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I have chronic pain in my upper left arm. The problem is…

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I have chronic pain...

I have chronic pain in my upper left arm. The problem is more pronounced at night when arm is at rest. The pain will wake me up.The pain is periodic through the night and improves when I get up. Heat or ice does not seem to help. Exercise with light weights doesn't help.

Doctor's Assistant: What seems to make the symptoms worse or better? Have you noticed any swelling?

No swelling noticeable. Lifting or moving heavy objects may exacerbate problem. Ice may help a bit temporarily.

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

Have seen a cardiologist. No problems there. Blood work in normal range.

Submitted: 9 months ago.Category: Medical
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Answered in 1 minute by:
11/17/2017
Doctor: Dr. Arun Phophalia, Doctor replied 9 months ago
Dr. Arun Phophalia
Category: Medical
Satisfied Customers: 39,103
Experience: MBBS MS. Post doctoral fellowship in Sports Medicine. General surgeon and sports medicine specialist
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Welcome to Just Answer.
Answers here are for education and information.
I will respond shortly with an answer, or further information request.

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Doctor: Dr. Arun Phophalia, Doctor replied 9 months ago

What is your age and gender?

Since when are your symptoms?

What are investigations / medical imaging done?

Are your shoulder and neck movements painful or restricted / limited?

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Customer reply replied 9 months ago
Age is 77. X rays negative except for arthritis. No restriction in neck or shoulders. Symptoms for at least 6 months. Have had 1 course of predisone. Good result but pain returned.
Doctor: Dr. Arun Phophalia, Doctor replied 9 months ago

Thanks for the additional information. I am writing the answer for you and will get back to you in 4-5 minutes. If you get a phone call request, you may ignore it as that is an automated site trigger. Thank you.

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Doctor: Dr. Arun Phophalia, Doctor replied 9 months ago

This is most likely due to the pinched nerves in the neck which is giving you night pain in upper left arm. This can be due to;

1) Herniated/degenerated disc in neck

2) Cervical spondylosis; bone spurs in the neck vertebrae pressing on the nerves.

Following investigations would be required;

1) X-ray of the neck spine

2) MRI of the neck

3) Nerve conduction velocity (NCV) study

4) Electromyography (EMG)

Following measures would be helpful;

1) Neck care in the activities of daily living.

a) No working on computer for more than half an hour in a single stretch. Same for TV.

b) Monitors and televisions exactly in front (180 degrees).

c) Contour pillow: Should fill the hollow when lying on back or straight. Available over the counter.

2) Anti-inflammatory analgesics like Ibuprofen

3) Acupuncture

4) Some physicians do give oral steroids in severe radiculopathy cases, in whom pain is quite significant.

5) Physical therapy: gradually increasing exercises from passive stretching to active against resistance regime.

6) Electrotherapy in the form of TENS, interferential and laser and ultrasound.

You may consult following specialists;

a) Orthopedist

b) MD in Physical medicine and rehabilitation.

The other possibility of the diagnosis can be frozen shoulder or Bicipital tendonitis.

Treatment is not vastly different, as discussed above. MRI of shoulder would be recommended.

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Customer reply replied 9 months ago
Thank you for your opinion. Will follow up.
Doctor: Dr. Arun Phophalia, Doctor replied 9 months ago

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Doctor: Dr. Arun Phophalia, Doctor replied 9 months ago

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