Pain in Right Shoulder, armpit, arm, & neck

by Reita
(Williamsburg, KY, USA)

Pain in Right Shoulder, armpit, arm, & neck x 3 mos?

Hi! and thank you so much! I hurt my right shoulder (I thought) lifting box above my head 3 mos. ago. It progressed from shoulder & upper arm, neck, and radiated to armpit & wrist with in the week.

I still have pain although not as severe along with aching, numbness, and severe weakness (almost no use) of my right (dominant) arm. I had MRI that showed herniated disk at C5-C6 with Left lateral forminal stenosis and broad based buldging disks at C4-C5 and C6-C7 with mild spinal stenosis.

My neuro doesn't think it looks that bad and doesn't think it's causing my right arm weekness...due to the stated left side?

Would this cause my issues? I am seriously hurting here, and off work, and need to get back to business. Test of EMG are pending...thanks for any insight you can give me. My nerves are shot!!

Hello Reita,
I need more information.

See below

Oh, one more question. Anyone mention a "cervical rib" seen on your X-rays?

Dr B

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Nov 07, 2013
Thoracic Outlet Syndrome
by: Reita

1. Turn your head slowly to the right, and then look up. Repeat to the left. What happens?
ANS: Turning right- I get pain that goes to my right shoulder & down into my bicep area ( I cannot tell if it shoots from my neck.) Turning left- I feel numbness, but not the same kind of pain, from my left shoulder down to my wrist.

[You have a positive Spurling sign, for a pinched nerve.]

2. Prick your arms following the patterns found at tingling in arms and hands and determine just where it feels either numb, or hyper sensitive.
ANS: I think it feels more hypersensitive in forearm, lower arm, wrist. But my Tricep, Deltoid, & top of shoulder (Trapezius?) feel numb. [The lesion appears to be affecting more than one nerve root. As confirmed lower down that the whole ulnar nerve is affected. Hence less likely to be a slipped disc at one level.]

3. Just which muscles are weak? In the hand? The triceps? Try and be specific.
ANS: Tricep & hand are majorly weak in right. I have no control over tricep at all, and cannot lift anything over a spoon with that hand. I have weekness in forearm as well but it is not as bad and throbs with pain when using it. [Mm, do you know which is the triceps? It EXTENDS, straightens the elbow. Again, signs that more than one nerve root is affected.]

4. Raise your arms in the air. What do you feel?
ANS: I do not feel pain, but my right arm goes cold very quickly. However I do have to use my left arm to raise my right arm because I cannot raise it at all with out assisting it. [Again, a negative Shoulder Abduction Relief sign for a slipped disc. However, that going cold points to a nerve AND artery being affected. Called a Thoracic Outlet syndrome.]

5. Do this test: Upper Limb Tension Test What happens?
ANS: I have severe pain in both arms doing this, greater tingling & tightness as well. [A little confusing. With a pinched nerve would have expected the right to be much more painful / tighter than the left]

6. Do you remember if anyone tested the pulse in your arm whilst you looked up and took in a deep breath? Adson's Test.
ANS: Yes they have but did not comment. I just tried it but I still have a pulse when it is raised. [This is very difficult, and subjective test, but is critical: the Thoracic Outlet Syndrome would affect the artery and nerves. A difficult test, you wouldn't be able to do it yourself, takes a long time and a lot of experience to master it.]

[We are not much further forward Reita, except to say there certainly is a problem, and from a distance I would suggest it may be a serious problem.

To cause that weakness in the arm there has to be severe nerve pressure.

An opinion from a vascular surgeon may in order to test if the subclavian artery is being affected. A smoker? Very occasionally a condition in the upper lobe of the lung may affect artery and nerves.

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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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