I am a 30 year old male. In Dec. of 97 I awoke in the middle of the night with severe pain and numbness in my right upper arm. I was unable to sleep because of the pain and no matter what I tried the I could not get comfortable enough to sleep. I was however, able to sleep during the day. The next night, at about the same time, the pain returned. This time I soaked my upper arm in very hot water which seemed to alleviate the pain. My entire upper arm, just the portion facing outward, from my shoulder to just before my elbow was completely numb. I went to the hospital and they took x-rays and MRI's. Eventually I was told that I had a minor cervical disk hernia between the 6th and 7th vertabrae and this was causing a problem with the nerve root leading to my deltoid muscle. I began rehabilitation but noticed no improvement. One day my wife noticed that my shoulder muscle appeared to be sagging. The doctor told me that the muscle was in a state of atrophy due to lack of use. After this, I went to another hospital to seek another opinion. The doctor at this hospital stated that there basically was no hernia in my neck and furthermore, the nerve root that exits the vertabrae at the 6th and 7th vertabrae does not even go to the deltoid muscle. I am to return this week for another MRI. The doctor gave me two possible diagnosis for my problem.
1. I have a form of gangrene around my collar bone area and this built up tissue is causing compression on the nerve leading to my arm. (I should mention here that I am in Japan and there may be a problem with mis-communication. When the doctor said gangrene, I thought that came from infected wounds)
2. I have a virus in my body and this may be the cause. If this is the case, the problem will "spontaneously" resolve itself in about 6 months. I have trouble believing this. I actually don't think any of the doctors that I went to have any idea what they are talking about. I also know that the Japanese have a bad habit of not telling the patient when there is something seriously wrong. Sometimes I feel like I am not getting the whole story.
When this pain first happened, I was recovering from a rather nasty bout of dizziness that had me in the hospital over a weekend. This dizziness came on suddenly and it felt like I was drunk. I could not eat anything because when I would stand up I would become nauseous. I was told that this was caused by an inner ear disturbance. In regards to the pain in my shoulder, I was told that it was just coincindental.
After the first week, the pain in my arm ended. The numbness has remained but the area of numbness has decreased. After the pain left, I had none until recently. My shoulder had become so thin that when I push on my shoulder bone I feel pain.
Any advice would be greatly appreciated.
P.S. I have full range of motion with my shoulder. The only problem is when I isolate the deltoid muscle. This makes it hard, not impossible, to move my arm.
The axillary nerve is derived from primarily C5 and a small part of C6. This is the nerve that supplies the deltoid muscle. It is frequently injured in shoulder dislocation, fractures and brachial neuritis (which I will discuss shortly). Injury to the nerve cause difficulty is lifting the arm straight away from the body (on the side), atrophy, and impaired sensation over outer shoulder region. A disc herniation at C6/C7 will NOT affect the axillary nerve; the nerve exiting the spinal cord at this level is C7. Brachial Neuritis (also known as neuragica amyotrophy or parsonage tuner syndrome) is an illness that develops in an otherwise fairly normal individual; it may also complicate and infection, and injection of anibiotics or vaccine, and a few other scenerios that would not apply to your case. The average age range is 20-65 years. It tend to affect males slighly more than females. It usually begins as an ache in the shoulder which rapidly becomes more severe; it is followed after a period of 3-10 days by a rapidly developing muscular weakness and sensory and reflex impairment. The pain is worse by movements in the muscle region. There are certain muscle groups that are more frequently involved including the serratus anterior, deltoid, biceps and triceps muscles. A few highly restricted forms of this disorder can occur affecting one or two nerves. The long thoracic nerve and AXILLARY are common single site affected. An EMG test and lumbar puncture (shows mild pleocytosis and slightly increased protein) are beneficial tests. An MRI (whih you already had done is also important to help differentiate this from other disorders). As a general rule, the pain subside with the onset of weakness, but in some cases can last for weeks. Recovery from the weakness and restoration of sensation are usually complete and occur between 6-12 weeks but sometimes not for a year of longer. Some additional disorders that may cause similar symptoms in addition to those mentioned above include 1. polymyalgia rhematica 2. sarcoid and other granulomatous infiltrates 3. carcinomatous plexopathy. I realize some of the terms that I used may seem a bit technical, however, I would recommend that you discuss these options with your doctor (preferably a neurologist). As far as gangrene and viral symptoms, I am not going to speculate on what your doctors have been referring to. Good Luck.
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