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Forum Name: Neurology Topics

Question: Burning pain to Left Arm radiating from approx. T-1


 Isabelle49 - Tue Apr 14, 2009 7:57 pm

I have had almost constant burning pain to the left arm, most intense at the dorsal aspect and continuing medially to the hand and 5th, 4th, and 3rd finger. The pain seems to originate at an area near T-1 and crosses the left scapula. It is often felt in the deltoid muscle as a deep pinching, occ in the left axilla as a stinging sensation. The pain is at it's worse when I am driving my car. I have a history of C-5, C-6 ddd for approx. 15 years with no medical intervention needed.
This pain started 2/22/09.

I have had to seek care at two urgent care clinics in our area, and I have seen an orthopedist. The orthopedist thought I had a pulled muscle and said he thinks I am "too tense when I drive my car". I am a home health nurse and have been for almost 8 years; I've been driving for over 35 years.

I do have relief from the pain when I lay on my left side, but often have what feels like a muscle spasm from the neck to shoulder when I first get into this position.

I am at the end of my rope. I have had Skelaxin, flexeril, Robaxin, Zanaflex to no avail. I have also had Ultram and Darvocet. Presently I have Darvocet N-100 1 po bid and Zanaflex 4 mg 1 po hs. I am having to take the Darvocet every 4 hours to be able to work. If I do not take the Darvocet the pain is excruciating and I am unable to drive my car. I do not take the meds at bedtime, because I don't have the pain while asleep on my left side.

I am to see a Neurosurgeon (no referrals, my own scheduled apt) this Friday, 4/17. Am worried he won't believe me and treat me like the orthopod did. I am rapidly reaching a point where I will have to stop working, and cannot do this.

Help. Much appreciated.

Isabelle, R.N.
 John Kenyon, CNA - Thu Apr 30, 2009 10:38 pm

User avatar Hi Isabelle49 --

BEcause of your 15 year history of DDD in the cervical spine I strongly suspect pressure has been brought to bear on C7, T-1, which may be pressing on the ulnar nerve and this often begins as severe pain, muscular in nature, across the scapula, deltoid, and then shows up down the ulnar aspect of the wrist with pain and/or numbness in the 5th and 4th fingers. Prettty much exactly as you describe. You should have been offered an MRI of the C&T spine already, and hopefully the neurosurgeon (probably a better choice than neurologist for this because of the strong emphasis on anatomy) will order this for you. Everything you describe strongly suggests early ulnar neuropathy. The muscle spasm and pain across the upper back and shoulder often improves over time, but the hand may ultimately be adversely affected if the problem is not managed appropriately.

I hope this is helpful and please do update us as to the outcome of your consult with the neurosurgeon. This is something that often can be repaired and even more often can be managed to good effect, especially if not allowed to go on indefinitely.

Good luck to you. Please let us know how things turn out.
 Isabelle49 - Sat May 02, 2009 8:48 pm

John, thanks so much for your reply. I had the MRI on 4/25 and will see the neurosurgeon for follow-up and results on 5/5. Am hoping something can be done, soon. My escapes are oil painting, needlework and classical piano, none of which I have been able to participate in for over 2 months. The love of my life is my 4 year old granddaughter, and I have not been much of a fun grandmother since this started.

Again, thanks so much. Will keep you posted.

Isabelle
 Isabelle49 - Mon May 04, 2009 3:26 pm

OMG you are not going to believe the phone call I received today, an automated message telling me that my appointment scheduled 5/5, to go over the results of the MRI I had on 4/25 has been cancelled and rescheduled for 5/25. I just about had a heart attack when I heard that.

What is a person to do? I am in alot of pain.

Isabelle
 Isabelle49 - Wed May 06, 2009 2:15 pm

Saw neuro today. MRI inconclusive. Still with alot of pain, rate 8-10 most of the time. Can't do much more than lay on my side.

Plan: Cervical epidural on 5/8/09 - am told that I will be given IV sedation, good thing, cause I am the biggest weenie that ever walked the face of the earth. Am an RN for 23+ years, that doesn't help at all. I want enough sedation to be so close to death and when they are done they can jerk me back. No pain, No gain is NOT my motto. I don't do pain well at all. Pray for me.

EMG to be done on 5/15. More needles, ugh!

Isabelle
 Isabelle49 - Fri May 08, 2009 6:30 pm

Update: had epidural steroid injection today. Sill in alot of pain. Can't convince MD's that 1 darvocet q 12 hrs is not effective.

Isabelle
 Isabelle49 - Wed May 13, 2009 3:22 pm

Update: Had the nerve conduction studies done today and doc said positive for C5 compression. Now wait to see what is next, if the doc's assistant will return my calls.

Thanks for your support.

Isabelle, R.N.
 Isabelle49 - Tue May 26, 2009 7:23 pm

Update: saw new neurosurgeon today. Surgery scheduled for July 2, C5,6 6,7 fusion. I am hoping it will be moved up. I can't wait to see what it felt like to be without pain. This pain is never-ending, it often reaches a "10", or at least I hope it does, since if it doesn't, I sure don't want to know what pain that is worse than this feels like.

Isabelle

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