shoulder pain, rumbness and tingling down the arm

[caveman27 208]

Well, my right shoulder started bother me, pain-wise, but I started getting pain and numbness radiating down the arm, hand and fingers. Thumb is good to go. I went to the doctor, he worked on my shoulder previously for a torn labrum repair. I have a huge bone spur growing at the the humerus at the top near the ball of the bone. It showed up in the x-ray. It could be nerve pinched at the neck. Could be nerve pinched at the shoulder.

Anyway, the tingling isn't bad, and doesn't happen while playing, but the numbness is affecting my grip strength. I can see my slapshots aren't as strong. I need to be more deliberate with passes so I'm not dishing out weak passes. Anyone else had/have a similar issue? I'm planning on getting a cortisone shot this week.

[BenBreeg 493]

I have had this type of issue for years.  They never positively diagnosed it.  Some stenosis in my neck but not a lot.  I have seen tons of docs, had MRIs, etc.  Bad posture seems to aggravate mine, so the stenosis would be effectively worse as my neck bends.  I focus on posture and do a lot of upper back work to help with it.

[th6252 25]

23 hours ago, caveman27 said:

Well, my right shoulder started bother me, pain-wise, but I started getting pain and numbness radiating down the arm, hand and fingers. Thumb is good to go. I went to the doctor, he worked on my shoulder previously for a torn labrum repair. I have a huge bone spur growing at the the humerus at the top near the ball of the bone. It showed up in the x-ray. It could be nerve pinched at the neck. Could be nerve pinched at the shoulder.

Anyway, the tingling isn't bad, and doesn't happen while playing, but the numbness is affecting my grip strength. I can see my slapshots aren't as strong. I need to be more deliberate with passes so I'm not dishing out weak passes. Anyone else had/have a similar issue? I'm planning on getting a cortisone shot this week.

does the tingling in the arm start above(shoulder side) or below(wrist side) the elbow.  which part of your hand/fingers are involved(last 3/pinky, ring and middle or first 3/thumb, pointer and middle)? the way you're describing it, it could be anything from a pinched nerve in the neck(due to a disc issue, degeneration, arthritis or combo of things), to thoracic outlet syndrome(from a possible 1st rib issue or something muscular like spastic scalenes) to ulnar tunnel syndrome along with a bunch of other possibilities.  doubtful that the bone spur in your humerus is causing that.

but the fact you're having some weakness in your arm/hand is no bueno.  that likely means there is some chronicity to your issue and likely some nerve damage going on in which the impingement on whatever nerve(s) involved needs to alleviated asap along with some therapy to assist in regeneration of the nerve(s).  regardless, you need to be properly examined so that course of treatment can be administered asap to limit any possible nerve damage.

[caveman27 208]

6 hours ago, th6252 said:

does the tingling in the arm start above(shoulder side) or below(wrist side) the elbow.  which part of your hand/fingers are involved(last 3/pinky, ring and middle or first 3/thumb, pointer and middle)? the way you're describing it, it could be anything from a pinched nerve in the neck(due to a disc issue, degeneration, arthritis or combo of things), to thoracic outlet syndrome(from a possible 1st rib issue or something muscular like spastic scalenes) to ulnar tunnel syndrome along with a bunch of other possibilities.  doubtful that the bone spur in your humerus is causing that.

but the fact you're having some weakness in your arm/hand is no bueno.  that likely means there is some chronicity to your issue and likely some nerve damage going on in which the impingement on whatever nerve(s) involved needs to alleviated asap along with some therapy to assist in regeneration of the nerve(s).  regardless, you need to be properly examined so that course of treatment can be administered asap to limit any possible nerve damage.

As for the tingling, it's in the last 3. Now, it's always tingling, instead of on and off. Pain still comes and goes along the shoulder blade and tricep area in a sporadic manner.

[BenBreeg 493]

You need to see a doc.

[th6252 25]

10 hours ago, caveman27 said:

As for the tingling, it's in the last 3. Now, it's always tingling, instead of on and off. Pain still comes and goes along the shoulder blade and tricep area in a sporadic manner.

can't really be sure, but it sounds like a lower neck problem.  C7 innervates the triceps and middle finger, while C8 innervates the ring and pinky.  go see either a good musculoskeletal based chiropractor or ortho (preferably not an urgent care facility or a gp/pcp as they tend to really be terrible with musculoskeletal and nerve injuries) to get a proper work up asap.  the longer you let that nerve issue go, the higher the chance it can cause permanent issues.

