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Numbness and tingling in arm after fall, EMG showed median nerve compression. Done surgery. Now pain in face

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Internal Medicine Specialist
Practicing since : 2001
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Hello back in Feb 2008 I fell down 7 hardwood stairs at home , my symptoms of my right arm began with numbness and ti ngling when I raised my arm to wash or blow dry my hair. i ignored this and I began experiencing more symptoms, dropping things unable to turn keys in lock and severe right upper extremity pain , shoulder, deltoid, biceps, radiating into axillary and breasr. I also had pain radiaitng into my fingers and hand.. One evening my fingers became so clawes and painful I finally said something to my neurosurgeon. An EMG was done an results were of severe mainfestation of median nerve compression. I went ahead with endoscopic surgery which helped the hand but did nothing from the wrist upwards, I was diagnosed with TOS neurogenic and vascular. I had surgery transaxilary rib resection. The doctor found alot of scar tissue in the scalenes and subclaviane vein compressed. the surgery was done in October of 2009. Its been up and down but a slow recovery unti I recently fell again. An MRI was done to r/o any rinjury to the bracial plexus which all appeared intact however, the is now a shoulder impingement in the acrimion. I have had several injections that were helpful but now last one did nothing. The pain distribution is a bit different its on the right side of my scalp, face radiates to thru the neck, shoulder, trapezius and deltoid muscles and sometimes includes the other symptoms I had with TOS. What could be going on. IN alot of pain and quite disscouraged. The TOS surgery was very painful and difficult surgery.
Posted Wed, 12 Sep 2012 in Brain and Spine
 
 
Answered by Dr. Ram Choudhary 1 hour later
Hi XXXXXXX
Thanks for writing in to Heathcare Magic!
What a sequence of agonies!
First thing I would advise is to be careful to prevent any more falls!
The distribution of pain to so many sites at a time suggests severe local trauma resulting in pulled muscles and associated pain.
It is also possible to have bony injury in the spine, would like to get MRI Cervical and Upper thoracic spine to rule out any cord compression.
The local injections should be avoided any more because they are mostly steroids and cause local atrophy and carry risk of infection.
Rather you can use warm hydrotherapy locally and opioid pain killers orally to soothen the pain and spasm.
If you have any further query please let me know I would try to answer it for you.
Wish you a great health!
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