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Muscle burning and pain
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by boogirle, Sep 13, 2006
Okay background. I have had 2 surgeries in 2 years for CTS. The last one in 01/2006. I have since gotten worse and still not returned to work. My neck and shoulders, arm and hand all hurt worse now. My middle, ring and pinky finger all go numb at times. I drop things without knowing my hand opens or can feel it do so. If I lay on my side to sleep it hurts, if I sit too long in one position it hurts and if I walk with my arm to my side it hurts. I also have muscle aches in my hip pelvis area. My leg muscles are weak. I can not climb stairs without stopping after a couple. My legs and hips ache while laying down. This has been going on for about 2 years also. My muscles feel like they are burning and my husband said I feel hot to the touch even though I am freezing. My shoulder joints, neck and wrist joints all pop and crack constantly.I had MRI and it showed bulging disc at C5-6 but surgeon said it was not causing my muscle weakness and has ordered new test from a neurologist. He gave a diagnoses of muscle damage?
I had RAI in 2/2006 for Graves disease but my doctor has checked my levels every month and they are under control. I now take replacement thyroid medication.
HELP I am so confused I don't know where to begin.
Answer:
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by CCF-Neuro-M.D.-SH, Sep 14, 2006
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.
  The symptoms you describe of neck/arm/leg pain, proximal muscle weakness and numbness in the middle/ring/pinky are more extensive than would be expected in carpal tunnel syndrome (median nerve entrapment at the wrist).  Given your pain and proximal muscle weakness, I would evaluate you for an inflammatory myopathy (inflammtory cells attacking muscles).  I would recommend an EMG and a muscle biopsy along with some blood work (ESR, CRP, CPK, aldolase, copper, zinc, vitamin E, ANA, B12, and paraneoplastic panel).
  The numbness in the ring and pinky fingers are more consistent with an ulnar neuropathy and the EMG will be helpful in finding out what is going on.
I hope this has been helpful.
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Member Comments (20)
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by Kathi49, Sep 13, 2006
I saw your post and thought I was reading about myself!  I feel your pain and can really relate to what you are saying.  Okay, here is my two cents worth.  A Neurologist is the best place to start.  I have multiple issues with my neck and lumbar spine but can't go into all of them here.  I also have gastro problems, weak pelvic floor and on and on it goes.  I am also scheduled for a C5/C6 fusion in one more week.  Anyway, I was diagnosed with idiopathic small fiber peripheral neuropathy about two years ago.  Now, my podiatrist and other doctors are calling it radiculopathy.  Who knows for sure. There are hundreds of reasons for neuropathy which I couldn't even begin to list here. To me, and I am NOT a doctor, but it sounds like a sensory neuropathy and not really a muscle thing.  When the nerves are damaged, and from what I understand, it can feel like muscle or joint pain.  The main sensation I have is a constant burning.  A Neurologist can run a lot of tests (bloodwork, EMG, QST) etc.  They can also prescribe medications; usually Neurontin, Lyrica, Cymbalta, etc. to help with this kind of pain (neuropathic).  I take Klonopin because it was the ONLY med that allowed me to function.  But that is me and there are plenty of people who do well on the meds I just mentioned. Also, I have been told over and over again that neuropathic (if that is what you have) is very difficult to treat.  I don't mean to sound like a "downer" here it just that I have been going through this process of elimination for a long time now and I now believe it is all resulting from my spinal issues.  But it can be treated and you CAN get pain relief.  Anyway, I also went to my Rheumatologist yesterday, and again, same thing...neuropathic pain.  On a lighter note, most of the doctors believe that if I have this second fusion a lot of my symptoms (especially in the arms) will dissipate.  Hang in there...you can get relief and get to a good Neurologist.
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by mike1105, Sep 13, 2006
i disagree with the post above. to me, it sounds like muscle imbalance issues. I had pain in my neck, arm, hand, and pelvis--msotly (80/20) on the right side for 2 1/2 years. had a few muscoloskeletal surgeries that did squat. I started improving afer a month or two of posture related exercises and stretching (3-4x per day for 30-45 minutes at a time). my posture got rounded due to my job as a dentist. do you have good posture?  do you sit alot at the computer ? do you even know what good posture is? when you stand back against a wall with the back of your heels touching the wall, does the back of your head touch the wall???...... it should. See a website by Dr. Jolie Bookspan and do reseatrch into posture. you may indeed have neuropathy but when muscles are in spasm (as they will be in a muscle imbalance scenario) they tighten up around nerves and cause symptoms. also do research on a guy named John Barnes. pelvic pain is a classic sign of postural imbalances-- your pelvis is the base for your skeleton. NEck muscle tightness can cause pain into the chest, back and arms--all due to tight scalenes!!! do your reading and get to work. that's my 2cents. i've been through it and i fixed myself.
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by Kathi49, Sep 13, 2006
I agree with you somewhat.  But because the original poster mentioned the C5/C6, her symtoms of "dropping things", etc., are typical of a problem with that level.  If you look at a dermatome chart it will reflect what she is speaking of as far as her hands and arms go.  Also, in reference to the pelvis.  Orginally, I was diagnosed with a weak pelvic floor. I, too, could not lie on my hips, my legs were weak and in pain. I went through PT to strengthen the pelvic floor muscles.  In actuality, it made me much, much worse in that while I was doing the "muscle" exercises, it actually caused a cystocele and rectocele.  My PT had me to stop immediately and go to my ob/gyn.  I was then refered to a Urogynecologist who did even more extensive testing.  In the long run it was determined that I had "symptoms of a weak pelvic floor" but it was due to "nerve root impingement at the L5/S1".  My arms and legs are both weak due to radiculopathy and/or nerve damage.  In addition to all of this, I was recently told that the cervical level can cause the symptoms she is speaking of from the neck on down. This is why I mentioned neuropathy or neuropathic pain to her.  It does cause the sensation of burning, tingling and pins and needles.  In any case, I still maintain that her next step should be with a neurologist.  Before I would do anything chiropractic or any form of exercises, I would find out first what the neurologist would have to say.  I found out the hard way that exercises can sometimes make things worse.  If it is truly muscle imbalances, then the neurologist would probably be able state that.
