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Pain in right arm. Vein like line swollen on arm. Minimal amount of pain on stretching. Pain in bicep and joint region. Suggest treatment?

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General & Family Physician
Practicing since : 2007
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On Sept 30, 2013 I woke up with a pain in my right arm. I was unable to stretch out my arm without feeling pain. In the night a vein like line became swollen and red on my arm (bicep). It also pains whenever I touch it. The swollen red line runs from the opposite side of my elbow up to my bicep closer to my armpit. I did not lift anything heavy. I am 26 years old, 5'6'' and weighs 160 lbs.

I saw a doctor on Oct 2, 2013 and he didn't rule out Superficial thrombophlebitis and took blood for CRP and ESR tests. From Oct 3- 7, 2013 the pain started to reduce and the swelling went down, however there was minimal amount of pain upon extended stretching of the arm. I got the result of tests done (CRP, ESR) on Oct 7, 2013 and the doctor suggested I return on Oct 14, 2013 for a follow up and repeat of those tests (mentioned above). The CRP showed negative (Sensitivity >6mg/l) and the ESR shows some graphs and this at the bottom ESR: 40 mm/hr Westergren (0-20). However on Oct 12, 2013 @ approx. 5pm I felt the same right arm on my bicep starting to feel stiff and within minutes the venous pains started however it felt like this was another vein. The pain also now extended from my armpit down my bicep, on my arm and to my hand (after my wrist but stop before my fingers). Most of the pain is felt on my bicep and in my joint region. Any advice on this would be greatly appreciated. I forgot to mention that with this new venous pain I am not seeing any redness or swollen area on my arm like I did when this first started. But I'm definitely feeling the pain.
Posted Sat, 2 Nov 2013 in Bones, Muscles and Joints
Answered by Dr. Lohit K 3 hours later
Brief Answer:
Neurovascular/vascular bundle compression.Evaluati

Detailed Answer:
Hi XXXX, thanks for using XXXXXXX
I went through the query and understand your concern.

The swelling and pain along with visible dilated vein suggest some compression/obstruction in the vein most probably in the axillary region or in subclavian region. There may not be thrombophlebitis. These all signs suggests venous obstruction.
In arterial obstruction there won't be swelling or redness but you can see pallor or cyanosis with severe pain and numbness.

Its very difficult to diagnose without examination. So I suggest you to consult your doctor and get checked for your BP in bath arms, pulse examination at different sites of forearm both side, general physical examination (look for any swelling/problem in axilla or shoulder joint) and you need cervical x XXXXXXX to rule out ant extra rib that may causing this problem and radiological examination in subclavian and shoulder joint region. May also require angiography to diagnose the site of obstruction.

For now keep your arms in normal position even while sleeping (to prevent any position that may cause obstruction of vessels) and get evaluated from your doctor.

So I advice you to continue the above measures and consult your doctor once for further management. Hope this information is informative and helpful to you. Feel free to ask if any related query and I will be glad to answer them.

Wish you good health.
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