shoulder and right arm pain

[Stanley__0]

Posted by Stanley on July 13, 1999 at 09:26:19
It has been 3 weeks, my shoulder and entire my right arm pain, and sometime feel numbness at my right finger tips. Is this neurological problem? How can i seek help?

Posted by CCF Neuro MD MM on July 13, 1999 at 11:02:33
If you have pain in the shoulder that radiates all the way down to the fingertips then it is possible that you have damaged or in some way irritated a nerve in the shoulder. The pain is being felt in the sensory territory of the nerve which extends all the  way down to the fingers.
I would suggest that you consult a neurologist ,ideally one who can perform
an EMG examination as this would identify the exact nerve involved.
I do not know where you live but any latrge University clinic would have these facilities. If you want a consultation at the Cleveland Clinic the number for Neurology appointments is (216 ) 444 5559, no referral is necessary.

Posted by Elizabeth on July 15, 1999 at 13:18:18
Dear Doctor, It is me again, the one with "problems"! I was admitted to the ER
on 6/22/99 and now have my records! DX Cervical Radiculopathy which I am supposed to follow up with my primary doctor not a neurologist referred. However, I think a MRI is in order as a numbness now is ocurring under my right forearm which was not there before. The scapula pain has subsided from a level of 6-7+ to bearable but the pins and needles still are present.  Would a MRI still see the cause of this episode or is it too late to verify the dx? All this esculated during the acute vision loss.  Could this vision loss be a part of this problem?  I hope you will respond if you see this post!  Thank you!  Elizabeth

Posted by CCF Neuro[P] MD, RPS on July 16, 1999 at 12:39:36
Dear Elizabeth:
Yes, an MRI would give some indications to the etiology of your radic.  There are several other tests that also might help.  Some blood work and especially the EMG.  Have you had an EMG?  This will help your neurologist tell if the problem is demyelination or axonal loss.  The MRI will only show what is there but not really give you the etiology of your radic.  The real issue is what is the etiology.  If you know the etiology then one can possibly treat.
Sincerely,
CCF Neuro MD

Posted by Elizabeth on July 16, 1999 at 15:25:59
Dear Doctor, No, I did not have any tests relating to the primary reason I went to the ER.  They were so concerned that I might be having a MI or a PE that the scapula pain with P&N was the last on the list even though they were giving increasing levels of Morphine for the intense pain. Lab tests were mostly normal (blood work) but the ekg was abnormal ie left atrial enlargement, poor R-wave progression, borderline low voltage in frontal leads, sinus rhythm rate ranged from 59-86 ( I do have a redundant mitral valve leaflet w/effusion).
Then the dx of cervical radiculopathy;see your primary physican for follow-up.
Will a "family practice" doctor follow-up on the emg, etc or shoul I just rely on HIS diagnosis if he doesn't refer me to another Neurologist? If there is only bearable pain remaining but numbness and P&N still, will the emg show anything goin on? or would the mri/spinal be helpful? Thank you for your quick response!
Elizabeth  

Posted by CCF Neuro[P] MD, RPS on July 16, 1999 at 17:38:28
Dear Elizabeth:
No, you will have to see a neurologist.
Sincerely,
CCF Neuro MD

Posted by Marcie Crain on July 25, 1999 at 21:04:22
Hello again. I have MS, diag. in 1986, and my entire right side has pain from the skull down.  Two or three months ago I was watering my flowers and had picked up a stick to fluf up the leaves after watering.  I just kept going when I started bending over and grabbed for the fence bar.  I kept on going, trearing my muscles in my right shoulder and my bicep.  Went to see my PCP Dr.(an Internala Med Dr.) who pulled around on it and said it was not broken and gave me copies of excercises to do.  My med's currently are Elavil for sleep 25mg, Paxil 25 mg for depression & pain, Hydrocodone for pain. I have several questions.
1. The injury was to the same side that I have my MS pain, my right side.  It still have  a sore line on the front of my shoulder radiating down at an angle to my chest area.  I also have sore area's underneath and the inside of my bicept PLUS my MS pain.  If I move my arm wrong it seems to reinjure it.  Have had to start taking 2-3 hydrocodes a night and sometimes during the day.  Do you feel this has in anyway 'worsened' my MS pain?  Is it there to stay if so?
(I tell my husband the right arm and shoulder pain is much worse now but we don't see how it could have made my MS pain worse  BUT it seems to be what has happened?????)
  
  This heat & humidity is terrible in OKC.  My Physiatrist has prescribed a cooling vest before she dismissed me from care.  What is the best kind to get when you have MS?  Do you know where to  get one from?

Thank you so  much for your help and opinions.

Posted by CCF Neuro[P] MD, RPS on July 26, 1999 at 13:02:06
Dear Marcie:
First of all, you should be on one of the interferons or capaxone for your MS.  Second, if your pain was due to muscle strain your pain should have been getting better by now.  I would see if you can see a neurologist just to check things out (at least for the interferon) and he/she could also check out your right shoulder and arm pain.  
The pain from your MS is likely from the spasticity created by your central lesions in the brain.  The pain from your accident is perpherial due to trauma of the falling.  Likely they are two different etiologies for your added pain you have been feeling.
Go see a neurologist and start interferon and get your muscle/skeletal system checked out.
Sincerely,
CCF Neuro MD

Posted by cas on August 01, 1999 at 22:46:08
Thoracic oullet Syndrome should be ruled out with these complaints.        
see my web page www.tos-syndrome.com

Posted by CCF Neuro[P] MD, RPS on August 05, 1999 at 17:22:34
Dear Cas:
Thoracic outlet syndrome is a vascular problem, either venous or arterial.  There should be signs and symptoms of vascular compromise, blue cyanotic digits, lack of venous pulsations with various movements etc.  Thoracic outlet neurogenic pain is lower trunk pain (brachial plexus) and the symptoms describe do not fit the lower brachial plexus picture.
Sincerely,
CCF Neuro MD