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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