Severe painm and tingling oin righjt hand and arm

[Graywolf6962]

About 6 weeks ago my doctor sent me to the ER with abad infection  in my right index finger. I was given nerve block shots between the fingers and the doctor dug around with a scalpel, then gave me a script for antibiotics.

A week later I woke up with severe pain and tingling that began at  the site of the injections and spread up through my wrist into my shoulder. This happened whenever I tried to lay down or sleep. When I got up the pain would subside after 15 minutes. Over time it has daily gotten much worse, the pain so bad I pee'd myself a few times. The pain makes it impossible to sleep. After 2-3 hours being up most of the pain goes away and I'm left with pins and needles.

Vicodin did not touch the pain so my doctor put me on Lyrica since I cannot tolerate Neorontin, but have had the same side effects with Lyrica. I have essentially gone without sleep for over a month now and have had some hallucinations, cannot function adn cannot sleep

The only way to describe the pain is a severe crushing, pounding pain mixed with lots of tingling that throbs and moves up and down the fingers to shoulder in waves.

I also have moderate stenosis in my cervical spine and lumbar spine (serious muscle wasting in legs from nerve compression in lumbar area,

I saw a spine pain specialist who said it could be from the nerve block injections, cervical spine or carpel tunnel but he didn's specify. hand/arm x-ray looked normal. He said onw possible treatment to try is methodne. Geeze I am not about to start taking heroin for pain. They don't seem too much in a hurry to find and fix the problem

I just want them to find the cause and fix it before I totally go out of my mind. I normally have a high pain threshold but on a scale of 1-10 this current pain comes in at a 99 My qualkity of life is 0 and not worth living iif this is the way I have to live for the rest of my life

Any real help appreciated

[Sara Khan]

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.

In answering this question, I am presuming that the initial infection resolved completely, and that you have no signs of infection at this time, which include fever, swelling or redness in your hand/arm etc.

You may have a condition called " Complex regional pain syndrome" ( CPRS).  This usually presents with severe pain, which can be burning, stabbing or crushing in nature. It can be associated with skin sensitivity,redness, swelling, change in temperature and change in sweating pattern of the involved limb.  Many cases of CPRS occur after an initial injury or trauma to the limb, and the symptoms appear in the same limb. They can start with in weeks or months of the initial injury. The reason why this happens is not known. In you case the initial insult was probably the infection.

The course of the disorder is highly variable. It can improve on its own, spread to more parts of the limb, or increase in intensity. Unfortunately the pain is very difficult to control. You have been tried on the right medications. Elavil ( which is a type of antidepressant) is also an option for this kind of pain.

I don't think that this pain is coming from your cervical spine. It would be very unusual as it is not following specific nerve root pattern, which we look for with spine problems.

I would advise you to see help from a neurologist. Unfortunately if all medications fail, you may have to try opiods for some relief. We also encourage physiotherapy and keeping oneself active. Try applying cold packs to your skin. That can be soothing. Certain topical pain relieving creams and patches are also available which may help.

I hope this helps and you feel better soon,

[Graywolf6962]

Thank you Sara for the reply. The finger is still a bit red and swollen, but according to doctor there is no sign of infection. It looks like a new nail is trying to grow in under the old nail. The reason a neurologist thought it might be the stenosis in my cervical spine  is that pain is unbearable about 15-30 minutes every time I lay down (posititional), then after an hour or two after I get up settles to numbness in the hand and arm. The neurologist also said it "might" be due to damage from the nerve block infection, which may or may not resolve itself within a few months.

As I mentioned Ibuprofin, vicodin then Lyrica did nothing for pain. I had a severe reaction  to neurontin years ago and the saem seems to have occured with Lyrica.

I do not drink and and have never used drugs so one suggestion a doctor made, using methodone to control the pain is out of the question in my book. I dont need to develop a heroin addiction on top of everything else

I'm schediuled to see a hand specialist in the neurology dept in 2 weeks