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by freeman9007, Sep 13, 2006
May I suggest you get a copy of your thyroid blood test. Especially ask for FreeT3 and FreeT4.  A TSH is usually all that the doc asks for but dosent tell enough.  The TSH test range of (0.5-5) is seriously under debate, and as a result patients are left to suffer while it is sorted out.  Anadecdotely people report that they feel better when the FreeT4 is at the top of the range and FreeT3 just above mid range. TSH under 1 - 1.5.    I recommend you read "The Great Thyroid Scandal" by Dr Barry Durrant Peatfield. or Mary Shomons books about hypothyroidism (which you most likely have after the R131)  Endocronologists are notorious for sticking with the TSH and ignoring clinical systems and replying on the outdated TSH.  Also Ferritan best between 50-70 and no SOY anywhere in your diet
This may not be all of  your problem. but a correctly medicated thyroid condition will make alot of difference as it affects every cell in your body.  Mary shomon also has a thyoid forum at www.about.com  A survey by the American Assoc of Clinical Endroconologists in Jan 2004 stated that 1 in 14 have a thyroid condition  - that half are not treated, and half of those that are treated are undertreated.  They recommended the TSH range be lowered. Thyroid is one area you have to look after yourself -  Endroconologists dont have a good wrap from patients.
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by mike1105, Sep 14, 2006
a neurosurgeon said the buldging disc is not casing muscle weakness. Most adults have "buldging discs". skeletal dysfunction is probably most of the time caused by muscle imbalance and muscle dysfunction (unless of course there is trauma) Your muscles brace your skeleton. If muscles are weak or out of balance, your skeleton (spine included) is affected, as are the nerves inside the spine. It is entirely possible that the c5/6 nerve root is involved, although the pinky finger is actually c7/t1 if I'm not mistaken. regardless, the pelvic weakness and overall muscle burning and pain to me is not characteristic of nerve root involvement, which is usually very specific and causes specific weakness and numbness. to me the symptoms point to muscular weakness/lengthening, tightening/shortening, poor posture, pelvic muscle weakness etc......thats my 2 cents.
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by Kathi49, Sep 14, 2006
I agree that the pinky finger and ring finger are usually characteristic of C7.  But dermatomes can overlap as well.  Also, nerve root impingement can cause muscle atrophy.  What sent up a "red flag" to me was the burning she is speaking of.  I stand corrected if burning sensations are also symptomatic of muscle imbalances but I have never heard of that being the case.  If her surgeon is referring her to a Neurologist, then that tells me he may believe something neurological is going on which is exactly what happened with me.  And when I say Neurological I don't mean just neuropathy.  There could be a whole host of things going on.  Okay, as far as the pelvis goes, and being female, I have had a child and also a hysterectomy which can weaken the pelvic floor.  What originally sent me to the Urogynecologist folks was that my spinal pain management doctor thought I might have a weak pelvic floor and/or sacral problems.  We already knew I had problems with L5 and S1.  Anyway, after PT and exhaustive testing which is too graphic to go into here, the Director of this group said that the L5 and S1 and all the muscles, etc. all tie in.  In other words, if there is a nerve problem, it is not telling my muscles how to work appropriately. Anyway, he will NOT send me into physical therapy at this point as he states "it would send me over the top" at this point in time.  Instead, I must first attempt to get those nerves (L5 and S1 facets to be exact)calmed down. I did receive an ESI and also an S1 injection a few months back which totally obliterated my leg, knee, ankle and foot pain and weakness.  So, that tells me that those levels are my pain generators.  The next step would be to get an L5 FACET injection and a determination made if I have a SI Joint Dysfunction.  I am still in that process but have to wait awhile until after my cervical fusion.  Even a Neuro here on this forum stated that hopefully the majority of my symptoms will improve after the fusion.  Hopefully, the original poster here can get help from a Neurologist.
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by boogirle, Sep 14, 2006
Thanks to you all for the comments.  I will keep you all posted on the neurologist visit next month.
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by mike1105, Sep 14, 2006
my opinion in a nutshell is that when muscles are weak or out of balance, the skeleton is affected. I am living proof. I fixed a myriad of painful problems by correcting my posture and doing the appropriate stretching and exercise. For example, when facets cause pain, it means your spine is not oriented correctly. It DOES NOT blanketly mean that there is something wrong with your facets and you need injections. Right now as I sit here, I have some burning pain from my groin to my right knee. I'm going to stretch my hip flexors for 10 mintes, and I will be fine for the rest of the day....maybe longer. It wasn't always this easy. In the beginning, it did not help at all because I was so tight. It takes time, belief, and committment. I was probably worse off than ther person who made the original post. And BTW, the pinky finger is innervated by the ulnar nerve c7/t1. while dermatomes can overlap, I doubt his problem with his pinky is from c5/6. The neurosurgeon referred this person to a neurologist it seems not becasue he suspected something, but rather becasue he suspected nothing and was unable to help the patient based on his findings--that's the implication of the post, in my opinion. That's what doctors do. When they can't find anyhing, they refer you to someone else to cover their butts. I understand you are having a fusion. I wish you well with it, although if your problems are muscular in origin it will not help, and may make things worse becasue you will in essence become less mobile from he surgery by eliminating a joint. good luck