I am a 22 year old medical student with a past medical history of a L4/L5 disc prolapse with chronic radicular pain. For the past year I have had sharp, constant pain down my left arm and hand (C7-T1 dermatomes), left shoulder pain and my trapezius is in constant spasm with severely reduced cervical spine range of motion. The hand/arm pain is worse when I use my arm, and when I wear a rucksack. I have dysthesia and paraesthesia in the left hand in C7 and C8 dermatomes and weakness of the intrinsic muscles of the hand, especially finger flexion, thumb and finger adduction and abduction.
I also have acrocyanosis to both hands, but much worse on the left. In the cold my arm becomes globally weak and numb, with no active movement; sympoms are relieved by warming.
I have had a cervical MRI which did not show a cervical prolapse. It did show ?stretching of the lower cervical spinal cord and bulging CSF. I han a thoracic MRI which was normal, so this was just put down as an anomaly. I have had nerve conduction studies of median and ulnar nerve which were normal. My investigations by orthopaedics were stopped at this point, and the pain management service have put the neurological findings down to Wind-up/central sensitisation. I am left hand dominant, and being a medical student in my clinical years of training the hand weakness and dysthesia severely limits my clinical work.
I have recently changed GP, and after her examining me she was not convinced of the diagnosis. I suggested a rudimentary cervical rib and I am currently waiting for a chest x-ray to look for this. Abduction of the arms exaccerbations symptoms and caused a reactive hyperaemia of the left hand when the arm was adducted. I wondered what your opinion was? I have learnt to cope with my pain but the neurological deficits in my hand severly hinder my function, and I feel that my specialists have given up too soon looking for a diagnosis.
The Content on this Site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease; or a recommendation for a specific test, doctor, care provider, procedure, treatment plan, product, or course of action. MedHelp is not a medical or healthcare provider and your use of this Site does not create a doctor / patient relationship. We disclaim all responsibility for the professional qualifications and licensing of, and services provided by, any physician or other health providers posting on or otherwise referred to on this Site and/or any Third Party Site. Never disregard the medical advice of your physician or health professional, or delay in seeking such advice, because of something you read on this Site. We offer this Site AS IS and without any warranties. By using this Site you agree to the following Terms and Conditions. If you think you may have a medical emergency, call your physician or 911 immediately.