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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Experiencing Severe Pain Down The Neck Across Shoulder

I am experiencing sharp, shooting pain down my neck across shoulder/ shoulder blade. Occasionally, my right hand fingers will go numb. I drop things i am holding without knowing and couple times i did minor injury to fingers. If pressure applied to elbow, my shoulder blade get sharp pains in it. If i turn my head either way i get pain down my right arm. And if looking down for a period of time, it is ver difficult to move back up to see straight ahead. I can lift up to 10 pounds before pain will occur. I am able to lift 20 pounds for about 20 feet before pain is so bad, I have to stop or lose feeling in arm. What is/ can be the cause of this??
Mon, 9 Jan 2017
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Orthopaedic Surgeon 's  Response
Hi,

In my opinion it is a sort of neurovascular injury of your median nerve or neurovascular comrpession of cervical spinal nerves. Your symptoms is showing Carpal Tunnel Syndrome which is a medical condition due to compression of the median nerve as it travels through the wrist at the carpal tunnel.

The main symptoms are pain, numbness, and tingling, in the thumb, index finger, middle finger, and the thumb side of the ring fingers. Symptoms typically start gradually and during the night. Pain may extend up the arm. Weak grip strength may occur and after a long period of time the muscles at the base of the thumb may waste away. In more than half of cases both sides are affected.

Risk factors include obesity, repetitive wrist work, pregnancy, and rheumatoid arthritis. There is tentative evidence that hypothyroidism increases the risk. It is unclear if diabetes plays a role. The use of birth control pills does not affect the risk. Types of work that are associated include computer work, work with vibrating tools, and work that requires a strong grip. Diagnosis is suspected based on signs, symptoms, and specific physical tests and may be confirmed with electrodiagnostic tests. If muscle wasting at the base of the thumb is present, the diagnosis is likely.

Being physically active can decrease the risk of developing CTS. Symptoms can be improved by wearing a wrist splint or with corticosteroid injections. Taking NSAIDs or gabapentin does not appear to be useful. Surgery to cut the transverse carpal ligament is effective with better results at a year compared to non surgical options. Further splinting after surgery is not needed. Evidence does not support magnet therapy.

Hope the above information helps you. Any further clarifications feel free to ask.

Regards,
Dr. Ahmed Aly Hassan
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Experiencing Severe Pain Down The Neck Across Shoulder

Hi, In my opinion it is a sort of neurovascular injury of your median nerve or neurovascular comrpession of cervical spinal nerves. Your symptoms is showing Carpal Tunnel Syndrome which is a medical condition due to compression of the median nerve as it travels through the wrist at the carpal tunnel. The main symptoms are pain, numbness, and tingling, in the thumb, index finger, middle finger, and the thumb side of the ring fingers. Symptoms typically start gradually and during the night. Pain may extend up the arm. Weak grip strength may occur and after a long period of time the muscles at the base of the thumb may waste away. In more than half of cases both sides are affected. Risk factors include obesity, repetitive wrist work, pregnancy, and rheumatoid arthritis. There is tentative evidence that hypothyroidism increases the risk. It is unclear if diabetes plays a role. The use of birth control pills does not affect the risk. Types of work that are associated include computer work, work with vibrating tools, and work that requires a strong grip. Diagnosis is suspected based on signs, symptoms, and specific physical tests and may be confirmed with electrodiagnostic tests. If muscle wasting at the base of the thumb is present, the diagnosis is likely. Being physically active can decrease the risk of developing CTS. Symptoms can be improved by wearing a wrist splint or with corticosteroid injections. Taking NSAIDs or gabapentin does not appear to be useful. Surgery to cut the transverse carpal ligament is effective with better results at a year compared to non surgical options. Further splinting after surgery is not needed. Evidence does not support magnet therapy. Hope the above information helps you. Any further clarifications feel free to ask. Regards, Dr. Ahmed Aly Hassan