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Dr. Mark
Dr. Mark, Doctor (MD)
Category: Health
Satisfied Customers: 11946
Experience:  U.S. Physician/Surgeon in Neurosurgery
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I have extreme nerve pain it feels like lightening bolts then

Resolved Question:

I have extreme nerve pain it feels like lightening bolts then after that pain goes away the tendon hurts for weeks and sometimes months. This has happened in my left elbow my right thumb and today in my right ring finger. What could be causing this? I have bilateral trigeminal and occipital neuralgia that is controlled by meds and rhizotomys. So I know what nerve pain is but these new symptoms are worring me
Submitted: 8 years ago.
Category: Health
Expert:  Dr. Mark replied 8 years ago.
This certainly sounds as if you are having peripheral nerve compression.

Numbness in the little and ring finger suggest a condition called "ulnar neuropathy", where the nerve in the groove of the elbow (also known as the "funny bone") can be compressed, and cause pain or numbness in the outer part of the forearm as well as in the pinky and ring fingers.

This can occur due to the pressure of the ligament over the elbow, pressing on the nerve, or by you, resting on your elbows while at a table, for example.

 

http://www.neurosurgeon.com/conditions/ulnar_neuropathy.htm

 

Also pains that are in the right thumb can be from carpal tunnel, where the median nerve is compressed in the wrist.

 

Often times, the best treatment is to remember to stay off of your elbows, not lie on your elbows at the table, keeping them padded so that there is no undue pressure on the elbows.

Should this problem persist, a test called a EMG and nerve conduction velocity can help to determine which specific nerves in the arm are responsible for the problem (and confirm the ulnar nerve as the culprit, if it is what we suspect here in this case), and then treatment can then be directed at that cause.




Customer: replied 8 years ago.
I have had an emg in the past and it showed i had moderate carpal tunnel bil. but surgery was not an option because when they did a nerve block in that area it only made the pain worsen. This new pain is much more acute and severe more like trigeminal pain. what could be the underlying cause of all these neuralgias?
Expert:  Dr. Mark replied 8 years ago.
When you have pain in the hands and fingers, it usually is a result of specific nerve compression.

I'm not sure why a "nerve block" made the pain worsen, since carpal tunnel pain is due to compression of the nerve, and if you had a test that showed this nerve was being compressed, surgery is an option.

Perhaps you would best be served by having another EMG and nerve conduction study performed, so they can look for both carpal tunnel and ulnar neuropathy.
Customer: replied 8 years ago.

The block only aggitated the nerve in my wrist making the pain worsen. So the surgeon said that releasing the nerve surgically would not help the pain. I can never get anyone to tell me why I have all of these nerve problems. like having trigeminal and occipital neuralgia bil and nerve pain followed by tendon pain and weakness in other areas of my body.

Expert:  Dr. Mark replied 8 years ago.
The nerve block could also have easily caused more compression by injecting a substance directly over the nerve. Of course, if there was not much compression in the first place, then surgical decompression would not help.
Customer: replied 8 years ago.
do you have an answer to the second half of my question?
Expert:  Dr. Mark replied 8 years ago.
Trigeminal and occipital neuralgia are also thought to come from compression of these nerves by blood vessels (trigeminal) or muscle / ligaments (occipital).

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