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What Causes Pain In Shoulders, Tinnitus, Balance Issues And Visual Disturbances?

Posted on Thu, 19 May 2016

Question: i have an identified cervical spine stenosis ( currently not being treated) Symptoms include vertigo, pain from my left shoulder running through my arm to the back of my left hand. Tinnitus , Some balance issues, visual disturbances with some double vision. Tingling in my left hand and both feet . Some gait awkwardness (particularly on my left side) My left hand is often swollen looking and discoloured compared to my right hand and often very dry flaking skin is in evidence. I have been diagnosed ( Six years ago) with Parkinsons but have nagging doubts about the accuracy of the diagnosis. What light can you shed on my dilema and what course of action can you suggest? I am known as having a very cheerful disposition. I have noticed that the pain in my left arm is intensified by tilting my head backwards and that it will subsided when I am seated or lying down. I am 69 years old and enjoy an active retirement which involves building renovations etc even though the above symtoms are troublesome. I have been taking tablets for Parkinsons at a basic level for over 5 years and have not increased the dosage .... I never really feel any benefit or otherwise from them. I am hoping to be able to sort out what is going on and will appreciate any comments or suggestions you may have so I can be treated in the most appropriate way. Thank you so much .

Answered by Dr. Dr. Erion Spaho (53 minutes later)

Brief Answer:
Other conditions besides Parkinson's should be considered.

Detailed Answer:
Hello and thanks for using HCM.

I have read your question and understand your concerns.

Pain in shoulder, tingling, gait problems and some balance issues could be explained by cervical spine stenosis.

Symptoms worsening or improving in certain neck and head position suggest cervical spine instability too.

Dizziness and vertigo, tinnitus, vision problems are not related to spinal stenosis and are not typical symptoms of Parkinson's.

These last symptoms could be related mostly to brain conditions such increased intracranial pressure, stroke ( small ones ).

In my opinion, you should discuss with your primary care Doctor about getting examined further about above mentioned conditions.

In my opinion, there is need for a complete neurological examination, cervical spine x-rays in neutral, flexed and extended position and brain MRI, in order to achieve a correct diagnosis.

Treatment depends on the diagnosis.

Hope you found the answer helpful.

Let me know if I can assist you further.

Greetings.

Above answer was peer-reviewed by : Dr. Naveen Kumar

Follow up: Dr. Dr. Erion Spaho (21 hours later)

Dear Dr.Spaho ....Thank you very much for your prompt answer... I attended an appointment with my General Practitioner yesterday and he has given me a referal to a Neurosurgeon .... I am waiting to hear about an appointment with them. In the examination and the referal letter the G.P. states "I have examined his shoulder and apart from some pain on internal rotation he has a normal examination" also "He is neurologically intact" Would these observations be consistent with the symptoms I am reporting i.e. gait , shoulder /arm pain and the intensifying pain with altered head/neck posistioning? The Dr I saw was concerned that "He is becoming symptomatic from his central spinal stenosis"" He suggested for the time being that I stop any building work I am currently involved with. He also said that I should immediately report to the local hospital shoulder I develop difficulties with holding objects ( i.e. dropping things. ) He prescribed a drug called Lyrica 75mg BD. He asked me if I had experienced an event likely to have some causation effect .... which I was unable to do ..... other than mention I was in a car accident (Me driving ) 3 years ago and required some medical attention as an out patient ..... but not to do with the neck/head at the time. The cervical spine stenosis was existing and known of at that time. (C6/C7)as it had been picked up 2 years prior to my car smash.Thanks for your assistance ..... I am keen to sort out what is going on as I am confused about the possibility of overlapping problems as symptoms seem to be similar in certain cases. Regards XXXXXXX XXXXXXX

Answered by Dr. Dr. Erion Spaho (4 hours later)

Brief Answer:
Neurosurgeon's evaluation is the right thing to do.

Detailed Answer:
Welcome back XXXXXXX

Being neurologically intact is a very good news, because, whatever is the condition that is causing your symptoms, it means it is at its first stages.

However, I think the condition will be more clear after the Neurosurgeon's evaluation and probably imaging studies, if he will see necessary to order.

Even if the head and neck didn't get involved at the accident, previous conditions such spinal stenosis could be worsened, so, being checked about this is a must.

Please let me know the Neurosurgeon's evaluation results and feel free to discuss any health concerns with us.

Greetings.

Above answer was peer-reviewed by : Dr. Raju A.T