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Shoulder, forearm and wrist pain
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Shoulder, forearm and wrist pain


  : About 6 years ago I started experiencing this sharp shooting pain in the thoracic (T3-T6) part of my back, but to the right of the spine - in the muscle area.  This went on for quite sometime, then it started to radiate from there to my shoulder and armpit area down into my arm and wrist.  (At the time of this I was a full-time office worker and worked on the computer most of the time.  I also had a horse farm and did a lot of work - from tossing feed bags and bales of hay).  I couldn't take the pain and finally saw a doctor.  I had two EMG's - the first being inconclusive and the second showed a mild case of carpal tunnel syndrome.  (I thought if this was mild - extreme must be unbearable).  I was given meds and told to come back if things weren't better......I could hardly hold a pen, let alone write, and my grasp - well, what grasp?!  Eventually, my wrist and hand just kinda flopped w/ virtually no control.  It went numb, felt cold and hot and sometimes sweaty.  I went back to the doctor and he was lost for words, gave me a wrist splint and told me I stressed a nerve somewhere just above the shoulder blade (lower brachial plexus??)  And it would "heal" in about a week.  It did get better over time and I quit my job abut 6 months later.  (Not being on the computer really helped.......Now, it's back.  But,  some of the symptoms vary.  The back pain is there again and I'm seeing a Chiropractor for that (C7,T4 and L1) and so far it's helped a little.  I've only been going a couple weeks.  Most of the pain now is starting in the shoulder (front), skips the bicep and goes to the forearm (underside) and into wrist (inside, under & top).  Sometimes the pain is isolated.  i.e. shoulder (specific spot) twitches/spasms and has sort of a pulsating/throbbing, sharp and burning feeling that maybe radiates a couple inches into the front of my bicep without pain in the forearm or wrist.  The same goes for my forearm and wrist.  Lately it's been inside wrist pain and top (same as shoulder).  What gets me is that the shoulder pain sticks around and the forearm and wrist just hit.  Extremely painful.  It's worse in the evening.  I tried just simple rotation of the wrist for a form of exercise and stretching.  At a certain point, when rotating clockwise, it pops (very irritating) and with counter-clockwise there's nothing and less pain.  I try to keep my wrist straightened as much as possible, but even preparing a simple meal caused pain and fatigue (almost the only time the forearm and wrist hurt together - except evening).  I noticed that my right shoulder/arm fatigue alot quicker than normal, with normal daily activities - followed by an achy feeling.  I also noticed that my right hand is cold when my left is normal.  This occurs daily no matter what I'm doing.  And sometimes if I lay/cross my arms resting on my stomach, that my ring and pinky fingers and the outside of my hand goes to numb and tingles.  I often wake up with that same feeling, no matter the position I'm in.  My shoulder is also very stiff in the morning, but once I get up and around it's okay.  The only thing, so far, that seems to help is ice and sleep (once I get there).  Another oddity is that, in order to fall asleep, I have to lay on that right side.  Extreme pressure seems to  dull the pain enough to fall asleep.  It's 10x worse if lay on my left side.....I'm in my late 20's and am the Stay-at-Home Mom of very busy pre-toddler.  I'm having trouble when picking him up, but I can't just stop caring for him, because I have this problem.  (The fact that he's 23 lbs. doesn't help - he's quite an arm load).  I've always carried him on my left side.....Can having a fall 15+ years ago possibly affect me now???  I appreciate your patience,  I'll explain briefly what happened.....I was running across the playground (asphault/concrete) when a kid threw a dodgeball at my feet.  My right hand, arm and shoulder "broke" my fall.  The school nurse treated me for the obvious (large chunk of skin out of the palm of my hand - closest to the wrist).  At the time that was all that seemed to hurt, until I got home.  My wrist and forearm (underside) were just pounding with excruciating pain.  Man, did it hurt. I couldn't hold a pencil or write.  It hurt no matter what.  I didn't want to move.  I was good at hiding pain back then. It eventually went away, but I was never treated for it.....Is it possible something was wrong and it healed incorrectly???  That popping w/ clockwise wrist rotation????  Is Carpal Tunnel back????  Overuse injury - muscle strain (shoulder area)????  Are they even connected????  I work part-time on a horse farm, caring for 14 horses (includng my own).  Could a jerk (when caught off guard) while leading one of the horses cause this????  That happens on occasion.  Any advice would be greatly appreciated!!!  I sincerely apologize for the length of my message. Thank you for taking the time to listen to me.....Take care....Lisa      
  
  ====
  Doctor,
  I just had a lengthy dicussion w/ my Chiropractor about this problem.  I've been going 3x per wk. for 3 weeks now and I feel my pain is getting worse.  Today's Wed. and I was in Mon. and Tues. for an adjustment. (C7,T4,L1) and I was fine while standing in the office, but as soon as I got into the car it  started all over again.  Today I had the worsed pain in my life and I haven't even left the house.  All I've done is played w/ my son and straightened up the house a little.  That's why I called him.  Also, because I'm having a new symptom. It feels like a combination between your hair standing up on your arm, skin crawling or something liquid running down your arm.  And to go along with the cold hand, my hand is clammy...Is this strange??  At the same time, I've noticed that I'm perspriring more - just that right side.  I never had this problem before (6 yrs ago) it was more toward my hand (wrist). ---  This has been going on for 8 months and I had to stop going to the gym, (this is when I started to notice the problem - forgot to mention that, sorry) because when I do any weight training w/ my arms it felt like my shoulder was going to come right out of the socket.  And then that sharp burning pain around T4 would go.  Over time it ended up in my arm and wrist, as well. -- He says my back is pretty screwed up, along w/ my neck (hardly any pain there though - just some stiffness now and then) and that's what's irritating those nerves.  He said those muscles are pretty much training the back out of alignment.  But my bones and discs are fine.  Sometimes it sure feels like T4 is pushing it's way through my skin, though.  Like it's bruised.  I know it will take time to get the back re-trained to stay in alignment, but I'm out of alignment everyday.  And any type of physical labor (my job) or excercise while it's out is making it worse, right???  My questions now are:
  1)  Will Chiropractic care eventually help this??
  2)  Should have another EMG???
  3)  What do you think my options are??
  Your time is once again greatly appreciated.  
  Sincerely, Lisa
=
I apologize for the delay in answering your question. I hope this still is helpful. Of course, I won't be able to answer the questions posed directly because giving medical advice really requires a face to face interview and physical exam, no matter how much helpful detail you provide in your account.
However, I do want to point out the distinction between a "pinched nerve" in the neck (radiculpathy) and carpal tunnel syndrome, because that will be relevant to you and will serve as the focus for your visit to a neurologist.
A radiculopathy is what you get when a nerve root is irritated or damaged somewhere betweeen the spinal cord and where the actual nerve is formed from the merging of several nerve roots. The most common problem in this case is debris plugging up a little hole in the side of the spine and leaving less room for the nerve root which uses the same hole. Of course, this can occur on the right or left ,and at any level (8 cervical, 12 thoracic, 5 lumbar ,and 4 sacral roots on each side). The debris is usually disc material or other products of wear and tear on the spine. The most common regions affected are cervical (neck) and lumbosacral (lower back). Your 20s is a bit young, but not impossible.
Carpal tunnel syndrome results when a specific nerve is irritated or damaged by compression at the wrist. Symptoms can be similar: after all, I am talking about compression type damage to nerves in either case. But the location of symptoms is different.
I'm not confident that chiropractic is going to help you diagnose this. You should see a neurologist. If you are shown to have a fair amount of debris in your cervical spine, then manipulations of the neck may be hazardous.
I hope this helps. CCF MD mdf.




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