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shoulder, arm, hand tingle, ache

  I worked as a admin assistant until 1 month ago, heavy computer, mouse with right hand.  The problem seems to be progressing even tho I am now on computer less than 1 hour/day.  Several times each week I awake in the night with right arm tingling, often past tingling and nearly numb but deep ache.  Often I am unable to shake it off and can't find a position in which to sleep, arm continues to tingle regardless of position.  I end up out of bed for the rest of the night, sometimes hunching over with chest sort of caved in helps, sometimes not.  
  Often the tingling will start when holding a newspaper to read.  An hour of working the garden results in deep aching for a couple of days.  There is a specific sore spot on both shoulders but more pronounced on right, it is at the top of the shoulder, sort of the "corner", just at the end, about the size of a quarter, also sometimes there is a "line" of soreoness from wrist up the inside of the arm up the entire length.  Also the hand is stiffening, not as limber as the left, thos the left also seems to be stiffening somewhat.  
  I don't seem to be loosing strength, but am loosing ability to do normal activities.
  I am female, age 50.
  What sort of medical expert should I seek?
  thanks for your assistance.
Hello Jan!!
The symptoms you describe are compatable with either "writer's cramp" dystonia or, more likely, are due to carpal tunnel syndrome or an analogous condition where one of the nerves in your wrist or arm is being entrapped dur to repeated movement and irritation caused by repetitive mouse-clicking. Another posibility is a pinched or inflammed nerve in the cervical spine (neck). Nocturnal pain is a very common symptom of early carpal tunnel syndrome. The good news is that if there has not been any weakness or wsting away of hand muscles, that it is likely at an early stage and more easily treatable. Treatments for carpal tunnel syndrome include pyridoxine (vitamin B6) tablets (although beware--- taking too MUCH of it can also cause carapal tunnel syndrome ironically!!), wrist splints at night to keep you from curling up your wrists at night as most people do, which further compresses and irritates the entrapped nerve, and surgery to release the entrapped nerve. It (and other conditions that imitate its symptoms) is diagnosed by a test called an EMG, which consists of multiple electric shocks and pokes with a needle electrode, all designed to analyze how well the nerves in the arm are conducting electricity, although some patients still insist that it is really a glorified accupuncture-torture session!!! Most people (especially women) tolerate the test just fine, although few volunteer to have it done again. I would definitely suggest you see a neurologist ASAP, especially if the symptoms are preventing you from working and doing things at home you need or want to do. Any competent neurologist should be able to diagnose this common problem and distinguish it from other problems that may imitate it. If you are near the Cleveland area and would like to be evaluated at the Cleveland Clinic, our number is 1-800-223-2273/extension 45559, although for such a case I could not honestly encourage you to make a special trip. Please remember that the information we provide on the forum is intended for general medical informational purposes only and that the actual diagnosis and treatment of your specific medical condition should be strictly in conjunction with your treating physician(s). We hope you find the information helpful.

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