Cause of bilateral arm pain?

Exactly one month ago I began having upper left arm pain the bicep region. It felt as though I had just been given a flu shot.  Since then, it has also been in the right upper arm as well, although not as bad as the left arm.  I can't sleep at night very well due to the the pain of lying on the arms.  It's difficult for me to sit at my desk at work or home and perform clerical tasks, as my arms are fatigued.  It's as though I've just lifted weights all day.  Simple tasks such as washing the kitchen table or opening a heavy door will also result in pain and muscle fatigue.  My neurologist has performed 2 clinical exams which are normal, a cervical spine MRI which was normal, CBC, sed rate, and lyme titer, all of which were normal (thyroid tests normal as well).  My orthopedic dr. gave my left shoulder a shot of cortisone, which has not helped at all.  I've also had widespread muscle twitches.  The neuro says the only test left to do is an EMG test, which I would like to have done. I worry about ALS, even though I'm only 32 (and female).  This pain and muscle fatigue is affecting my daily activities, and I'm almost to the point where I'd seek a second opinion at somewhere like Mayo if that would help nail down a diagnosis of some sort. Something is definitely wrong, but my neuro just can't figure out what it is.  Any suggestions?  Thanks much.

[Kevin Pho, MD]

If ALS is a concern, you can consider electrodiagnostic testing (i.e. an EMG) in addition to the MRI you have had.  

Other possibilities would be various muscle disorders - such as myositis or myesthenia gravis.  Creatinine kinase, as well as aldolase levels can also be considered.  The EMG can also help diagnose these muscle conditions as well.  The most diagnostic test would be a muscle biopsy - and can be considered if the preliminary testing is non-revealing.  

If myesthenia gravis is considered, a Tensilon test can be performed.

These options can be discussed with your neurologist, or in conjunction with another opinion.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_b

[frankiehall27]

I was on this website looking up the same symptom.Mine isnt as bad...my arms are very painful when poked...even when my husband barely pokes me to get my attention.I was beginning to worry.They dont hurt until they are touched.could this be the same thing you think?

[abcsoup]

I had an EMG of the left arm (neuro tested deltoid, bicep and tricep), and also a nerve conduction study of that arm, all which was normal. I'm continuing to experience pain that won't let me sleep in both upper arms, fatigue in both arms when I do simple tasks such as wash my hair, twitches in both arms/hands, and also a "sick" feeling in the arms, like a weakness, although there doesn't seem to be any clinical weakness at this point. I am wondering if a brachial plexus/thoracic outlet syndrome could be occurring?  Would the EMG of the deltoid, bicep or tricep show that? Or would the need have to be positioned up by the brachial plexus?  Thank you.

[CatDancer]

One week ago I came down with a horrible pain in my left arm.
It is all muscle pain.  It can radiate to my nect shoulder
and into the muscle of my left arm.  I have taken Robaxin and
Vicodin and that seems to help a lot.  But if I don't take anything the pain is horrendous.  Sometimes it feels like
someone hit the funny bone sensation; it twitches and sometimes it feels like a membrane is stretched over it and pops loose.
I am a diabetic, type 2 (60 units insulin) and I take norvac, hydrochorithizide, tenormin and an ace inhibitor.

[stuffy7]

A related discussion, ooh my arm hurt was started.