Discussions By Condition: I cannot get a diagnosis.

Severe Arm Pain

Posted In: I cannot get a diagnosis. 5 Replies
  • Posted By: ouch123
  • January 16, 2008
  • 03:00 AM

Having a tough time getting a diagnosis (or diagnoses) - would appreciate any thoughts on this:

Active, 80-years-young grandfather has severe arm pain that began gradually, then suddenly got much worse. It is his dominant arm, and the pain is so severe that strong pain medication (Vicodin) is not helping. Pain becomes so bad when he lies down that he can only sleep sitting up with his head tilted downward.

Symptoms began gradually about 6 months ago - just occassional numbness in a couple of fingers that went away by shaking/rubbing his hands.

After doing some painting in his carpentry workshop one weekend, the pain suddenly worsened. His entire arm and hand sometimes swell considerably for no apparent reason and there is intense burning. The hand/arm have at times become very red during such episodes, but not always. He's tried ice, long periods (weeks) of rest, etc. to no avail.

Pain medication allowed him to sleep lying down for a couple of weeks, but then the pain broke through.

He has seen several doctors, including a neurologist. Tentative diagnoses are both carpal tunnel and tendinitis, but neither of those seem to account for why the pain is so excruciating when he lies down.

He is not a complainer at all, but the pain is so severe that it is disabling. He cannot even use the computer.

He is a non-smoker and has asthma that is controlled with medication. No other health issues.

I suspect that the hand/arm pain is caused by multiple issues. Any ideas???

Thanks!

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5 Replies:

  • I came across a video on youtube of a young guy describing similar conditions that he encountered after taking the antibiotic Levaquin. You may also want to check this site: www.adverse-drug-reaction.net
    medpro5 2 Replies
    • January 16, 2008
    • 03:09 AM
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  • we have a great chiropractor in SE Arizona that might be able to help. In the meantime, acupuncture works wonders for arm pain, but you need to stick with it. Are you sure it's not heart related???
    Monsterlove 2921 Replies
    • January 16, 2008
    • 06:15 AM
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  • Thoracic outlet syndrome? Thoracic outlet syndrome is a combination of pain in the neck and shoulder, numbness and tingling of the fingers, and a weak grip. The thoracic outlet is the area between the rib cage and collar bone.Causes Thoracic outlet syndrome is a rare condition caused by compression of blood vessels and nerves in the area of the clavicle (collar bone). This compression usually is caused by the presence of an extra cervical rib (above the first rib) or an abnormal tight fibrous band connecting the spinal vertebra to the rib.People with long necks and droopy shoulders may be predisposed to develop this condition because of extra pressure on their nerves and blood vessels.Symptoms Symptoms of thoracic outlet syndrome may include:Pain, numbness, and tingling in the last three fingers and inner forearmPain and tingling in the neck and shoulders (carrying something heavy may make the pain worse)Weakness of the muscles in the handExams and Tests Upon lifting, the arm may appear pale due to compression of the blood vessels. The arm may be smaller on the side of the symptoms, as this is often a congenital anomaly (present since birth).Tests to confirm the diagnosis include the following:X-ray (may reveal an extra rib)MRI (may reveal fibrous band)Nerve conduction velocity studyElectromyography (EMG)Treatment Physical therapy helps strengthen the shoulder muscles, improve range of motion, and promote better posture. Treatment may also include pain medication.Surgery is used as a last step. Your doctor may use bypass surgery to reroute blood around the compression or remove the structure that is causing the symptoms. Your doctor may also suggest other alternatives, including angioplasty. Take grandpa to the doc.
    rad-skw 1605 Replies
    • January 16, 2008
    • 11:20 AM
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  • Have they checked Reflex Sympathetic Dystrophy?Reflex sympathetic dystrophy, also known as RSD, is a condition of burning pain, stiffness, swelling, and discoloration of the hand. Reflex sympathetic dystrophy includes other medical diagnoses, such as causalgia, Sudeck's atrophy, and shoulder-hand syndrome.Reflex sympathetic dystrophy occurs from a problem in the sympathetic (unconscious) nervous system that controls the blood flow and sweat glands in the hand and arm. The nervous system becomes overactive. A burning pain, swelling, and warmth are felt in the affected arm. If not treated, reflex sympathetic dystrophy can cause stiffness and a loss of use of the affected part of the arm.
    Anonymous 42789 Replies
    • January 16, 2008
    • 07:09 PM
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  • Thanks for all the helpful input! You've all shared several things that we hadn't thought of. We'll share the ideas with the doc and see where it takes us. Thanks Much!
    ouch123 1 Replies
    • January 17, 2008
    • 01:57 AM
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