Pain under arm, around the front and back and shoulder blades

[Henriete-Schwab]

Posted by Henriette Schwab on July 02, 1999 at 09:14:06
Dear doctors,
Four months ago, I awoke one night with pain under my left arm.  By morning
it was on both sides.  Over the following weeks, the pain moved around
the arm muscles in the front, to the back, under the arm and around the
shoulder blades.  At first the doctor thought it might be costochondritis,
but it wasn't.  Ibuprofen didn't help.  My heart checked out fine - had
the usual tests.  I then went to physical therapist after that.  She said
my posture needed to be much straighter and she gave me some exercises to
strengthen what seems to be real weakness around the arm muscles.  There
are days when the pain is minimal, but then it seems to return.  She said
it would take some months before it is resolved.  I know that I have
strained these particular muscles, especially over the past year, and yet
do you think that it should take this long to get better?  I have difficulty sleeping sometimes, and other nights it is not too bad.  The pain is usually worse in the morning, although I have had some pain free mornings too.  Nothing seems to make any sense at this point.  Any advice you may have would be greatly appreciated.

Posted by CCF Neuro[P] MD, RPS on July 02, 1999 at 13:56:51
Dear Henriette:
Sorry to hear about your pain.  There are a couple of things that strike me.  First, without examining you and knowing your history, it is difficult to give you an exact diagnosis.  Since the pain is sort of waxing and waning but never disappearing, it may be that something you do puts stress on the nerves that go to the muscles you describe (nerves in the cervical spine).  It may be a sleeping position or a new routine at work or at the gym.  It may also be due to a worsening spinal cord/disc/neural foramen problem.  It might be best to go see a neurologist and have a full neurological examination.  This way a trained person who specializes in nerve problems will be able to fully access the problem.  Sorry I couldn't be more specific.
Sincerely,
CCF Neuro MD

Posted by Elizabeth on July 06, 1999 at 15:50:37
Dear Doctor, I have just recently been to a neurologist in which he says that y symptoms are not specific enough to make a diagnosis. Must wait and see! One week later I was in the emergency ward with a possible heart attack or muscle/nerve problem.  Although, the heart problem was the most concern with all doctors, the muscle-nerve problem was not addressed. Just that it was not a HA and take motrin for the pain.  Ok!  It seems that the medical field is not as aggressive today as just 20years ag0 although they should be more educated in peoples diagnosises and other problems now!  The pain still is present, the tingling is still present and I eat motrin and advil probably until it eats my stomach away!  The pain is in my upper right side near the spine with tingling down the arm including my fingers.  It is most annoying! The pain seems worse at night only because I am sitting down with my husband and family and not very busy!!!and I notice it more in which it waxes and wanes in intensity.  I feel I needed a cat scan to rule out a problem with my nerves/muscles or is it just Fibromyalgia, the catch-all of all things! Yes, I have been dx as having FB. Is it the FB or is it something else?  How is one to know if it is not a part of a chronic condition or something other?  Another question.  Can a anaphylatic reaction trigger Fibromyalgia?  Is this possible? and other problems in the system ie eyes? Please let me know what you think! Elizabeth            

Posted by CCF Neuro[P] MD, RPS on July 06, 1999 at 17:44:10
Dear Elizabeth:
Sorry about your bout with the ER.  I am assuming that all the cardiac enzymes were normal and this was a flair of your pain syndrome.  Actually, an MRI of your cervical spine would be better than a CT.  The CT would pick up boney changes but the MRI would not disc, nerve roots, vertebrae, soft tissue changes etc..  I think I would call your neurologist and explain this last experience you had and ask about what you should do.  If there is no response, then I would seek a second opinion from another neurologist.  If your in an HMO or have a gate keeper physician then you will have to talk with that person.  
I hope you get this resolved soon.
Sincerely,
CCF Neuro MD

Posted by Henriette Schwab on July 08, 1999 at 10:11:43
Dear doctor,
Thanks so much for your comments.  Can you tell me what I can expect
with a visit to the neurologist?  I've gone back to my chiropractor and
he said that although I don't show any sign of nerve damage, my nerves
are definitely irritated.  He gave me some supplements to help the
nerves and muscles.  If that does nothing in the next month, then I will
make an appointment with the neuro.  I meant to tell you that whenever
I have pain, it is exactly the same in intensity and location on both
sides of my body, which leads me to think it has something to do with
the spinal nerves.  I am keeping up with my exercises, but wonder if
there is anything else in the meantime I could do.  Besides MRIs etc.
what can a neurologist do for intermittent pain?  Thanks for your
help.  H. Schwab.

Posted by CCF Neuro[P] MD, RPS on July 08, 1999 at 17:10:56
Dear Henriette:
I think you need to see a neurologist.  A chiropractor just assesses alignment and not nerve roots, neural foramen, disc degeneration, vertebral degeneration, etc.  This is partially what a neurologist will be doing in his exam.  Depending on the etiology of the pain, he/she will devise a proper medical plan to treat your problem.  There is a place for a chiropractor but not in this case as of yet.  If it were, he/she would have begun to correct the problem.
Sincerely,
CCF Neuro MD