Neurology Expert Forum
Shoulder Pain
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Shoulder Pain

I have had pain in my shoulder going on four years now!! Every time I sit down my shoulder and shoulder blade in back starts in,I have a dull aching pain and then my arm goes numb just to the inside of my arm, not all the way down to my hand.  It gets particulary worse when I am trying to sleep, my arm is numb and I can not get to sleep no matter what. I can only sleep on my left side for it is my right shoulder and arm that is hurting.I have had four MRI's nerve conductive test, xrays. No one can find anything wrong..
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Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.


Pain in the shoulder can be of many causes. If it radiates and follows a particular nerve pattern, i.e., a dermatome, it may be a cervical nerve impingement. Other causes could be from a rotator cuff injury, capsulitis, or brachial plexus injury. The diagnosis would rely on the exact location of the pain and the examination. Another possibility could be arthritis of the glenohumeral, sternoclavicular, or acromioclavicular joints, which all cause chronic changes leading to a dull achy feeling. This would be diagnosed by xray of the shoulder. Causes of the arthritis can be long standing repetitive motion. It can be treated conservatively with NSAIDs and physical therapy. Intra-articular cortisone injections maybe used to relieve the inflammation. If patients fail conservative treatment, surgery is an option for these.

Another possibility is that there has been injury to the intercostobrachial nerve. This nerve is a sensory nerve that supplies the skin on the inner surface of the upper arm and chest. It may be injured in surgical procedures.

It is good that you have had an extensive electrophysiological and structural workup with the EMG and MRI to evaluate peripheral nerve, plexus, and root causes for your symptoms. I would recommend that you continue following up with your neurologist. Also, if you haven’t had one performed, you may need an xray of the shoulder to evaluate for bony causes of pain.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.

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