pains in arm, shoulder and neck

[rierie123]

I have had alot of tests done. xrays nerve tests MRI
I have been diagnoised with ostioporosis and two years ago I had fractured my left wrist and I have had so many problems with it the bone doctor did no type of surgery and my last appointment he told me that corpal tunnel had set in the neurology doctor did a nerve test and comformed that I had corpal tunnel. One thing my doctors have not figured out is why I have pain, numbness, tingling and pinching like someone is sticking pins in me it starts at the base of my neck on the left side of my body to the tips of my fingers. I have wondered if it was fibro but, want to know what is wrong with my arm. some days even if some one grabs my arm it hurts. Please help! I live in Pascagoula, MS and if you know who can I go see.

[Shazia Alam, DO]

You had mentioned you had an MRI…was that of the cervical spine or just the brain?  

Osteoporosis, which is essentially weakening bones, increases the risk of compression fractures in the spine.  These fractures can cause your vertebrae (spine) to get crushed, which can compress your nerve roots leaving that area, causing a cervical radiculopathy. So even though the nerves are affected at the spine, the symptoms may be felt in places where the nerves travel (like the arm in your situation).  Radiculopathy pain travels down the arm in the area of the involved nerve, usually described as sharp, or pins and needles.  Sometimes the pain can get worse with certain movements like sudden head turns, or bending your neck forward or back.   Other conditions that can cause radiculopathy include herniated sicks or bone spurs (seen in arthritis).  

Usually an Xray of the neck can show if you have any fractures.  They can also show if you have any narrowing of the "holes" that your nerves exit the spinal cord. CT scan of the neck can show your bones in more detail and MRI is better at looking to see if soft tissues (such as bulging disk or herniations) are the cause of your nerve compression.  

Im unsure how long you've had this, but majority of radiculopathy will slowly get better with time, but there are nonsurgical options you may want to try.  Physical therapy can strengthen the neck muscles around that area so you're not putting strain on your neck.  Soft collars can also be used to give your muscles some rest by limiting neck motion.  This will hopefully decrease any pinching of your nerves, however you can only use these for short periods of time, because you will then make your muscles weaker!  Some medications commonly used are Motrin, Alleve, etc, but PLEASE do not use without consulting your doctor as there are certain medical conditions that you cannot use common over the counter medications.  Other treatment options could be a spinal injection (which is injecting steroids where the nerve is pinched).  This may lessen the pain and swelling, allowing your nerve to heal.  

I would recommend seeing your doctor.  Hope this information helped you.  

      

[Christopher R Newey, DO]

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 obtain a history from you and examine you, I can not comment on a formal diagnosis or treatment plan for your symptoms. However, I will try to provide you with some information regarding this matter.

Pins and needles sensation may be a form of neuropathic pain, which is pain associated with nerve damage. Since the pain travels from the neck to your fingers (I’m not sure what distribution the pain travels such as on the outer or inner side of your arm, etc), a herniated disc should be in the differential. A herniated disc is the expulsion of the cushioning material between the vertebrate toward a nerve or the spinal cord. These discs normally allow for mobility but can be squished out over time or with injuries. In most people the pain associated with a herniated disc may resolve within 4-6 weeks. A minority of patients do not respond to medical/conservative management and require surgery.  Symptoms suggesting the need for urgent surgery include muscle weakness, loss of bowel or bladder control, loss of sensation, and progressive pain. A neurologist would need to evaluate you for this and perhaps refer you to a neurosurgeon, if indicated.

Part of the evaluation is a test called EMG/NCS, which you had for carpal tunnel syndrome. But this test can be tailored toward cervical disc herniations, if indicated, and thus provide information on the extent a nerve is being compressed or damaged by a herniated disc. This test is performed by neurologist at most local offices.

Treatment for neuropathic pain includes neurontin and lyrica, and medications such as elavil but a careful cardiac workup needs to be performed prior to starting this medication.

You mentioned a condition called fibromyalgia. Fibromyalagia is a medical condition that leads to whole body pains. Its cause is unknown, but it is characterized by diffuse aches, sometimes GI symptoms similar to irritable bowel, sleep abnormalities, low pain threshold, and other features. It is best treated with medications such as lyrica and neurontin, exercise, and physical therapy.  Fibromyalgia occurs frequently in patients with chronic fatigue syndrome. If no cause of the condition is identified, it is best to look for other contributing factors such as anxiety or depression.

I am not familiar with neurologists in the Mississippi, and thus, cannot recommend any one person or any one group. I would recommend seeing a neurologist who has neuromusclar/EMG training and is board certified.

Thank you for using the forum, I hope you find this information useful, good luck.