Brief Answer:
Pectoral muscle strain, Painful XXXXXXX Brachail plexus palsy, Spondylosis

Detailed Answer:
Hi there.

Thanks for the query.

I have read your query and understood your problem. I hope you could answer a few questions for me to be in a better position to help you.

Have you been underweight most of the time or is it a recent change ?

Have you less appetite for food than before ?

Have you traveled to tropical countries like XXXXXXX or temperate XXXXXXX ?

Have you been sleeping in the wrong position lately, done a lot of lifting work or pulling activities ?

Have you any pins and needles sensation over you hands ?

Have you sustained trauma to your collar bone recently ?

According to the history provided by you, I can understand that you have a chronic pain over the pectoral girdle area, centred over the collar bone, which is made worse on lifting the hands up.

I have treated many patients with this complaint and is mostly due to muscle strain of the Pectoralis major muscle due to severe acute pulling activities, lifting activities or Painful XXXXXXX syndrome. In painful XXXXXXX lifting the hand about midway by the side will cause pins and needles sensation and pain about the shoulder.

I would advice you to try a week of conservative therapy by applying cold packs to the painful area around the collar bone. Avoid sitting or sleeping in a position that puts stress to the shoulder. Avoid bending the head forward, which can put stress on a pinched nerve. Avoid smoking and drinking alcohol. Get 6-8 hours of sleep daily. Reduce stress by deep breathing exercise and Yoga.

You can take oral pain killer like Tab. Ibuprofen 200mg twice a day for about 4-5 days. You may also apply pain killer and muscle relaxant gel containing Diclofenac and Thiocolchiscoside as the main components or the like. Apply hot packs to the affected area 3-4 times daily. Avoid lifting weights or any strenuous activity with the arm of the affected side.

If there is no relief, it would be better to consult an Orthopaedic surgeon to rule out any difficult disorders like Rotator cuff injury, Brachial plexus palsy, Cervical spondylosis which can cause nerve pinching in the neck. He/she will do a thorough physical examination and do necessary investigations like Xray or MRI and necessary laboratory tests like Blood count and Serum Uric acid.

I hope I have answered your query.

I will be available to answer your follow up queries.

Thanking you.

Regards,

Dr. Aashish Raghu

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Brief Answer:
C8-T1 nerve compression

Detailed Answer:
Hi there.

Thanks for your reply to my questions.

I would you suggest you do not lift your arm above your head for a few days. Apply hot water bottle or warm packs over the collarbone area and the upper outer chest area, thrice a day. Take pain killer and muscle relaxant as mentioned in the previous conversation.

I believe that you are having cervical nerve root compression at C8-TI level which is why you are having tingling and numbness. I advice you get an MRI Cervical spine after consulting with your Doctor to look for nerve compression.

I hope I have answered your query.

Thanking you.

Regards,

Dr. Aashish Raghu

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Brief Answer:
Degenerative spine, Slipped disc progressing

Detailed Answer:
Hi there.

Thanks for sharing that piece of information.

Yes. This report being as of 14 years ago indicate degenerative changes in the spine bones of the neck and early stages of slipped disc.

As of now your symptoms have increased and you have developed tingling and numbness of the medial two fingers indicating the slipped disc has progressed to compress on the nerves going to the hand from the back of the neck.

Kindly discuss with your Orthopaedic surgeon if you need to get an MRI to know the present status of the cervical stenosis and disc bulge. Also since you have pain around collar bone, your Doctor should look out for Thoracic outlet syndrome which can also cause compression of the nerves in the neck.

I hope I have answered your query.

I will be available for follow up queries.

Thanking you.

Regards,

Dr. Aashish Raghu

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