[puckpilot 312]

I had something similar. It started with light muscle spasms just below the deltoid. Then my arm would go numb and tingle. That progressed into fingers numb and pain referred down my arm. Then it went into full pinched nerve, shoulder pain, referred pain, and a month of agony. Went to doctor. X rays showed some wear on a disk. Scared the shit out of me. Went to physio. They gave me stretches and exercises. In a week the pain went from like a 7 to a 2. 

It was muscle tightness around my shoulders, specifically some muscles in around my peck/armpit area clamping down on a nerve. Took me a few months of stretching all the muscles in my neck and around my shoulders to get things to where there was no pain. It was an hour of stretching every day during that time. The problem tries to raise its head from time to time, but I recognize the feeling and nip it in the bud with regular stretching. 

[the_game 452]

I'm in the camp of getting to an Ortho as soon as you can, ideally getting an MRI of your neck. I've got 3 levels of my neck fused together and a titanium plate so when anyone starts mentioning any of the symptoms I had before my surgery I always tell them to get it looked at ASAP. Not trying to scare you or anything but like everyone says if you don't get this addressed the nerve damage can really mess things up and living in pain really does take its toll.

My only other piece of wisdom here is to push for the health care you want & need. Push to see an Ortho, push for an MRI, push for second opinions, etc. etc. etc. The healthcare system can kinda suck and some providers just want to shuffle you along, pass you off to PT, or give you pain meds or make you go to PT for 8 weeks before they'll see you again. Definitely be your own best advocate and if you want something or you're getting info you don't think is right, speak up for yourself and ask for you what you want. 

[caveman27 208]

On 1/23/2020 at 10:52 AM, the_game said:

I'm in the camp of getting to an Ortho as soon as you can, ideally getting an MRI of your neck. I've got 3 levels of my neck fused together and a titanium plate so when anyone starts mentioning any of the symptoms I had before my surgery I always tell them to get it looked at ASAP. Not trying to scare you or anything but like everyone says if you don't get this addressed the nerve damage can really mess things up and living in pain really does take its toll.

My only other piece of wisdom here is to push for the health care you want & need. Push to see an Ortho, push for an MRI, push for second opinions, etc. etc. etc. The healthcare system can kinda suck and some providers just want to shuffle you along, pass you off to PT, or give you pain meds or make you go to PT for 8 weeks before they'll see you again. Definitely be your own best advocate and if you want something or you're getting info you don't think is right, speak up for yourself and ask for you what you want. 

I have pretty good insurance. I've already had a variety of surgeries in the last couple years. Last one was a spinal fusion, L4 and L5. A couple months before that was a hip arthoscopy. A couple years before that was shoulder labrum repair. 

The cortisone shot helped the shoulder pain a bit. It's been two days since I got that shot. The numbness/tingling is still happening in my pinky and ring finger. Pain in fingers, hand and arm are sporadic. MRIs are pretty expensive, especially if you need the dye. Does neck MRI require a dye? I know for my lumbar, it didn't.

Surprised you can play after three cervical vertibrae are fused. 

Edited January 24, 2020 by caveman27

[th6252 25]

9 minutes ago, caveman27 said:

I have pretty good insurance. I've already had a variety of surgeries in the last couple years. Last one was a spinal fusion, L4 and L5. A couple months before that was a hip arthoscopy. A couple years before that was shoulder labrum repair. 

The cortisone shot helped the shoulder pain a bit. It's been two days since I got that shot. The numbness/tingling is still happening in my pinky and ring finger. Pain in fingers, hand and arm are sporadic. MRIs are pretty expensive, especially if you need the dye. Does neck MRI require a dye? I know for my lumbar, it didn't.

Surprised you can play after three cervical vertibrae are fused. 

typically no dye necessary for spinal mri's when looking for disc issues.  dye is sometimes necessary when looking for a labral tear because it can be difficult to pick up on the images and the dye will fill any cracks or tears in the cartilage.

