Dreaming of amputating my arm

by Lm
(La Paz, Mx by way of Orange County, Ca)

It could be the C5 or 6 dermatomes.

It could be the C5 or 6 dermatomes.

Dreaming of amputating my arm; a brachial neuralgia is one of the most painful conditions known to man. You can't escape it.

I have always had a flat neck from an injury in my 20's while working on a fishing boat in the Bering Sea. I have been able to keep it at bay with Pilates for the last 20 years. This year my husband got transferred to an office in La Paz, Mx and we sold, packed and stored everything from our 4000 sq foot house and my Pilates studio (all by ourselves w/o the help of movers) and drove our 4 kids, dogs, bikes and computers down to La Paz. About 3 mos later, without any regular Pilates, I woke with a terrible neck pain. I did what stretches I could but after a month the pain was traveling into my shoulder - specifically my deltoid was hot and aggravated. I now had numbness around my shoulder, down my forearm and into my thumb. I also felt like I needed an adjustment.

After a week of searching for a chiropractor in La Paz (quiropracticos in Mx.) I found someone. By now I am beside myself with pain, I have not slept through the night in a month and I can't get comfortable with my arm, it helps to put it over my head but then the pain starts somewhere else so it's just a matter of moving the pain all day/night long. With my limited Spanish and his limited English, he gave me an adjustment and told me all 6 of my cervical vertebrae were out.

When he was doing the adjustment, I felt a sharp nerve pain between the vertebra and the shoulder blade on the problem side. He also gave me some pain killers and sleeping aids. I slept that night for the first time in a month. He told me to come back in 7 days if I wasn't better. I went back in 3 days because the pain was escalating. At that time, he examined me (no adjustment) and then called a local traumatic orthopedist and made an appointment for me the next day.

That doctor had even more limited English and I thought was telling me I had a rotator cuff tear but in hindsight, I am realizing he was telling me I had a pinched nerve with referred pain. He also gave me meds to calm down the inflammation and nerve pain. He told me if I still had pain in 10 days I should return and that maybe I needed a cortisone shot. After 7 more days, I was still in the same amount of pain, had found a new sharp pain under my armpit. Now, I was dreaming about amputating my arm and in the dream, I look at my severed arm on the floor and feel a overwhelming sense of relief and peace. That is until I look at my bloody stump and then I realize that wasn't such a good idea. But the point is that even my subconscious is aware of this pain and is seeking relief and all I can do is manage it all with meds. That's not a solution to me - that's just a band-aide. So my husband convinced me to get on a plane back to the states. After 6 weeks, I finally walked into my chiropractor's office. He worked on me and put my shoulder back in place (that gave me a lot of relief) found 2 dislocated ribs and suspected 2 herniated discs with referring pain into the arm. He did a lot of muscle testing and some ART, all gave me a good level of relief. I was only in town for one week so I got an MRI which did show C5 & C6 herniations. My chiro treated me everyday for a week and we were gaining footing. My shoulder pain was still there but only at night and everything else seemed better. He suggested I get a Posture Pump before I left so that I could rehab my neck and try to regain some curvature in my cervical spine. He also suggested decompression in the neck. He has one of those specialized beds but it requires 2 weeks of treatments which, I didn't have. As a plan B, be recommended another home treatment - a neck cuff that can be inflated for decompression like results. I purchased both items and, armed with these, headed back to La Paz.

I have been doing my treatments with the pump and cuff everyday now for 2 weeks. I've also been taking Etodolac everyday for pain (these were prescribed by a doctor friend before I left the states) and I felt like I was about 80% better. Then, last week I woke up with excruciating pain nerve in my bicep. It was gripping, I was crying and I was at my wits end. My husband called a work colleague to translate for me and I went back to the orthopedic surgeon in La Paz with my MRI hoping maybe I could get a cortisone shot or last resort, an amputation. He examined me and basically told me he felt that cortisone shots in the neck were too dangerous and that surgery would be a better option for me. So, I asked for an oral steroid or something equivalent and he gave me a prescription for a shot of steroids (my husband administered) that would work over a 3 week period. He also gave me more meds to help calm the nerves and the pain. So now, I am 5 days post that treatment. It has been 9 weeks since the first pain and I feel like I have aged 9 years. I have no pain in my neck, deltoid pain is still present but mostly at night and feels better when I place my arm over my head. Bicep nerve pain is still bad, it feels better when I put my arm in a sling. Hurts to extend arm and flex arm, so it's better bent without gravity.

Especially hurts to push or pull things - that sends electric shocks up the arm. Thumb has been numb since the beginning and over all arm and hand strength is gone. I can't lift a gallon of milk. I am afraid to work out or do Pilates because I did once and was in pain the whole next day. Also, orthopedic doctor told me not to stretch the neck since that will pull the nerves and inflame them. My question, should I start looking at surgery even though that's really the last thing I want to do? In Pilates, I taught dozens of clients who had surgery for this same thing and all seemed to still have pain, just a different sort of pain. Should I just hang in there and give it more time? I really hate being on meds, I don't even like aspirin. Or, should I go back to the states and stay long enough to do the decompression therapy? I am starting to have dreams again of amputating my arm...

Hello Lisa,
You have in medical terms what is known as a brachial neuralgia; in basic English, a pinched nerve that goes to the arm. In all that you're written the most significant is that you get relief with your arm over your head; it's called the shoulder abduction relief sign, or SAR.

It's one of the most difficult and painful conditions we treat; your story is that unusual. It hurts; a lot.

I'd go back to your chiropractor in the States, and stay as long as you need to. You must have friends or family there. His treatment seems similar to what I would do, and obviously is helping.

You'll probably find the triceps is the muscle in the shoulder going weak; extension of the elbow.

There may alas be surgery down the road and as you say it often doesn't cure it; I'd go back to your known friend, the chiro in the States.

You are right; no Pilates at the moment. And don't carry anything heavy in that arm.

Spend the time learning Spanish! I learnt Dutch in two weeks at a language school; can be done. Mind you with that neck, perhaps not the right time.

Let me know how you get on.

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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