Nerve damage (loss of Rotator Cuff muscle use)

[dave]

Several months ago (9 months) I woke up one morning with really bad pain in my left arm.  If fely like I slept on it wrong and had a really bad charlie horse.  I've done this before and it usually goes away but the next day.  But this time it lasted for a long time and when it did go away about a week later I noticed that I had no strength to rotate my arm out away from by body.  I eventually had an EMG test done and I was told that I had almost no messaging going on with the suprascapular nerve.  I have very faint response from my supraspinatus muscle but almost nothing at all from my infraspintaus.  But I had the EMG done twice (~3 months apart) and I don't think there is any improvement.  My question is what is the next step if we see no improvement (via the EMG test)?  Is there any kind of surgery that can be done?  I'm scheduled for another EMG in 3 months.  Is the nerve torn, dead, pinched, etc?  I believe that this was casued from weight lifting, although at first I thougth I just slept on it wrong...

Thanks for any help...I'm starting to get a little frustrated with my progress.  This nerve damage limits many of the physical activities I used to love to do.

[sky]

dear everyone,  hi my name is nancy and on thrusday April 5, 2001 i gave blood at my communaty blood and when they did that they hit a nerve in my right arm and now in my ring finger and my middle finger i can't feel anything. and if anyone can give some information about this it would be a great help thank you

[j.j.]

Dave,
Your situation sounds very similar to mine! I had the same weakness in external rotation of my right arm following open rotator cuff repair (Oct 99). Initially they thought I wasn't trying enough during rehab I think, but after atrophy of the muscles was evident I was sent for EMG testing which confirmed that the nerve was not being stimulated. They thought this was due to brachial neuritis of unknown origin, but didn't think it was related to surgery. They eventually did do a suprascapular nerve release in July 2000 but did not really find evidence of nerve entrapment. Meanwhile, I began hurting more and more, probably from misuse of the compensatory muscles involved. Well, I wish I had better news for you, but just last week I had a repeat EMG which showed no evidence of reinervation (the results were even a little worse than before). I know this is not a good prognosis for me, I hope you have better luck with your situation! If you want, you can email me and I can give you more info on what I have found out about this condition. I am also interested in what you have been told! You can reach me at ***@**** .

[MD. KHAYRUL BASHAR]

Subject: Seeking Advice on spinal injury
>Date: 1st february,2001
>


> Dear Doctor
> Thanks a lot for your twice reply mail. Now please note brif history about my
> facts and problems.On 16th july in 1981 I had been fallen from a tree in
> seating position like "L"and it was about 40'hight from ground, and
> suddenly my lower portion was paralised and I was hospitalised. Since then
> I had to go to different hospital to have better treatment and ultimately
> though I recovered after six month(without any surgical treatment) ie; I am
> able to walk and can move as usually but a few problem was laying with me
> and in course of time all those problems are increasing severly which are
> as under:
> 1.After the accedent since my lower part was paralised so My Bowl and
> Bladder was also inactive and then the Doctors used to Catheter for
> Bladder(mixuration)
> and for Evacuation of Bowl The Doctors used to some lubricating jelly
> like(Glicerine) which inserted into annus and they applied hand pressure on
> bowl from outside. After my release from Hospital I also used to the same
> procedure for evacuation and mixuration( Some times I apply extreme breath
> preassure or external hand pressure on bladder). I have been suffering from
> this neuropathetic Bladder and Bowl since then. Though I am a male patient
> about 35 years and single but in my mined I feel desire for sex and
> erection is OK.but when I Imagine about sexual topics then after a few
> munites I feel a
> bite and burning at very inside of penis and then at first urine comes
> out(if any urine  remaining in the bladder) with motion and ejaculates,but
> feelings
> of Ejaculation is not in hermonic motion  and not so much exteremly
> enjoyable like before of this accedent.In the otherhand some times when I
> get loos motion only then I fell very normal & comfortable discharge of
> Stool and Urine. Oftenly I feel that while evacuation my rectum comes out.
> I cannot squize & expand my annus as I wish(Automatically),which I could do
> earlier before accedent.Two square inches area arroud of the annus is
> almost senseless ie; I have feelings but no pain is there.Some times I can
> not control urine and it comes out automatically.
> 2. By the last few years I have been getting sever back pain ie; I get pain
> all arroud in the back side, Also getting pulling pain back side of my leg and
> which is conteneous. Some times I get pain in collarbone.
> 3.To have treatment for all these problems I have consulted with many
> Orthopedic Surgon , Neurologists and Urologists here in Bangladesh but all
> of them made me hopeless. Then severel times I went in India and consuslted
> with
> some Urologists and Neurologists, they conducted different types of medical
> test and only for Bladder they advised me to use Catheter and for bowl they
> dont give me any advise, and for other problem they are hopeless.
> Recently I went to Singapore and consulted with Urologist, and Orthopedic
> Surgon with my MRI Scan, and during consultation they also made Ultrasono,
> Urodynamic test and X-Ray and finally the Orthopedic surgon advised me for
> Operation on DorsoLumber Vertibera in Singapore General Hospital. Thereafter
> I went to UK and I consulted with someone Orthopedic surgon of PINEHILL
> Hospital, The doctor advised me not to go for operation and he referred me to
> a physiotherapist and the therapist advised me to practice some physical
> exercise.Then I have come back from UK. and trying to follow the same advise
> but on improvement.  Thus I mailed to you and awaiting for your advise.So
> after
> receiving this mail if you think there is any chance for my treatment either
> in your mind or anywhere in the USA then let me confirm your understanding
> and then I will send my MRI SCAN and X-Rays to you.Hope you will try on
> humanitorian grround and would be kind enough.
>
>  Thanks and Regds.
> Khayrul Bashar.
>
>

[CCF Neuro[P] MD, RPS]

Dear Dave:

I am really sorry to hear about your problem.  What exactly did the EMG show-muscle fibrillation and fasciculations?  Was there segmental demyelination?  We usually think that the peripheral nerves will regenerate about 1 cm per month for about 12 months.  If there was peripheral nerve damage in the axon, then likely by now you should have had some return of function.  So, it may be that you damaged the nerve cell body itself, and thus regeneration will likely not happen.  This is maybe why they didn't offer you surgery from the initial visit nine months ago.  However, I am not sure since I don't have the neurological exam or testing results.  Is there another possible explanation that was given to you concerning possible etiologies?  If there is another possibility then maybe this is why your strength has not returned.  I am sorry I am not much help.

Sincerely,

CCF Neuro MD