/6 expent with localied anterior indentation on the thecal sac and on the cervical cord.  C6/7 moderate diffuse bulge with same as 4/5.  I have an appt. with a neurologist on Jan. 11th.

I noticed this morning that my (L) shoulder is grossly different than my (R).  The shoulder joint has pulled closer to my neck, is extremely higher than the (R) shoulder and there is shortening of the arm. This has scared me.

My theory is that I have a rotator tear, the muscle spasms are what has caused the cervical spine injury, a nerve is captured in the muscle but none of the MDs will listen to me.  Considering the MRI and my symptoms am I totally off the wall with this theory?
Doctor's Answer

by CCF-Neuro-M.D.-PW, Dec 19, 2005 12:00AM
One cannot be sure that the MRI findings (per the report) were just the same prior to the injury - I suspect they probably were. Tingling in the thumb an index finger can be from either a C6 nerve root problem or a median nerve problem anywhere along its course from the axilla to the hand. Entrapment in a muscle is very unusual, unless there was acute injury/swelling of the muscle in the lower arm. YOu do seem to have a lot of muscle spasm , and spasm or a dystonic reaction of the trapezius muscle could cause your shoulder to elevate like that.

An EMG may be able to tell objectively if there is any nerve or nerve root involvement and how significant this is, this should be able to be doen at the neurologists office. If not then the problem may be predominantly muskuloskeletal. You do have some disc disease in the neck - symptoms to be conerned about for spinal cord compression are weakness or spasticity in the legs and , bladder dyscontrol.



Good luck
Member Comments (13)

by ArmyAviator, Dec 13, 2005 12:00AM
35 days ago, I was HIT with same.  Horrific pain.  I am 43 yr old male, career Army Officer/BlackHawk pilot.  Diagnosis: herniation @ C7. Orthopae wants to cut and fuse...Army flight docs no like that...me either.  I turned the corner 7 days ago, pain down at least 75%, "pins and needles" in forearm less intense and shorter duration, numbness @ index finger tip diminishing.  I have read and read and read and asked all I could.  This is what I came to: surgical intervention maybe in order, but certainly not now.  Most people will not tolerate the pain long enough for this to heal...and in 95+% of the cases, they do heal.  You just have to REST and amend your activities that may have contributed....mine was lifting weights.  Your shoulder position...mine L one is still pulled up....am told it is the body's reaction to the spinal cord "impact" and will go away. Mine is somewhat returning.  Atrophy in L arm from disuse, no progressive neuro deficits. I will continue in this conservative path....which includes prayer...LOTS.  I hope I helped.



--Bryant.

by ArmyAviator, Dec 13, 2005 12:00AM
35 days ago, I was HIT with same.  Horrific pain.  I am 43 yr old male, career Army Officer/BlackHawk pilot.  Diagnosis: herniation @ C7. Orthopae wants to cut and fuse...Army flight docs no like that...me either.  I turned the corner 7 days ago, pain down at least 75%, "pins and needles" in forearm less intense and shorter duration, numbness @ index finger tip diminishing.  I have read and read and read and asked all I could.  This is what I came to: surgical intervention maybe in order, but certainly not now.  Most people will not tolerate the pain long enough for this to heal...and in 95+% of the cases, they do heal.  You just have to REST and amend your activities that may have contributed....mine was lifting weights.  Your shoulder position...mine L one is still pulled up....am told it is the body's reaction to the spinal cord "impact" and will go away. Mine is somewhat returning.  Atrophy in L arm from disuse, no progressive neuro deficits. I will continue in this conservative path....which includes prayer...LOTS.  I hope I helped.



--Bryant.

by myjas2001, Dec 13, 2005 12:00AM
I also went through the same thing in June. Some of my symptoms started last Oct. and gradually got to the point you talk of. I did all the conservative methods and only got worse. I was only able to sleep 1 1/2-2 hours at a time due to the pain waking me up. I was even taking 2 percoset at bed and still having to take more later in the night but still could not sleep all night. I am on neurontin which did help with some pain.



I finally did have ACDFP of c6-7 Nov. 10. When I woke up in the recovery room all my preop pain was gone. I am almost 5 weeks now and still doing good. I do have some pain in my shoulders from time to time, which is different then before and I think it is more surgery oriented, and take 500 mg of tylenol which takes it away.



I did get a copy of my surgery report today and when he went in he found fragments severly compressing the c6 and c7 nerve roots and theacal sac, 2 tears and osteophytes. Neither my MRI or CT myelogram showed these problems.



I do agree with surgery being you last resort but don't let it go to long. Do get 2 to 3 opinions. If you develop bowel/bladder incontinence or can't walk get medical attention immediatly.



Research cervical radiculopathy. Will probably match your symptoms.

by mike1105, Dec 14, 2005 12:00AM
To: LKC
your MRI report is not very impressive. most middle aged people have what's in your report.. in fact, many have worse reports and are asymptomatic. Since your range of motion is good I would agree that you probably did not tear your cuff. i would not assume that your pain is from hard tissue/disc issues in your spine. it is entirely possible that you injured/overused the shoulder musculature itself, and it has gone into spasm/imbalance, entrapping nerves that run through this musculature. I would not necessarily rely on "rest". this can lead to atrophy from disuse and even more guarding. I would consult a qualified myofascial release therapist and consider stretching, muscle release techniques which may help in freeing up the nerves that are entrapped and are causing the sensations down your arm. i had similar but more diverse problems for 2 years-- shoulder surgeries and even a minimally invasive neck surgery did nothing. I had severe pain which made me give up dentistry. Only now, after 5 days in a myofascial release clinic, am i seeing results-- stretching/muscle