Pain in upper arm + arm tremor

[Orchidsusa]

I have intermitant pain in the upper right arm where it joins the shoulder and more and more tremor in my right hand to the extend sometimes I can barely write. The pain is more pronounced sometimes when I move my arm or when I change positiion when laying in bed.

In my work (floral design) I extensively use shears to cut bamboo, willow bracnhes.. My physician sent me to consult  a specialist who could not determine the cause. The specialist did not think it was Alzheimer and Parkinson. He did not think it was brain cancer but suggested I might want to have a brain MRI to rule it out.

I will be grateful for any suggestion.

Thank you.

  

[Neuro Forum]

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 tell you what the exact cause of your symptoms is. However I will try to provide you with some useful information.

Shoulder pain can have many causes, some of which are neurologic. Musculoskeletal/orthopedic causes (related to muscle or bone pain) are the most common causes. Rotator cuff injury, tendinitis, bursitis, or even just regular osteoarthritis can cause severe shoulder pains that worsen with movement. Repetitive movement of the shoulder, such as it sounds like occurs in your case due to your occupation, may worsen symptoms. Treatment often involves oral medications including anti-inflammatories and in some cases surgery.These disorders are best diagnosed by a rheumatologic or orthopedic surgeon depending on their exact nature.

Neurologic causes of shoulder pain include radiculopathy. The spinal cord is encased by bones called vertebra. Nerves start to form as they come off the spinal cord and exit through holes formed between the vertebra. If a nerve is compressed on as it exits through these holes, particularly in an area called the nerve root, a radiculopathy results. The compression could be due to arthritis of the spine or due to a herniated disc or other lesions. The symptoms include pain at the level of the problem (i.e. neck or back etc) and pain that may radiate down the shoulder, arm or leg (depending on where the problem is). In more advanced cases, muscle weakness or sensory symptoms such as tingling or numbness may occur. Radiculopathy is best diagnosed with MRI of the neck.

Shoulder pain in the setting of a tremor may be due to Parkinson's disease. The tremor in Parkinson's disease occurs at rest and improves with movement. Other symptoms of Parkinson's disease include decreased facial expression and voice volume, slowness of movement, changes of gait including slowing down of walking and shuffling, and other symptoms. Shoulder pain is sometimes the first symptom of Parkinson's disease and is due to increased muscle tone (called rigidity) in the shoulder. Parkinson's disease can be primary (idiopathic, without a cause), or Parkinsonism can occur in the setting of brain pathology such as stroke or less likely conditions such as tumor etc. This is best assessed with an MRI.

I recommend continued follow-up with your regular doctor and neurologist. If your tremor is interfering with your day-to-day activities or worsens, evaluation by a movement disorders specialist may benefit you.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.

[anniekw]

Hi-
I'm not a doc, but just posted a question here and thought I'd look around the forum.I saw your question, which of course was beautifully answered by a professional.

I have no tremors so perhaps it's not at all the same thing but my condition started some time ago with terrible pain in my shoulder/upper arm. It was unbelievable! Having been knocking myself around training horses for decades I'm a tad immune to pain :) and so did not go to docs for a long time. It turned out to be various sorts of damage to my cervical spine- narrowing, flattening of the spinal cord, little spikes growing in bad places, arthritis, some displacents, etc. Kind of a long list. My point is that mine wasn't just from one single thing but alot of 'little' damage which have combined to WOW. OUCH.  Your shoulder pain just sounded very familiar so thought I'd add my bit of experience. Hope you find it's something easily treated! Mine will require an op, which my doc wishes to put off as long as possible because he say I'm just too young to go under the knife. Have to love my doc because I'm 50! :) Think I'll keep him!
Anniekw