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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Have asthma, arm pain, tinnitus, blocked ear and feeling fatigue. Any suggestion for cure?

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Dr. Naveen Kumar

ENT Specialist

Practicing since :2001

Answered : 2386 Questions

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Posted on Wed, 16 Jan 2013 in Asthma and Allergy
Question: I have had congestion for three months. No cough or runny nose. Just gagging mostly in the morning and bringing up phlegm. I have been on antibiotics three times and on steroids with no improvement. I have asthma which had been a little worse and take Seratide. For the past few days, I have noticed that if I put my had on an angle, water drips from my nose. I have not had a head injury. I also have chronic pain in my left arm and left side of neck which had lasted 2 yrs with no diagnosis. I have tinnitus and a blocked feeling in my left ear. Constant fatigue, dizziness.
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Answered by Dr. Naveen Kumar 3 hours later
Hi

Thanks for posting the query

The symptoms described by you seem to be Allergic rhinosinusitis with Eustachian tube (the tube connecting nose and the ear) blockage.

The tinnitus and the ear block sensation are because of the Eustachian tube blockage secondary to the sinus infection. When there is mucosal edema the opening of the Eustachian tube gets blocked following which, negative pressure is created inside the middle ear giving rise to tinnitus and ear block sensation.

Mere antibiotics are not enough to treat your problem. You will require a mucolytic (such as bromhexine/ambroxol), to reduce the consistency of the sinus secretions. A saline nasal spray followed by steam inhalation 3 - 4 times a day, helps in keeping the nose patent and reducing the phlegm. An antihistaminic (such as fexofenadine/levocetrizine) is beneficial in controlling allergy.

Finally, the watery secretions draining from the nose could be due to either nasal allergy or CSF leak. The former can be treated with the above management and the latter has to be confirmed by an endoscopic examination of the nose.

At present, you can try with the above management and check for the drainage. If the drainage of the nasal fluid exists even after the above management, then you will have to consult your doctor for the further investigations.

Hope I have answered your queries; I will be available for the follow-up queries.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Naveen Kumar 34 minutes later
Could you suggest any possible diagnosis for my issue with chronic pain? About 2 1/2 yrs ago, I had an injury on the inside of my elbow and arm. I was attacked and my leather handbag was pulled repeatedly against the inside of my elbow. I had initial pain which got worse then improved after a couple of months. I had an Xray at the time, and that showed no breaks. A year later, the pain suddenly came back. At this time I began reducing psychiatric medications, had a blood test which seemed to hit a nerve as it caused immediate pain and shooting pains for a couple of weeks. I also did a lot of heavy lifting around that time. The elbow pain became very bad, both on the outside and inside of elbow. I developed pain along the forearm, and have had numbness and swelling in my hand. I had physio as they thought it may be a nerve in my neck. I have gradually developed worsening neck pain on the back of the neck, halfway between the spine and side of neck, pain in line with the artery at the side, a sensation that the artery is throbbing, and pain in the shoulder blade. The arm pain is much worse after minor exercise. The neck pain is always bad. I have had MRI of elbow, CT scan of neck and ultrasound of neck and arm which have showed nothing. Doctors have no suggestions for me now as the tests were clear, but I still have constant pain. I have noticeably lost muscle bulk in the left arm in the past year, but this could be due to not using it. I have been referred to pain management. There is a long waiting list and I would prefer a diagnosis and treatment. Does this fit with any specific condition that would not have shown up on those scans? Which specialist would be capable of diagnosing this unknown condition?
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Answered by Dr. Naveen Kumar 36 minutes later
Hi

Thanks for writing back

I would have preferred an MRI of the neck and CT scan of the elbow rather than the other way round. The possibility of stretching on the nerves in the elbow (neuropraxia) has to be ruled out. Similarly, cervical spondylosis and other nerve compression disorders have to ruled out.

The best person to consult is a neurologist or a neuro-physician. At present, stop the physiotherapy and consult the above mentioned specialist.

Hope this answers your query. Good luck.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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