Numbness Down Right Arm (EMG??)

[Moonman13]

Hello,

A couple of months ago, I was in a car accident.  Another party struck the side of my car.  Side curtain air bags and a seat belt saved me from serious injury.  About 10 days after the accident I started to get a periodic numbness sensation on my right shoulder down to my elbow.  It's been around for the past 6 weeks.  No pain and very little discomfort just the numbness that goes away in a few seconds.

I've seen a chiropractor but did not have much luck.  Got MRI's of the neck and shoulder.  Just went and saw my family MD who put me on a steroid pack for 6 days.  No effect so far.  

My question: my doc suggests the next step be an EMG and nerve testing.  This procedure does not look like fun and I am wondering is it worth it?  Even if they confirm there's an pinched or impingement of a nerve, will the treatment change (if there is a treatment)?  

Cost is not a factor for the tests.  There is really no pain and I have not noticed any loss of strength to the bicep or triceps area.  I'm still playing golf and tennis without any issues (except for occasional numbness sensations).  

Two interesting items (1) stress will bring the numbness sensation, which make sense and (2) if I lift my right arm up above my head the sensation goes away immediately.

MRI results for cervical (C5)

C4-5: bilateral neural foraminal narrowing from osteophyte formation, right greater than left, is seen with no disc herniation or spinal stenosis or cord compression

C5-6: a broad-based disc osteophyte complex with right lateral recess and neural foraminal narrowing is seen without cord compression or flattening

[caregiver222]

Prednisone, used long vterm, will cause deterioration of the cartilidge, so it should be used judiciously. That being said, on a short-term the benefits outweigh the risks. Some physicians may recommend a less intensive steroid protocol.

In addition to range of motion, avoid "up-and-down" vibration. Get an inflatable cushion to put under your seat ahen you drive.

Isometric exercises to strengthen muscle tone are useful. Put a hand against your forehead and push forward for ten seconds. Take a break. Do ten repitions. The put a hand against your left temple. Force the skull to he side to tense the muscles for ten seconds and release pressure. Ten repitions. Same with right side and rear. Twice a day.

Muscle relaxants are commonly prescribed, but they degrade muscle tone, so they are not a good idea.

Usually these complaints show up months after the initial incident.

You may have to keep the portable traction device handy and use it for years whenever there is a re-occurance.

You have a classical subluxion injury, taught in the second day of witch-doctor school in the smallest villages in Ouwakadugu. Often there is a co-factor, such as a bit of arthritic degeneration..

[caregiver222]

It's going to get progressively worse (pain city and a frozen shoulder and a walker and cane) unless you start treating the problem properly.

I hesitate to criticize, but your treatment protocol leaves something to be desired.

You have a classical subluxion injury and need to find a physician who knows what he is doing.

A cervical collar is contraindicated. It will cause loss of muscle tone.

An EMG is rather pointles/meaningless. Prednisone alone won't do anything.

The pain dermatone defines the pinched nerve.

First keep well hydrated and keep glucose levels down. No big meals. High glucose levels increase osmolality and impinge on the nerve.

Absolutely positively no vibration therapy or ultrasound therapy.

You need axial traction as of yesterday. Plus the steroid. Prednisone is usual. This is a common protocol. Start with 60 mg. Then fifty. Then forty. Then thirty. Then twenty. Then 10 mg a day for the next month.

Prednisone alone without axial traction will do ungotz.

Short sessions of perhaps fifteen-twenty minutes separated by an hour or two to start. The axial traction devices can be purchased without prescription for about $35 (U.S.). For the first week of this obviously you can't work.

In addition to the prednisone  first two days 800 mg Ibuprufin in two divided doses (400 separed by 12 hours) with food. Then 400 mg a day in two divided doses for three days.  Then 200 mg a day for the next month. That's only a suggested protocol. Consult your physician before taking any medications. My girlfriend tells me astrologers are also helpful.

Set it up so you can gently lower yourself, but not hang, providing firm upward axial traction. Discard the water bag.

After two weeks of axial traction therapy you need to begin "range of motion" exercises, rotating your head 360 degrees through the limits of pain.

You have a tort action in regards to the accident so consult a good bottom-feeder and be sure to document your medical history and keep going to a physician.

If not treated promptly an injury such as you have can cause a lifetime of chronic level-ten pain.