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Radiating shoulder pain, tingling
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Radiating shoulder pain, tingling

Hi, I'm a 45 year old female who is at her wit's end. I have had intermittent shoulder pain since I injured it (I believe) at the gym in July. There is tenderness on the front of the shoulder, tingling will often radiate down into my thumb and fore finger. Along the trapezius muscle area there is tingling as well.(it sometimes feels as if it is moving)  If I extend my arm and cross it over the midline it is very sore and if I extend my arm behind my back, I am unable to lift it as high as my other arm and when I cross over the midline, I experience pain. I have trouble, at times, sleeping on it. It seems to hurt more when I exercise but even after a few weeks of resting, it still was sore.
I'm hesitant to go to the Doctor's because I have a 3000.00 deductable!
I've iced it, applied heating pads, rested it to no avail.  Any thoughts?
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Dear Kittyjones,

Although I am sorry to hear that you've injured your shoulder, I hope that I can address some of your concerns.  I must preface my reply by clarifying that this forum should be used strictly for educational purposes.  Unfortunately, I am unable to speak with you or examine you, and as such, I am unable to offer you a diagnosis.

You describe a number of symptoms including pain/tenderness in the shoulder as well as some numbness and tingling involving the thumb and forefinger.  Based on the mechanism of injury (working out at the gym), it sounds as though you may have sustained a stretch injury involving the shoulder girdle muscles as well as the nerves that travel through there.  One important point that I would want to know is whether or not you are experiencing any weakness, and if so, where is the weakness located and what types of activities are you finding difficult now?  Answers to these questions would allow me to better localize your problem.

In any event, let me try to describe a few points regarding the anatomy of the shoulder, specifically with respect to the nerves that travel through that area.  The nerves in the arm are comprised of a very complex network known as the brachial plexus.  In general, there are large nerves that come off the spinal cord (C1, C2, C3, C4, C5, T1 nerve roots) which then branch off to form multiple other nerves which serve the upper extremity muscles.  As you might imagine, there are a great many anatomical structures within the shoulder girdle including bone, muscle, nerve bundles, etc.  Various situations including sports injuries can lead to either stretching or compression of one or multiple nerves within that network ultimately producing symptoms.  Oftentimes, symptoms include a combination of weakness and sensory changes.  The way you describe it, you have predominantly sensory symptoms and the distribution you describe make me think perhaps some of the sensory fibers coming off of the median nerve.  

You also describe some soreness in the region of the trapezius.  The trapezius muscle actually is not innervated by any of the brachial plexus nerves; rather the 3rd and 4th cervical roots provide the nerve supply to the trapezius.  There are a number of other muscles in that same territory that do in fact receive innervation from the brachial plexus, in particular the rhomboids and levator scapulae.  However, if all you are experiencing is pain without any weakness or tingling, it sounds as though you may have just overworked that particular muscle.

So. . . I have a feeling that you're not going to like what I'm going to tell you but the peripheral nervous system (i.e. nerves and muscles) is highly complex and in general, proper diagnosis and treatment of injuries to these components of the nervous system require an astute physician to conduct a very careful exam.  Although your symptoms may be nothing more than "over-doing it" at the gym, I would encourage you to be evaluated by a neurologist.  In particular, persistence or worsening of your numbness/tingling and/or development of weakness further suggest the possibility that you have injured one of the nerves.  Testing such as electromyography and nerve conduction studies can further confirm injury and may also offer incite into the etiology of injury.  Patients that have nerve damage secondary to compression may actually benefit from surgical decompression, although this is something that you will need to discuss one-on-one with your neurologist.

I'm hoping that by now, your shoulder is starting to feel better.  Again, I encourage you to make an appointment with a neurologist.  Thank you for your question, and I wish you the best of luck.

Sincerey,
JBT, MD
2 Comments
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You probably need to see a doctor. About 15 years ago I started feeling intermittent shoulder as you.
After about 2 months I went to see the doctor. The result was a torn rotator cuff, which required 2 surgeries. The doctor told me that if I had came in earlier that I probably would have only neede 1 surgery
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