[BenBreeg 493]

1 hour ago, caveman27 said:

I have pretty good insurance. I've already had a variety of surgeries in the last couple years. Last one was a spinal fusion, L4 and L5. A couple months before that was a hip arthoscopy. A couple years before that was shoulder labrum repair. 

The cortisone shot helped the shoulder pain a bit. It's been two days since I got that shot. The numbness/tingling is still happening in my pinky and ring finger. Pain in fingers, hand and arm are sporadic. MRIs are pretty expensive, especially if you need the dye. Does neck MRI require a dye? I know for my lumbar, it didn't.

Surprised you can play after three cervical vertibrae are fused. 

Common.  I described my issues to the neck ortho and basically said it is kind of numb, but kind of tingly and has a dull pain, all at the same time.  He said that was not at all out of the ordinary because with nerve issues the nerve is sending weird signals to the brain.

[caveman27 208]

1 hour ago, BenBreeg said:

Common.  I described my issues to the neck ortho and basically said it is kind of numb, but kind of tingly and has a dull pain, all at the same time.  He said that was not at all out of the ordinary because with nerve issues the nerve is sending weird signals to the brain.

My ortho (who specializes in shoulder and knee) suspected pain going below the elbow is from pinched nerve at C5. 

The pain that I get is usually along the outside of the forearm and along the triceps, and along the shoulder blade in the back. That pain level is like a 5 to 8. The hand tingling pain level is usually 1 to 2, but can go up to 4 or 5, and sometimes I get the effect of losing hand strength, like pressing on top of a soap dispenser or reaching into my right side jeans pocket, but I can still open up and close my fingers. 

[the_game 452]

I had c3-c4, c4-c5, & c5-c6 fused. Also experienced a lot of similar things to what you’re describing, my pain started out in my trap/shoulder and spread quite rapidly over a month. Just a dull ache/pain from my trap/shoulder down the backside of my tricep. Fingers, ring & pinky where def tingly or just felt off, holding a pen/trying to write was a chore, dexterity was just off. Also they we’re always cold. I lost grip strength in my hand, def could feel losing Strength it in my tricep and my chest. Again not trying to scare you but like I said any time I hear this stuff I urge people to get checked out. Def sounds as if something is pinched so I would push to get care focused in and around that. 
 

Neck MRI was no dye, just a small tube so it sucked considering I’m claustrophobic. But I was willing to put up with that to find out what was wrong ha. 
 

if you’ve got any questions don’t hesitate to hit me up and I hope you can this looked at and straightened out with minimal issues!

[caveman27 208]

I ended up asking for a cortisone shot in the shoulder, as the pain pill wasn't doing anything more than over-the-counter ibuprofen.

That helped stop pain across my back shoulder blade, top of deltoid, along the tricep, and the outside forearm. The loss of strength and pain in the hand and fingers went away. But now, there's a constant tingling in the pinky and ring finger. It doesn't go away. 

The orthopaedic surgeon didn't think it was worth removing the bone spur and has recommended to stop weight lifting and continue coming back for cortisone shots every 6+ months until I need shoulder replacement surgery.

So, I'm going to see a neurologist about my neck. There's one who did my lumbar fusion over a year ago so I trust him.

I'm going to look around for an orthopaedic surgeon who does 'ream and run" shoulder replacement. Anyone know of someone who has had that procedure done? I want to stay active, I'm not that old yet.

[Vet88 674]

Have you looked into ESWT? There are a number of studies out over the last couple of years that show it's effectiveness in the right circumstances. Whether or not it is suitable for you I don't know but ESWT versus cortisone studies in hip injuries such as gluteal or hamstring tendinopathy have shown ESWT to be more effective.

[caveman27 208]

I have cervical radiculopathy at C5 and C6. They are putting me through conservative options before getting an MRI.

I was prescribed methylprednisolone. A pack of pills you take with decreasing amounts each day for a week. I'm already done with that. I still have the tingling in the fingers with varying degrees of pain. It did nothing. I'll be starting physical therapy soon and doing that for a month. 

[BenBreeg 493]

My only other comment as someone who has these issues is as mine has come and gone, it never cleared up quickly.  Even after relieving the pressure on a nerve, it seems like it takes a while for the nerve to "settle down", so give it some time.  I was always 100% compliant on PT so don't skimp there either.

