Left Armpit/Breast Pain, left arm/hand numbness

History: Pain started Nov 2017. I had armpit pain on left side, it would radiate down my arm with numbing, across my chest, back and affect my left breast.
Dec 2017 mammogram and breast ultrasound were normal.
Saw a neurosurgeon and had ACDF (4-5 5-6) in April 2018.
The numbness got better. Surgery was successful according to all images. Did PT.
I have had 3T MRI, CT, Xrays, NC Series and there is no explanation for the pain I am still having.

Most pain is in my armpit and outside and top of left breast (no lumps), on the inner side of my arm. Most arm pain is above my elbow. Arm feels heavy and again experiencing numbness in my hand, fingers.
Pain in my neck at times. Pain will be in my shoulder and can travel around my back.
Everything is on the left side. It is dull and achy and sometimes burning.
Sometimes if I wear a shirt that rubs up against my armpit it will trigger the pain. I am constantly pulling my clothing away from my armpit area.

Some days are good....most are not.
I have recently become aware of sleeping on that side. It is uncomfortable and almost sore.

Neurosurgeon referred me to pain mgt who wants to do nerve ablation injections.
I have trouble with not knowing what it is or what is causing it.
Neuro said sometimes there is no explanation.

Do I see an othopedic? Chiropractor? Can you even see one after ACDF surgery??
Having a diagnostic mammo next week to check that again.

Any help appreciated...TY

Hello TY,
This is complex and because I can't examine you it's obviously even more difficult.

Let's start with some questions:

1. Before surgery, did you have neck pain?

2. What's your gut feel? Do you think this pain and numbness was all coming from your neck?

3. Turn your head to the left, and then look up. What happens?

4. Run your fingers down the joints between the ribs and your breastbone. Are any of them particularly tender. Are there any palpable and visual lumps?

5. Now run your fingers up to the sterno-clavicular joint between the collarbone and the breastbone. Tender? Lump? Use Google to find the joint if unsure.

6. Lie on your tum and ask someone to press quite firmly on the joints between the ribs and your spine just to the side of the bumps, spinous processes. Particularly tender? Where?

7. If either of those rib joints, one to the sternum, the other to your spine, are particularly sore, then palpate with your fingers along the rib, through the armpit area, under the breast. Very tender?

Please be very specific in your answers if you want anything useful to come out of this conversation.

dr B

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