Arms etc pins-n-needles, pulsating, burning, weak, un-usable

[March262007]

I took a bad fall in March 2007.  My feet suctioned in wet sand while my body fell hard and flat-out on the wet sand.  My torso went deep in sand due to heavier weight while shoulders/arms remained a normal sand level hyper extending my shoulders. My neck/shoulders/arms/hands have felt inflamed, tingling, limp, and a trembling/pulsating sensation etc off and on ever since.  It was worse at time of injury...and for months, it is still very present especially when I awake in morning and with even moderate use; it can last all day.  The odd thing is that sometimes it is just from elbows down, other times from neck down. My shoulders are now frozen.  Also my camera was around neck at time of fall with the impact causing great pain to chest, sympathetic nervous system, and vertebra directly opposite of impact.  Besides this, I’m told my central nervous system is still “scrambled”.  I had my neck fused and lower back surgeries in 2000 and 2001.  The nerve damage in neck settled down after 3-4 years.  Now my neck is fiery/tingling etc. again from vertebra out and down shoulders/arms/hands.  All this to say, although I cannot use my arms property, my IME neuro and ortho doctors indicate there is nothing wrong with me.  My symptoms are debilitating and this is not just in my head.  I really need answers to get well, plus my L&I will cut me off and say I'm perfectly fit and stable; this is far from my daily reality.  

[Bhupinder Kaur, MD]

Hello,

It is necessary to get this breath sound that you are describing as crackling to be examined by a physician.They can be crackles which are discontinuous, explosive, "popping" sounds that originate within the airways. They are often heard on inspiration and may be found in ARDS, asthma, bronchiectasis, bronchitis, consolidation, early CHF and interstitial lung disease.

Without auscultation,unfortunately I can not help you in this regards.So my advise is to get it checked from a physician.

Hope it helps.Take care and pls do keep me posted on how you are doing or if you have any other queries.

[March262007]

Along with the previously indicated symptoms, I've wondered about another:

After the impact to the chest from falling on the camera, I believe I had symptoms to my lungs.  Somewhere to the right of the breast bone, and left portion of the right lung, I had a sense of inflammation, pain, and a gravely sound and feeling that stemmed from the impact area and upward about 5 inches or more.  I also acquired asthma at this time with wheezing in throat.  

The gravely sound/feel in chest has mostly subsided, but along with the wheezing, I now have a crackling sound in my throat.  I can get by without an inhaler without a problem.  As I have no history of lung / asthma / or cracking...this one is new and does not seem to be going away.  

Any thoughts on this?

[Bhupinder Kaur, MD]

Hello,

Thoracic outlet syndrome (TOS) consists of a group of distinct disorders that affect the brachial plexus (nerves that pass into the arms from the neck), and/or the subclavian artery and vein (blood vessels that pass between the chest and upper extremity). It is of three subtypes.Brachial plexus disorders come under neurogenic TOS and is one of its components.TOS is predominantly a brachial plexus injury but other components like ptosis of eyes, enophthalmos (sinking of the eye into the orbit),feeble distal pulses may also accompany brachial plexus injury.It has other components apart from the neurogenic component also.

Botox shots can be tried for TOS.Other methods are cortisone injections,nerve gliding and surgery,Brachial plexus injuries are treated by TENS(Transcutaneous nerve stimulation )or surgery.

I feel that your nerve and spine specialist will differentiate and confirm the diagnosis.

Hope it helps.Take care and pls do keep me posted if you have any additional queries.

[March262007]

Hello,

I'm eager to get your input.  

I went today for a "block" in my neck muscle.  10-12 minutes after the block my symptoms were definitely less.  The doctor said it was Thoracic Outlet Syndrome.  When I mentioned Brachial Syndrome she basically let me know she didn't know what I was talking about and wondered why I would bring this up.

Are TOS and BP the same thing...treated the same...same symptoms with the pulse sensations?  She threw me for a loop when she didn't know why I should mention the BP.

She mentioned the best treatment most likely would be Botox injections in the muscles on both sides of the neck every 3 months since the distress is fairly equal on both sides.  

I'd love to get your input prior to seeing my Nerve and Spine specialist.

Many thanks.

[March262007]

Thank you for your input, it is very helpful.  This sounds a lot like my symptoms with the exception that my arms can be like this for 5-6 hours (or longer) on bad days.  Also, it's been this way since March 2007 with gradual healing over the months.  

I am seeing a neurologist and will bounce this possibility off of her.  

[Bhupinder Kaur, MD]

Hello,

I feel that all your symptoms are due to nerve compression during the fall.One strong possibility that I have in mind is brachial plexus injury.

A brachial plexus injury occurs when the nerves that connect your arm and spinal cord get stretched or torn. This usually happens when your shoulder is pressed down forcefully while your head is pushed up and away from that shoulder. Known as "stingers" or "burners," these injuries feel like an electric shock or a burning sensation shooting down your arm. Your arm may feel numb and weak, but these symptoms usually last only a few seconds or minutes

The brachial plexus is the network of nerves that travels from your neck and passes under your collarbone to serve your arm and hand.Minor injuries to the brachial plexus often resolve on their own within a few weeks, but severe injuries require surgical repair. In some cases, full function of the arm — especially the hand — can never be recovered.You can learn more about this injury from the following website:
http://www.ohiohealth.com/bodymayo.cfm?xyzpdqabc=0&id=6&action=detail&ref=3753

The second thing which I can think of is Multiple Sclerosis but the chances of which seem less likely.

I would advise you to please get yourself examined by a neurologist.Treatment is specific for diagnosis.

Hope it helps.Take care and pls do keep me posted on how you are doing.