[th6252 25]

58 minutes ago, caveman27 said:

I have cervical radiculopathy at C5 and C6. They are putting me through conservative options before getting an MRI.

I was prescribed methylprednisolone. A pack of pills you take with decreasing amounts each day for a week. I'm already done with that. I still have the tingling in the fingers with varying degrees of pain. It did nothing. I'll be starting physical therapy soon and doing that for a month. 

The pinky and ring finger are innervated by nerve roots C7 and C8.  Can make an argument the C5 and C6 was causing the shoulder symptoms, but not at all when it comes to the fingers.  Also, the fact that the medrol dose pack did nothing to alleviate your symptoms is alarming.  Honestly, you really need an MRI ASAP with your constant radicular symtoms and weakness.  Likely the only reason they're having you do a month of conservative treatment first is because your insurance likely won't authorize the test without it.

[caveman27 208]

1 hour ago, th6252 said:

The pinky and ring finger are innervated by nerve roots C7 and C8.  Can make an argument the C5 and C6 was causing the shoulder symptoms, but not at all when it comes to the fingers.  Also, the fact that the medrol dose pack did nothing to alleviate your symptoms is alarming.  Honestly, you really need an MRI ASAP with your constant radicular symtoms and weakness.  Likely the only reason they're having you do a month of conservative treatment first is because your insurance likely won't authorize the test without it.

According to X-ray review, there was disc space narrowing at c5-c6, mild narrowing at c4-c5 and c6-c7.

Going by this picture, I 'm getting the tingling where the photo shows c8. Maybe that's something an MRI would be able to pinpoint accurately.

 

Yeah, it's insurance related. Insurance companies want to resolve things with more conservative routes first, which does have its merits. No need to get invasive surgery, if physical therapy might fix a problem.

[th6252 25]

24 minutes ago, caveman27 said:

According to X-ray review, there was disc space narrowing at c5-c6, mild narrowing at c4-c5 and c6-c7.

Going by this picture, I 'm getting the tingling where the photo shows c8. Maybe that's something an MRI would be able to pinpoint accurately.

 

Yeah, it's insurance related. Insurance companies want to resolve things with more conservative routes first, which does have its merits. No need to get invasive surgery, if physical therapy might fix a problem.

if you can, try to find a place that has a computerized traction(cervical decompression, not static traction) machine.  that and targeted exercises may be the only thing that saves you from more aggressive medical intervention.

[caveman27 208]

4 hours ago, th6252 said:

if you can, try to find a place that has a computerized traction(cervical decompression, not static traction) machine.  that and targeted exercises may be the only thing that saves you from more aggressive medical intervention.

I've had spinal fusion surgery a little over a year ago. Years of weight lifting and exercise, I got degenerated discs in my lumbar region which resulted in spondylolisthesis. The surgery was successful and I got back into hockey last October. I get a feeling there's some nerve being pinched that isn't going to be relieved with traction or physical therapy. I could be wrong.

Anyway, what's your experience/background with nerve issues? Medical profession or patient.

[the_game 452]

Judging from my experience, the numbness/tingling/cold/weirdness in the ring & pinky can be associated with c5/c6. I had exactly what you described, started with the shoulder pain, radiated down the arm & into the fingers.

I know insurance sucks and wants you to go through their ‘process’ before you get an MRI but the only way you & your docs are going to know what’s really going on is an MRI. I’d go back to your doc or even on day 1 of PT and ask them to push for the MRI. The docs can get it pushed through, it’s a hassle & and extra steps for them but it can be done.

As someone who went through this I can attest to insurance sucking balls. All my primary care doc wanted to do is give me opioids and push me out the door saying it’s a muscle spasm. I got my surgery request rejected when I had a calcified disc putting so much pressure on my spinal cord my surgeon couldn’t understand how I was walking. After Surgery my PT had to have multiple ‘consultations’ w/ the insurance doctor to extend the number of sessions that were covered. The process sucks but so does living in pain and not being able to do shit. I’d push and push and push some more on anyone & everyone you can to get you an MRI.

Just my $.02 as someone who went through this nightmare.

