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Jan asked...

Tags: activity , injury , joint

About 3 months ago I suddenly had a pain in my arm. It was after a heavy bout of gardening and my arm felt brusied and I was unable to put my arm behind my back and other similar movements. I assumed it was just muscle pain. But I still have it. At the beginning my thumb became numb and I had a burning sensation at the tip which went after about 2 weeks. I had 2 chiropractor treatements becuase I thought it was a trapped nerve. No joy. I now think it is coming down from my shoulder pain (which I have had for years on and off anyway). I have researched on the internet and tried some exercises for arm and shoulder pain which I do every day such as holding a cloth with other hand and pulling my arm upwards at the back to the bra strap area. Not sure if I should just see what happens, see a physio or osteopath or get an mri to check what is going on. It is painful to drive, changing gears and hurts all the time. I cannot lift my arm above horizontal position without pain and other movements are restricted.

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The Answer

It is likely that you have a chronic shoulder rotator cuff problem and also an element of nerve root entrapment which is arising from your neck. The rotator cuff muscles move the shoulder and the associated tendons can get injured when doing heavy repetitive movements particularly above the head – e.g. lifting weights or cutting a high hedge. Swelling around those tendons results in shoulder pain with catching in certain positions. The shoulder and neck work together, so if the shoulder becomes dysfunctional the neck becomes tight with trapping of the nerve roots as they exit from the neck.

The tingling sensation in the thumb that you describe is typical of nerve root entrapment. It sounds like you have some chronic scarring/thickening of your rotator if this has been bothering you on and off for years. I would advise that you see a physical therapist for treatment but also to give you advice regarding shoulder and neck care in the longer term. If the symptoms don't settle, it would be worth getting a referral to a musculoskeletal doctor to decide on the most appropriate investigations and treatment.  If the problem keeps recurring and if standard physical therapies don't work, it is possible that an operation called 'subacromial decompression' may be an option.

Answered by Dr A Wright.

 

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