Nerve impingement in neck radiating to hand??

[dally7777]

I have been an active-duty soldier for 11 years and 5 years ago I was diagnosed with chronic right shoulder impingement.  In Dec 2002 I began to lose the strength in my right hand and have consistent nerve pain radiating from my neck to my right hand with considerable loss in strength in my right hand. I have muscle twitching in my hand and shoulder during short term use.  My neck has consistent stiffness. MRI results are as follows:
1) C3-4: Mild to Moderate left sided neural foraminal stenosis
2) C4-5: Mild left sided neural foraminal stenosis with mild spinal stenosis
3) C5-6: Mild bilateral neural foraminal stenosis with moderate spinal stenosis
4) C6-7: Mild right sided neural foraminal stenosis
5) C7-T1: Normal
No disc bulges or protrusion, ligamentum flavum hypertrophy, DJD, or uncinate joint hypertrophy is identified. IMPRESSION: Multilevel mild neural foraminal stenosis and spinal stenosis as described, which may be congenital in origin since there is no obvious disc pathology or joint pathology.
I received an EMG(From a Civilian Neurosurgeon) with the following results:The electrodiagnostic exam show no evidence of brachial plexopathy or right C5, T1 radiculopathy or entrapment neuropathy. I believe musclo-ligamentous strain of right shoulder seems to be the cause for continued pain. Since he has mild spinal stenosis, I recommend a neurosurgical consultaion. Phy Therapy may be continued and Pain Medications need to be continued. I have a spinal surgeon consult in Kansas City on 30 Apr. I currently take Tylenol-3(w/Codeine) every night so that I can sleep.

[kasi]

I am suffering from severe hands pain and reflex since two months. It's continues mild pain on hands. If I do any physical work pain will be more on hands and then  reflex will come out of my stomach, muscle pain start like spark on either side of the chest, stabing chest pain and sending pulse vibrations to hands for every 10 minutes.

It is worsening daily from 3 p.m to 10 p.m.


I am taking Nexium for reflex, Triple therapy(two week course tetracycline,metronizadoel, pespto bismal) for H- pylori infection and Vioxx for hands pain. By tomorrow 05/28/2003. my two weeks course is going to end. But there is no improvement on symtoms.
Any suggestion and help will be appreciated

[misspaula]

hey i have a question maybe some will help me......i am having tingling in my face on both sides and around my mouth.I have severe bouts of dizziness.....like I am off balance sometimes to the point of falling down.....I have headaches also......please does anyone know what this could be?????I have been to an ENT and have had all kinds of testing....but so far they say I have Meneires Disease which is a balance problem.....and the dizziness and tingling is getting worse.....help!!!!!

[CCF-Neuro-M.D.-JT]

It's extremely difficult if not impossible to give an accurate medical opinion without personally reviewing your films or examining you. However, the description of your symptoms does sound like there's a pinched nerve in your neck that's causing the pain and weakness. Right "shoulder impingement" in itself shouldn't technically cause radiation of pain and hand weakness. SOmetimes, an MRI is not as specific as an EMG if it's performed by a well-trained physician at a major academic center or reputable facility in the private practice sector. Other times, an EMG won't show anything this far out from onset of symptoms.  THey're best done within a year of onset. I agree with the neurosurgical consult, but keep in mind that even if the problem is attributed to the spine, surgery won't necessarily make the pain go away completely.  Be sure to bring your films for them to review it.  We often don't agree with the official readings from outside radiologists and have our own surgeons and neuroradiologists look at the films if surgery is an issue.  In the meantime, you may want to try some muscle relaxants to help with the stiffness or neurotin during the day for pain relief.  Best of luck.