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Posted by CCf Neuro MD *!* on December 22, 1997 at 16:28:04:
In Reply to: Chronic pain in ribs and numbness in left arm posted by David Todd on December 22, 1997 at 13:44:06:
: Just over a year ago my wife, an RN at a local hospital, suffered an injury to the left side of her rib cage (just below the breast) while lifting a combative and obese patient in bed. She has been in constant pain ever since. She has spasms and twitching in the area, which, along with a half-inch wide indentation, have spread around her side to her spine. In February, her left arm went numb, at least to the touch. The many doctors we have seen have called it costochondritis and neuralgia, but have never proven exactly what was wrong. She has taken a rainbow of pain relievers, even narcotics and Stadol, but they only take the edge off. She takes Flexiril, but still has spasms. They have her on Neorontin and Pamelor at high dosages as well. Nerve blocks on ribs 5 through 8 gave temporary relief of the pain, but the indentation remained, as did the arm numbness. The pain management center we were at disagreed with us over the effectiveness of the nerve blocks and refused to do any more or freeze the nerve. X-rays and a bone scan showed no damage to the ribs themselves. An MRI of the spine read normal. An EMG on the left arm was normal; the doctor stating the the problem was on the sympathetic and parasympathetic levels. No other tests have been done. Do you have any ideas as to what could be wrong, why she isn't healing, and what we can do next? The last surgeon we saw said "it was over his head." A neurologist we saw claimed there could be no relation between the rib injury and the arm numbness, but other doctors say there can be. Would a CT or MRI/MRA of the rib area be helpful? I'd like to see the problem treated and corrected, not just "pain management", but in the meantime she suffers. Please help!
The problem which you describe suggests local damage to the nerves arising from the spine at the levels T5 to T8, which has caused wasting of the muscles in this distribution, thence the
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