Ask a Gynecologist and Get Answers to Your Ob-Gyn Questions ASAP
Hello Terri Swan,
The spine nerves (neck, upper back, and lower back) supply our upper limbs, thorax/chest, abdomen and lower limbs. The upper limbs, and chest wall including the axilla (underarm) and breast are supplied by the neck nerves. The breast and underarm numbness, discomfort and sensitivity to cold (termed as paresthesia), with little and ring finger tingling is very likely to be associated with the pinched nerves in the neck. This can be due to degenerative disc disease on bone spurs pressing on the nerves (cervical spondylosis). Read about them in these resources;
With your family history of breast cancer, your apprehension is understandable, but these symptoms are not likely to be indicative of any breast disease.
Confirmation of the pinched nerves is done by MRI of the neck, nerve conduction study and electromyography (NCV and EMG). Your primary care physician will be able to get these investigations. You can get a referral for an orthopedist also.
Please feel free for your follow up questions.
The pain after lying down needs to looked for the following;
1) This can be again spondylosis of lower back and hip osteoarthritis.
2) Early morning stiffness or stiffness after lying down needs to be looked for a condition called as ankylosing spondylitis.
3) The mattress of your bed also can play a culprit in it. A mattress which sag too much or which is old and bit uneven can cause early morning stiffness.
Again physical therapy has a big role to play. Obviously imaging of these joints would be informative and give clue to the diagnosis.
Hello Terri Swan,
Do you have any breathing difficulty? Do you pain or other symptoms in breast tissue itself? Do you have any tenderness anywhere? Do you know self breast examination technique? Have you examined your breasts? Please let me know, if you have further concerns.
Let me answer you on the basis of the following;
1) Are your symptoms relate to any breast problem? The answer would be NO. Since you examine your breast regularly and there are no nodules felt, the symptoms you feel around the breasts and axilla can be better explained and seems to be more related to musculoskeletal pathology. As we discussed also, the very likelihood is pinched nerves (combination of the degenerative discs and bony spurs).
2) Any pathology related to breast? A very remote association can be of fibrocystic disease of the breast in which pain and nodularity of the breast and axillary region (breast tail) are the main symptoms with tenderness. This is a benign breast condition. Since you have no nodularity felt in the breasts, chances of this is quite less. It does occur in the age group of 30-50 commonly. And there are remission and aggravation of the symptoms. Read about the fibrocystic disease of breast;
3) What is the reason of your newer symptoms? Can be explained on the same musculoskeletal causative. Still I feel that a physician examination is important as it can decide more objectively the diagnosis and if needed further investigations can be initiated. The treatment and further management can be planned accordingly.
A trial of anti-inflammatory analgesic and a local analgesic spray can be done till you seek an appointment with your physician.
Hope this is helping you.
Please feel free for your queries.
You are welcome.
Did you tell your GP about the raised temperature, nausea and drenching night sweats? How much fever do you get? How does fever goes down? Are you stressed?
Yes, Terri, HRT doses may need to be increased. With your newer symptoms, I would atleast get up initial blood work up. Since your GP examined you, he must have not found any physical examination positive findings. So there might not have been any alarming thing, so called you after six weeks. Nausea, fever headache do warrant investigations. Please seek a fresh appointment with your physician in the light of newer symptoms. I am not sure of the tentative diagnosis at this point of time. But I feel, (whatever I can make out with this modality of information), breast should not be related with this. Axilla needs examination for any lymph node involvement/enlargement and so do the neck.
Please let me know, if you want to discuss it further.
Good to hear from you. Your initial evaluation of chest x-ray and blood work up is normal, so we need to concentrate on imaging for further evaluating the symptoms. Let me enumerate the things for which we are trying to find the answer; dizziness, which is more on lying down (off and on also), rapid heart beats, numbness underarms and breast area, lack of sensations, and itch spells. Please confirm me this and I will be right back to you.
Which specialist consultant are you contacting next week?
Sorry for this delay.
The symptoms you are experiencing may be related to the cervical spine and MRI of the neck is one imaging modality which should be done. Electrophysiological studies like nerve conduction velocity (NCV) and electromyography (EMG) may also be planned later on. The specialist to be consulted would be a neurologist. You can confirm your consultant whether they are neurological origin or vascular origin. Palpating or feeling your pulses would give the idea or any affection of the blood vessels. Although, I feel arteries should not be responsible for your symptoms. Dizziness can be explained on the basis of cervical spine affection and this is termed as cervicogenic dizziness or vertigo. Read the resource related to this;
I would also consider chronic fatigue syndrome or fibromyalgia for your symptoms, which are common in your age group. So you can discuss about them with your consultant.