Severe Arm Pain

[pamg77]

Hi!  I have been searching the internet for info about the pain I am having in my arms.  Found this site and thought I would submit my question.  I began having pain in my left arm last year that became quite severe so I went to an Orthopedic physican who did a cortizone injection first, which did not help.  He then sent me for physical therapy which also did not help.  My MRI showed that I had a 30% tear of the rotator cuff.  The physician said that the only other option was surgery since the other things did not work.  I was not able to have the surgery as my insurance plan required that I pay $800 up front.  I decided to just live with the pain.  Then at the beginning of this year, the pain became almost unbearable so I searched for another physician that participated with  both the insurance plans I am covered under.  This physician said that he did not really feel that I needed rotator cuff surgery but that he could do a "decompression" and clean up the area around the rotator cuff.  I underwent this procedure in February with a very long recovery period.  The arm continued to hurt for several months after the procedure but my physician assured me that this was normal and that it would eventually feel better.  He gave me exercises to do at home and my last follow up appt was around the end of May.  I cancelled the appt because I felt that he was not helping me and I still had the pain.  The last time I saw this physician, he told me that I would probably need to go back to therapy. Now approximately a month ago, my right arm has begun to hurt  just like the left one, only this pain is even more intense!  The left arm still hurts some (not quite as bad as before) but the right arm is now unbearable and pain meds are not relieving the pain!  The back of my upper shoulder hurts, and the very deep muscle in my forearm hurts constantly!  I have tingling and numbness in my right hand and fingers.  It is impossible to sleep at night because of the intense pain.  I am up every night until at least 2 a.m. due to the pain.  I had some left over Lortab pain medicine from my procedure in February, however, it does not help this pain at all!  I finally called to make another appt with my physician but am not able to get in to see him for 2 weeks.  Could this new pain in my right arm be due to a herniated disc in my back?

[sara_eagle]

The new pain you are having sounds like it might be coming from a problem in your neck.

[Dr. Kokil Mathur]

Hi
Welcome to the MedHelp forum!
What you have is probably Scalene Myofascial Pain Syndrome. When scalene muscle is the cause of pain, the pain is referred to (either all or a combination of) chest, inner lining of scapula (shoulder bone), shoulder, posterior and lateral sides of the arm right up to the thumb and index finger. When this muscle shortens, this can press on brachial plexus (bundle of nerves and blood vessels in the armpit) and the subclavian artery and can compress or irritate these structures and cause symptoms such as abnormal sensation in arms—pain or tingling, cold extremity, spasms of pain, and lymphedema (swelling of lymph channels causing swelling of arm or leg) in the involved extremity. Other than this it can be inflammation of veins or phlebitis, inflammation of lymph channels or lymphangitis, deep vein thrombosis or compartment syndrome.
Yes, pinched cervical spinal nerve is also a possibility and so also carpel tunnel syndrome causing back pain in arms.
Since I cannot examine you and know other related conditions you may be having, nor is a detailed history possible on net, I have listed the various possibilities that should be looked into. Please consult your doctor to run tests and examination to clinch a diagnosis.
Take care!