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Suggest Remedies For Shoulder Pain And Tingling Sensation In Feet

Posted on Wed, 8 Jun 2016

Question: I am 4 weeks after doing some light snow shovelling and started with intense shoulder pain. The pain has reduced but I still have very limited arm power, and my palms and bottoms of my feet are semi numb ( tingling almost constantly. My hands are colder than normal. Have been seeing a phsio therapist who has been manipulating my spine T2 and T3, and mentiooned also T6 relating to the tingling. The pain and weakness is in shoulders - I have no pain in my back.
Could there be something beyond the nerves in spine having been inflamed by the vertebrae?
Update: at 7 weeks after the mentioned incident:
The shoulder pain has nearly completely subsided, but the weakness in using my arms persists. The numbness in hands and feet also persists and almost seems to have become more pronounced, and seems to go slightly up my arms and legs.

Answered by Dr. Ajay Panwar (3 hours later)

Brief Answer:
Please tell some details:

Detailed Answer:
Hi XXXXX,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.

I have gone through your detailed history and I have understood your concerns well.I need to know some more details so that I can answer this well-
1)Are the symptoms symmetrical on right and left side extremities or of differing intensity.
2)Regarding shoulder pain-Did the pain arise in shoulder itself or was it neck pain radiating to shoulder?
3)You said about weakness in arms-how much functional limitation is it causing?What all activities you are not able to do because of weakness?
4)Any other past medical history or disease history?

I shall be glad to have you in follow-up with details so that I can answer this well.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ajay Panwar (36 hours later)

1.The numbness in hands and feet is symmetrical. The weakness in shoulders seems to have gone from being mostly in left side to now mostly in right side.

2 Originally the pain seemed mainly in the shoulders. and scapula I did not notice accute pain from neck.

3. Much reduced strength to lift arms out to sides or up high over head. If I use my arms much, the numbness in my hands seems to be more prounounced.

4. A few of months earlier i had some vertigo and nausea along with tinitus which still comes and goes. It was suspected as inflammation of the vestibuar nerve. This was mainly resolved when the onset of this shoulder issue came suddenly.
I now have a CD with MRI images of my cervical area of spine.

Answered by Dr. Ajay Panwar (11 hours later)

Brief Answer:
Please upload MRI CD.

Detailed Answer:
Hi XXXXX,
Thanks for being in follow-up and providing further details.

In view of your clinical history and X-ray findings,it is clear that your symptoms are due to degenerative spine changes.
It might be resulting in cord compression and radicular involvement.I would be in a better position to interpret,after looking at the MRI.

So,please upload your MRI CD on google drive and share the link here in the follow up question so that I can download it and review it.

I shall be glad to have you up for further questions.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ajay Panwar (31 hours later)

My MRI images are now on googledrive:

https://drive.google.com/open?id=0BzOy9pWIwx_8Y1pGVnhRZDl6SWc

I have also been asked to book an EMG test. I have to wait a few weeks for that. Will it be necessary do you think?

thanks
XXXX

Answered by Dr. Ajay Panwar (17 hours later)

Brief Answer:
Degenerative spine disease.

Detailed Answer:
Hi XXXXX,
Thanks for being in follow-up.

I have downloaded your CD and reviewed the MRI.You have got a degenerative spine disease with significant disc bulges at C3-C4,C4-C5 and C5-C6 levels.It is manifesting with the symptoms of nerve radicles compression.

For now,you should visit a physiotherapist for power charting and spinal exercises training.If there is a definite weakness,then spine surgeon should be consulted.If functional limitation of the arm is due to pain,then antineuralgic medicines(pragabalin,duloxetine,amitriptyline) along with methylcobalamin and calcium/vitamin D supplementation will help.In addition,dedicated cervical spine exercises will help a lot in the long run.

Hope that helps.If you have any further questions,I shall be glad to have you in follow-up else please close the thread,rate it and write a review.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ajay Panwar (3 days later)

Thanks -
I have a prescription for EMG tests and have been waiting about 1 month to get an available date. The numbness in my toes and bottom of feet has gotten a bit more than at the onset.

1. Is there risk of permanenet nerve degradation due to longer delays?
2. Since we already have MRI, what does EMG provide as additional diagnosis?

thanks Dr.
XXXX

Answered by Dr. Ajay Panwar (12 hours later)

Brief Answer:
Early treatment is important.

Detailed Answer:
Hi XXXX,
Thanks for being in follow-up.

According to my opinion,the diagnosis is pretty clear in your case and EMG is not necessary unless someone is strongly suspicious of an alternative diagnosis like motor neuron disease,which appears to be unlikely with your clinical description.
In my opinion,early treatment is important to prevent further worsening of weakness/deficits.At this point,a physical examination by a neurologist will further help towards the diagnosis.

Hope that I have answered your query.If you have any further questions,I shall be glad to answer else please close the thread,rate it and write a review.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar