AGONIZING ARM PAIN/NECK PAIN

[schubunny]

hello,

In the past two months, I ahve had two instances of severe neck/shoudler pain. The first time, it lasted for an agonizing week before going away, the second time, for a few days.
I have not done anything (sports, otherwise) that could irritate that region. I do, however, have cracking when I move my neck, as well as the 'sand' sound and sensation.

The second time, which was a few days ago... it went away, and then my left upper arm began to hurt. A pulsing, burning sensation in the muscle, as well as ocassional tingling in the fingers. Depending on how I have my arm, the pain will diminish to very low, or become very bad.

A few friends of mine say it is stress, as every time it comes up I seem to have a driver's exam, or something bad happens.

Please help?

Also, I have been using a PC for 10 years, and I am an analyst right now.

[caregiver222]

Yup. Pinched nerve city. The land that is very near the place called hell. The question is "where do we go from here?" Often stress (or high sugar levels after a meal) can make these symptoms worse. The reason has to do with osmolality. Fluid crossing membranes exerts additional pressure on the nerve. And that is mediated by osmolality. Some patients get these symptons after eating a big meal and are often told they are "crazy". Glucose levels also affect osmolality.  First of all you must consult a physicsn before fooling with this. That being said, the primary complication is "frozen shoulder". The normal human being views pain as a signal to "stop doing what you are doing". Unfortunately, this often results in greater and greater restriction of movement until not only can't you move your arm, you can't hold a pen or a pencil. By that time they have you being evaluated for psychiatric symptoms. Injuries such as yours are often due to neck flexure months or years before, and are sometimes subluxion injuries. One diagnostic test is to apply axial traction while you are having the pain and tingling. Lie flat on the floor and have someone place hands on both sides of your head and GENTLY pull you along the rug, along an imaginary axis extending directly up from an imaginary line drawn through your spinal column. If the pain and tingling instantly disappear you have won the lotto. We have assumed you have had a physician rule out any broken or fractured vertebrae. Often "range of motion" exercises are prescribed, meaning rotation of your head 360 degrees through the "crackling", through the limit of pain. An axial traction device (available non-prescription for about $35) used for three to seven minutes four or five times a day also helps. Don't use the water bag. Suspend it by a hook from inside a door and sit on a chair and GENTLY lower yourself so just a slight bit of traction is applied. You wil know this when the pain and numbness disappears. This treatment permits reduction of infloammation by allowing drainage of inflamed tissue, which impinges on the nerve. Physicians often prescribe short treatments with anti-inflamatories such as prednisone, followed up by Ibuprufin. You can simply try the Ibuprufin, remembering that at one time this very excellent drug was prescription only, and to avoid civilian overdoses the prescription dose is twice what is on the non-prescription package. The drug is a bit hard on the liver when used continuously over long periods. Generally these injuries never show on x-rays, which only cause damage. Usually, but not always, they will show on an MRI.  The thing to remember is that you absolutely positively have to rule out that you have a broken neck. Many emergency rooms simply have their patients wiggle their toes, move their arms and then never investigate further. It is the mechanism of injury (neck flexure)  that determines whether there is a possible fracture. I think this is unlikely, but you need an M.D.'s opinion before fooling around with this.

[caregiver222]

Incidentally. a cervical collar is often prescribe,  which gives temporary relief, but which invariably causes the problem to get worse and chronic  because you lose muscle tone. Simililarly muscle relaxation agents also cause you to lose muscle tone are contraindicated.

[Enoch Choi]

caregiver222 has a number of great suggestions which i agree with:

- NSAIDs such as ibuprofen often help, including ibuprofen (motrin/advil) which should be taken no more than 3200 mg a day (800 mg three times a day max)

- prednisone (prescription drug) helps decrease inflammation but is only used in a short time for those with symptoms of radiculopathy, while waiting to see a neurosurgeon.  Chronic use leads to osteoporosis, water weight gain, skin and emotional changes.

- traction is safe when used as directed, for symptom relief

- neck braces do decrease muscle tone and are not recommended since when you take it off, your neck is weaker