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How are ruptured tendons treated ?

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Internal Medicine Specialist
Practicing since : 1998
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I was changing the shower curtains (of two bathrooms) on April 3rd. I changed the hooks too, which were fairly thight. During the week, I felt slight pain, but i did not pay attention. On April 10th, I noticed an enlarged vein in my left armpit, in the middle of my right armpit, and I noted that I can raise my arm easily. Since then, I feel bunring and pulling senstion in my right arm, esp. close to my right elbow. I feel weakness and in some angles, I have pain. Since last week, I have the same burning and pulling sensation in my left arm too. Is it possible that any nerve in pinched? What is this vein under my armpit? Is it tendon or nerve? I saw an Orthopedist, who said has not seen any case like this. The x-ray of right shoulder did not show anything. I am waiting for MRI. Is it reoverable? Any risk of nerve damage? Please help.
Thanks,
Posted Sun, 22 Apr 2012 in TMJ
 
 
Answered by Dr. Jasvinder Singh 1 hour later
Hello Mit,

Thanks for posting your query. It is unlikely a nerve injury alone or pinched nerve alone because it would have caused burning sensation and tingling and numbness in the area and it would have stretched to the whole of inner arm upto the hand and fingers.

It looks more like damage or probably rupture of the muscle tendons in the area which has caused tendonitis. The other possibility is of throcaic outlet syndrome which is caused by compression of both the blood vessels and the nerves. This enlarged vein which you have mentioned can be due to the damaged and swollen tendon of the muscle or due to superficial thrombophlebitis of the superficial veins which is caused due to physical strain or even while axillary shaving. It presents as a linear, cordlike, thrombosed vein.

X-ray of the area is unlikely to confirm the diagnosis. You need to get a MRI scan of the area, physical examination and a Doppler ultrasound of the superficial veins of the area.

I suggest you to apply cold compresses in the armpit and take some prescription from your doctor. Give complete rest to the part and avoid doing any activity like raising your arms or stretching the arms which causes any further damage. Also avoid sleeping with the arm extended up behind the head.

Depending on the MRI findings, tendon repair and thoracic outlet syndrome may need a surgical repair but this is reserved for severe cases.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.
Above answer was peer-reviewed by
 
Follow-up: How are ruptured tendons treated ? 1 hour later
Hello Doctor,

Thank you for your response. I just wanted to know, what do you mean by axillary shaving? And this vein [or nerve/tendon] does not like thrombosed vein, as one can see during the blood test, and drawing blood- when in some cases the vein gets inflammed in one spot]. It is like a long, thick vein [or nerve or tendon] that now appears in the middle of the right armpit. It somehow divides my armpit in two, I mean exactly in the middle [to the extent that I can not shave easily, beside the pain that I have in raising my arm]. That I think there should be a problem, that caused it to be misplaced or tangled, and appeared here out of place! Beside the burning sensation in my arms, even forearms.

Is there any possibility that MRI of shoulder wouldn't show the problem? In that case What I should I do? Do I need MRI of thoracic spine or cervical spine? Or Ultrasound [as you mentioned]... or scan? Of which part?

Many thanks,
~Mit
 
 
Answered by Dr. Jasvinder Singh 7 hours later
Hello Mit,

Thanks for updating me.

Axillary shaving is shaving of the hair of the axilla (armpit).

The MRI is a very sensitive test to diagnose any problems in the shoulder joint and axilla. It tends to pick up most of the problems involving the soft tissues.

The venous engorgement or the flow can be assessed better by the ultrasound doppler. A combination of the 2 tests will surely help in delineating the underlying cause.

MRI of the thoracic spine will not likely be required. However, the MRI of the cervical spine may become necessary if the MRI of the shoulder and axilla don't diagnose the underlying cause.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.

Above answer was peer-reviewed by
 
Follow-up: How are ruptured tendons treated ? 1 hour later
Dear Dr. XXXXXXX

Thank you so much for your thorough and detailed response. It has been very comforting.

I wanted to give my thanks, before prssing "I accept the answer." It is more than accepting! Your response is greatly appreciated!

May the Lord continue to bless you.

~Mit

Follow-up: How are ruptured tendons treated ? 1 hour later
ps. Sorry Doctor, I don't want to take your time with my back and forth questions. In case you could answer one more question, could you plesae kindly let me know the answer: I also have discomfort and pulling sensation that I feel in my arms and forearms [exactly between arms and forearms area]. Does it relate to the same problem, which cause this pulling (and sometimes) burning sensation? I didn't have it before.

Lots of thanks,
~Mit
 
 
Answered by Dr. Jasvinder Singh 11 hours later
Hi Mit,

Thanks for your kind and encouraging words. It helps the forum in providing better service.

The pulling and burning sensation in between the arms and forearm area can be related to the tendinitis or thoracic outlet syndrome which is effecting the blood vessels and nerves. Get an MRI and a Doppler ultrasound for the blood vessels done and if the burning sensation is severe, then a nerve conduction velocity test can be done to assess the damage to any nerves as well.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.

Above answer was peer-reviewed by
 
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