Sharp pain radiates from collarbone to jaw also dull ache in shoulder and down arm to hand

by janet
(united kingdom)


I have had an ache in my shoulder, arm and hand (left side) for months; then three weeks ago I had a severe pain in my neck (same side as shoulder pain); it was that bad I couldn't turn my head to the side of the pain. I went to my doctors who said I had a trapped nerve in my neck and it was causing pain in shoulder,arm and hand; I was given anti inflammatories and gabapentin for the nerve pain.

Also I was referred to a physiotherapist who said it was not a trapped nerve but inflammation that was aggravating the nerves; by this time I had swelling at the top of my back and around the left collarbone and a tingling across the top of back. He gave me exercises to do; that was two weeks ago. I am due to go back in a week's time.

But in the meantime the neck pain has more or less gone apart from a sharp pain every now and again that goes from collarbone to jawline, but the dull ache is constant in my shoulder down my arm and hand. I don't get numbness but do get a tingling in shoulder and fingers (all of them).

Oh and to top it I am now getting sciatica down the left leg with a really sharp electric shock, kind of pain in my groin that prevents me from putting weight on this leg.

I hope you can shed some light on what all these symptoms could be as I'm not convinced it is all down to inflammation; my doc just says it will take time to settle down and when I asked for a scan was told it was too early to go down that route and anyhow it would be an ultrasound scan on the shoulder not an mri (don't know why).

Hello Janet,
There are some unusual symptoms in your presentation. Let me list them.

* Pain in all fingers. That means it's not a pinched nerve root. The whole brachial plexus is affected.

* The swelling around the collarbone.

* The pain in your left leg.

* It started in your arm and only later presented in your neck.

All of this suggests this may not be straight forward, and hence a need for extra vigilance on both your part and your doctors, all of them.

I'm surprised an xray of your neck hasn't been ordered, and to that I would add a chest xray. There is a strong possibility that you have what is known as "thoracic outlet syndrome."

Are you a smoker, and do you feel unwell? Cough? Obviously you are in a lot of pain, and the pills may be having side effects, but do you feel sick?

You either have two different conditions, one causing the pain in the neck and arm, and a separate problem in the hip. Or they may both be caused by the problem in your neck. Only a careful and thorough examination by a specialist will confirm the diagnosis.

How old are you? It's rare for a problem in the neck to cause pain in the leg in a young person. It's not even common, but does occur in older folk.

Three little tests;
1. When you have pain in the arm, raise it and place your hand on your head. Does it relieve or increase the pain in the arm?

2. Turn your head to the left, and then simulaneously look up. Does it immediately cause pain your arm?

3. Go to Chiropractic Help home page, find the search this site function in the navigation bar, and type in "upper limb tension test". With the help of a friend, do the test and let me have the result.

Keep to this thread, and please answer from a regular computer. It's tiresome having to correct your grammar!

My initial thought is this may not be a case for a chiropractor. An ultrasound scan of your shoulder is likely to be little value from what you've told me.

One of the tests that needs to be done is called Adson's test. Simple, but takes a clinician with a lot of experience at doing it.

Dr B

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Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I've left alone. After seven treatments his pain and stiffness is 50 percent better, and he's happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He's doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost painfree. 

Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he's well pleased; sixty five percent better after three treatments.

5. Mr T is a wise man; he's taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily walk has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. Xrays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65 year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88 year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done.  

10. Mr X is a 71 year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a year ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

12. Mr D is a 38 old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he couldn't sleep on that shoulder.

13. Mr D, a 71 year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.



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