P.S. I’m fine now after surgery, ha
 

P.S. Part Duex - hit me up if you need to talk, need advice or anything

[caveman27 208]

20 hours ago, the_game said:

Judging from my experience, the numbness/tingling/cold/weirdness in the ring & pinky can be associated with c5/c6. I had exactly what you described, started with the shoulder pain, radiated down the arm & into the fingers.

I know insurance sucks and wants you to go through their ‘process’ before you get an MRI but the only way you & your docs are going to know what’s really going on is an MRI. I’d go back to your doc or even on day 1 of PT and ask them to push for the MRI. The docs can get it pushed through, it’s a hassle & and extra steps for them but it can be done.

As someone who went through this I can attest to insurance sucking balls. All my primary care doc wanted to do is give me opioids and push me out the door saying it’s a muscle spasm. I got my surgery request rejected when I had a calcified disc putting so much pressure on my spinal cord my surgeon couldn’t understand how I was walking. After Surgery my PT had to have multiple ‘consultations’ w/ the insurance doctor to extend the number of sessions that were covered. The process sucks but so does living in pain and not being able to do shit. I’d push and push and push some more on anyone & everyone you can to get you an MRI.

Just my $.02 as someone who went through this nightmare.

P.S. I’m fine now after surgery, ha

P.S. Part Duex - hit me up if you need to talk, need advice or anything

As for surgery, what did the doctor do? cervical foraminotomy, fusion, or artificial disk replacement? Which cervical vertebrae were causing it all for you?

Edited February 28, 2020 by caveman27

[the_game 452]

On 2/28/2020 at 5:29 PM, caveman27 said:

As for surgery, what did the doctor do? cervical foraminotomy, fusion, or artificial disk replacement? Which cervical vertebrae were causing it all for you?

I had ACDF, Anterior Cervical Discectomy and Fusion. This was done on 3 Levels, C3-C4, C4-C5, & C5-C6. Biggest issue I had though was my disc at C3-C4 was herniated & calcifying. A herniated disc is one thing but a Herniated Disc calcifying and putting pressure on your spinal cord, well lets just say that's a good time to have a chat about upping the 'ol life insurance policy for the fam. With these discs its a Domino effect, when one fails the one below starts to take the burnt and get messed and then the one below that, and so on. My ortho did 3 levels as 2 needed it and the third was going and would eventually need to be done at a later date so he just went for them all in one shot. The scariest thing with my issue is I was fine one day and then woke up with the worst stiff neck you've ever had in your life and couldn't move the right side of my body. That went away over a few days but that's when the pain in the shoulder/trap area really started. That began to radiate down my triceps and then into my ring/pinky fingers started getting cold and pins & needles. I also lost a lot of dexterity, just trying to hold pen and write was excruciating and I basically couldn't even do it. After this I started to notice a lack of strength in my right side and also a loss of muscle mass in my arm & chest. All of this took place in the matter of 1 month.

Obviously my case is an exception, in one day I went from having an MRI at 7 AM, getting a call from the Ortho Surgeon around 10 AM saying I needed to come in immediately, seeing my ortho surgeon around 5 PM being told what was wrong (I passed out during this news) and scheduling my surgery for a week later. Even with my case insurance sucked ass, my primary care wanted to put me through the pain pills/cortisone shot/Physical Therapy before an MRI and I went to the head of the practice and told him I'm not leaving your office until I get an MRI (I had one scheduled in 2 days after this). The surgery my Ortho said I needed to make sure I resolved that calcified disc possibly severing my spinal cord, even that got rejected! My Ortho said that happens all the time and a phone call w/ him and the insurance company gets it pushed, but still its an insane process.

I still urge anyone who ends up with or thinks they have a Cervical Spine issue to get it checked out just because I had no clue how bad of shape I was in and the only way to find that out is by an MRI. If you've got any more questions or need any more info, please hit me up. I've kinda become an expert with this stuff after my ordeal so if you needed anything just hit me up.

 

[caveman27 208]

The physical therapy is actually helping more than I thought it would. The tingling isn't on 100% of the time, like it was in the beginning. It comes back once in a while. I have one more PT session. 

I went to a second orthopedic surgeon about my shoulder, as the effect of the cortisone shot is wearing away. He said I would be a candidate for ream and run surgery, but elective surgery is not an option with the corona virus thing.