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  • Avatarjfitz
    Member
    Post count: 1

    Hello,

    For nearly a year, I’ve been dealing with severe pain radiating from the left side of my neck down into my left hand, thumb, ring and pinky finger also severe sharp, burning pain between my spine and left shoulder blade. The pain is an almost constant burning ache along with shooting lightning bolts of pain down my left arm and into my left hand. I also have almost constant tingling along my left hand and into my pinky and ring finger and my thumb. I also experience pain in the proximal collarbone area. I have the tingling and numbness also along the left side of my neck and up into my left cheek. The vision in my left eye also changes to a blurred sensation.

    The pain is worsened by standing for long periods of time, typing, repetitive motion. Sometimes I don’t do anything and it hurts. I have limited range of motion in my shoulder and pain in the A/C join during overhead lifting. I seem to be losing strength in my arm, sometimes it feels difficult to use my wrist and hand; it becomes “clumsy” and feels disconnected.

    I’ve hand an EMG/NCS (in April) and the diagnosis was ‘Brachial Plexus Lesions’. The electrodiagnostic impression reads:
    1. Abnormal Electrodiagnostic study consistent with median nerve compression at left wrist, very mild.
    2. Abnormal Electrodiagnostic studies most consistent with a brachial plexopathy with left middle trunk most affected; no acute changes; there are polyphasics noted in the C6, C7, and C8.’

    My MRI report from 4/21/13 read:
    C4-5 Minimal shallow central extrusion. CSF is maintained wround the cord. Neural foramina are patent. No mass or abnormal enhancement.

    C5-6 Minimal shallow central protrusion with annular fissuring. CSF is maintained around the cord. Neural foramina are patent. No mass or abnormal enhancement.

    C6-7 Shallow right paracentral protrusion with posterior annular fissuring. CSF is maintained around the cord. Neural foramina are patent. No mass or abnormal enhancement.

    Impression: Stable minimal degenerative disk changes from C4-5 through C6-7 without significant neuroforaminal narrowing or central spinal stenosis.

    No acute cervical spine fracture, cord compression or pathologic enhancement.

    The neurologist and pain management doctors both refused to do anything to help treat my pain because they said they saw nothing of significance on the report. I am very frustrated and at my wits end because I deal with very real, severe pain daily. To the point of being in tears.

    Please, if there is any advice or recommendations you can make based on the information I’ve given, please, I would greatly appreciate it! Thank you very much for your time!

    Regards,
    JFitz

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 7637

    Left hand pain in the thumb, ring and pinky is unusual for any single type of disorder from radiculopathy to brachial plexopathy. The medial (thumb side) of the hand is involved with C6 disorders and median nerve disorders. The middle of the hand is involved with C7 disorders as well as some median nerve disorders. The outside (pinky side) of the hand is involved with C8 disorders and ulnar nerve disorders.

    Brachial plexopathy can involve both median and ulnar nerves but that association is distinctly unusual.

    Pain in the shoulder associated with reduced and painful range of motion could indicate that you have an intrinsic shoulder problem like a rotator cuff tear. This diagnosis would be supported by your posterior shoulder pain as this pain is not typically associated with a brachial plexus disorder. It is not uncommon to have numbness radiate into the hand with shoulder disorders.

    EMGs are generally not very good for delineating brachial plexus disorders as the EMG is normally negative (no findings) in the case of thoracic outlet syndrome, the most common cause of brachial plexus disorders.

    You can go to an orthopedist to have your shoulder looked at or a spine surgeon (who started off as an orthopedist) who should be able to distinguish what the source of your pain is.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
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