arm pain

[Kate7]

Hi, I'm a 42 yr old female and lately I'm having unexplained pain in both arms. The pain is in the top quadrant of each arm and aches intermittently throughout the day and night. When I press in a certain area on each arm, the area feels very tender and also lumpy (not sure if it is muscle or lymph node?).  Generally the areas feel sore and achy as if I had been punched there.  I have no neck pain and good ROM with each shoulder.  When I raise my right arm/shoulder up sideways though, I do feel the right arm pain.  

I'm a 4yr breast cancer survivor and we were concerned about a possible cancer spread so we MRI'd the shoulders 2 weeks ago and the scans came back negative (I don't know that they covered the arm areas though..)  I also have a lymph node (or some other kind of lump) in the middle of my left arm that has been swollen for some time (my underarm nodes were mostly removed). My oncologist has expressed concern about it but we thought at times that the swelling was down so we haven't biopsied it yet, though I'm thinking we need to now as it does seem to stick around.  I also have the sensation of a swollen groin lymph node though my docs don't feel it when they examine me.  PET scan of Jan 08 didn't show any concerns though my complaints about these areas have been increasing over the past year.  

On the one hand, I am concerned about possibly being so lucky as to now have lymphoma, and on the other hand perhaps these concerns are unrelated and my arm pain is related to an injury from last summer when I pulled myself up out of the water and into our boat.  The latter seems the most logical explanation though I don't understand why the pain would be worse now 10 months later (my shoulders were sore with ROM shortly thereafter but got better in a couple months -- now it seems I have arm pain minus any shoulder pain.)  

Please advise me if there are any other diagnostic exams or tests I could undergo to figure out where this arm pain is coming from. My orthopedic dr has (haughtily, I might add) dismissed me telling me I have fibromyalgia but I've looked it up and the symptoms don't match.  I haven't spoken any further with my oncologist on this after getting the negative MRI. Whatever it is, I need to get it fixed. My arms hurt.  Thanks.

[DrNavneetMD]

Hello Dear,

Well, I do understand your description of pain and the agony you are going through.
What is the exact site of the lymphoma? That would determine the relation of the pain and the lymphoma. However, based on the site of the tumor ‘Shoulder girdle neoplasms mimicking frozen shoulder syndrome’ has been documented to be associated.
Shoulder pain and immobility inhibiting joint motion which is said to be quite common.
This leads to the disabilities of the Arm, Shoulder, and Hand (DASH). Many patients do not undergo detailed imaging studies before treatment. The routine technetium 99 methylene diphosphonate bone scan would be helpful.

Take care.
All the best.

[Kate7]

Thank you Dr. Navneet for your reply.  Let me clarify though that I don't know if I have lymphoma or not.  I was only speculating (sarcastically) that perhaps that is the cause behind my various symptoms.  I don't know if my symptoms are un-related and my arm pain issues are likely related to injury from last summer as described, or if perhaps the symptoms fit better with a diagnosis of lymphoma (or something else).  Please let me know what you think makes sense as a possible diagnosis.  I will see about getting a bone scan.  Again, thank you for your consideration.  Kathy

[DrNavneetMD]

Hello Dear,

It is necessary to rule out the dangerous and the alarming causes such as lymphoma. I believe that your injury has been for few months now if not weeks which clinically lessens the chances of chronic pain.
Bone scan is a must to rule out lymphoma.
Also due have any significant loss of weight (that is more than 10% loss in last six months)?
How is your appetite?


Lets hope for the best.

Take care