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Avatar universal

Doctors have no answer

I have been having several attacks a week with the following symtons.
Pain starts in my left top chest goes down my left arm, chest is being crushed arm and hand goes numb, I have a severe  pain in my left rear shoulder about 6 inches down and 4 inches out from my spine, there is a knot that is very painful if you push on it in this region maybe 25cm in diameter . They last for between 1 mimute and 5, I have had both endoscope and colonscopy, all ok, chest and barium xrays both ok. They put me on a heart monitor for 24 hours and I did not have an incident during that time. I am on Indicid for 8 years,  I have AS and was diagnosed with Fibromyalgia 10 years ago, also BiPolar not medicated noe for 5 years for this. I am now on Zantak and Diazapan and Indicin.Is it possible a trapped NERVE OR DAMAGED NERVE COULD BE CAUSING THIS? OR WHAT COULD BE DOING IT.
My Doctors are at wits end and so am I. I had 2 this evening 10 minutes apart and they were very severe.
Kindest regards
David  
2 Responses
Avatar universal
MEDICAL PROFESSIONAL
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 your doctor.

Without the ability to examine you and obtain a history, I can not provide you with a specific diagnosis, however I will try to provide you with some information.

A neurologic cause to your symptoms is unlikely given your symptom description mainly because your symptoms occur episodically, in attacks, whereas if the cause were neurologic, symptoms would usually in such cases be constant or less commonly triggered by certain positions or movements. However, I will discuss some possibilities below.

One neurologic cause of arm pain in general is called a radiculopathy. Normally, nerves form from the spinal cord and exit the spinal column through little holes called foramina between the bones of the spinal column called vertebra. If there is a herniated disc or arthritis in this area, these nerves can be compressed on. The symptoms include loss of sensation, weakness, and often shooting pains down the arm.

Shoulder pain is usually not neurologic in cause, but one potential cause is a nerve entrapment syndrome, particularly one nerve called the subscapular nerve. This syndrome often occurs in certain athletes such as those that play basketball, volleyball, and gymnasts. One feature of subscapular nerve entrapment is that since this nerve does not provide innervation to the arm, shoulder pain occurs in the absence of arm pain. The pain is often dull, constant, and in the posterior shoulder region.

Some rare causes of chest pain include thoracic outlet syndrome and some other nerve entrapment syndromes however again these are usually associated with constant rather than episodic pain, and the pain is usually in one area rather than involving several areas such as in your case.

While other causes need to be excluded before a diagnosis of panic attacks is made, it should always be on the list of possibilities if other causes have been excluded.

I recommend continued follow-up with your physician, with consultation with a cardiologist if this has not yet been done. Aortic stenosis (if this is what you mean by AS) as I'm sure you  know can cause chest pain if it is severe, and that would indicate that intervention may be warranted. Evaluation by a neurologist may be helpful in ruling out a rarer neurologic cause if all other cardiac/vascular/pulmonary causes have been excluded.

Thank you for using the forum, I hope you find this information useful, good luck.
Avatar universal
Have you considered a trigger point injection?  Nerve entrapment by a trigger point is not unusual.  Have you noticed any warning signs that this is going to happen?  What position is your arm in when this pain and numbness occur?  Just something else to consider.

I have been dx with fibro since 1985.  I have massages every other week.  I also see an osteopath who practices traditional osteopathy.  My muscles knot up and my osteopath attacks the knots - he says by depriving the muscle of oxygen it has to let go.  He's right.  My muscles are contracted so much, I get massages to move the lymph.

I had a couple of head injuries from falls and then I started having spasms when I extended my right arm.  They are severe in pain and my hand often looks like a claw.  People have tried to pull my fingers out straight and I have yelled at the pain.  They don't move!  Since they started, I now have it happen body wide.

Mine happen from position and touch.  It might be a form of dystonia.
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