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Have pain in shoulder blade and upper back of arm with

Customer Question
numbness in first finger...
Have pain in shoulder blade and upper back of arm with numbness in first finger
Submitted: 6 years ago.Category: Neurology
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Answered in 11 minutes by:
11/27/2011
Neurologist: Dr Subbanna MD, Neurologist (MD) replied 6 years ago
Dr Subbanna MD
Dr Subbanna MD, Neurologist (MD)
Category: Neurology
Satisfied Customers: 5,821
Experience: American Board Certified Neurologist, Internal Medicine
Verified

Thanks for the question.

Please provide me the following additional details;

Are the symptoms on both the sides or only one side?

Is there any neck area pain as well?

Does the pain radiate or shoot down to the arm or hand/fingers?

Have you had any investigations done?

Any history of trauma or injuries?

Is the numbness in the thumb?

Any muscle weakness?

Best regards

Dr Sathya

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Customer reply replied 6 years ago
no neck pain.no pain down arm but tingling and numbness in first finger next to thumb.no investigations.no past history ,of trauma or injury.no weakness,just constant pain. symptoms on right side only.
Neurologist: Dr Subbanna MD, Neurologist (MD) replied 6 years ago

Thanks for these additional information; I will follow up at the earliest with all the details.

Best regards,

Dr Sathya.

(you may disregard the reply button unless you have more questions before my next post; this message was sent to convey you that I have already received your previous post, and when I am done with the typing of my answers I will follow up myself, and at the earliest)

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Neurologist: Dr Subbanna MD, Neurologist (MD) replied 6 years ago

Once again thanks for all the additional details and also thanks for the waiting.

Your symptoms appear to be secondary to what we call as cervical radiculopathy, which is nothing but pinched spinal nerves in the C spine area (Cervical spine or spine in the neck area). Generally patients experience pain in the neck area but there are some patients who experience pain in the adjacent area like shoulder blade, like in your case.

The pinching of the spinal nerve is due spine conditions like disc bulges, disc herniation, arthritis etc.

You need a test by name EMG/Nerve conduction study (a nerve & muscle test) of the arm, hand and neck along with an MRI of the C spine area. The EMG test will help in confirming the pinched spinal nerves, whereas the MRI will help in identifying the pathology in the neck that is causing the pinching of the spinal nerves like disc or arthritis etc.

The treatment options for the pinched spinal nerves & spine condition are grouped under 2 categories as below;

A) Conservative (non-surgical) treatments

B) Surgical treatments

The initial line of treatment for majority of the patients with pinched spinal nerve/spine condition is conservative (or non-surgical) treatment. It is mainly focused on pain control (symptomatic management).

Surgical treatment is considered only if the conservative treatment fails, or your symptoms worsen etc, and most of the patients do not require any surgical treatments.

The following are the conservative treatment options;

PT (physical therapy)

Ultrasound therapy

Heat & diathermy therapy

Electrotherapy including TENS & Interferential therapy

Traction therapy

Massage therapy

Chiropractor therapy

Laser therapy

Acupuncture

Pain medications like Pregabalin, Gabapentin, Amitriptyline

Muscle relaxants like Baclofen or Tizanidine

Anti-inflammatory oral pain medication like aspirin, ibuprofen (you have tried already)

Diclofenac anti-inflammatory pain medication skin patches to the painful area

Diclofenac anti-inflammatory pain medication skin ointment/creams to the painful area

Lidocaine anesthetic skin patches to the painful area

ESI (epidural steroid injections) etc

The above agents can be used alone or in different combinations depending upon the need and you may not require all these above treatments, I am just providing you with a list to show what your some options are now.

The finger symptom may also be due to some early onset carpal tunnel syndrome and the EMG test mentioned above will also pick that up, if you indeed have it. Some patients may have spine condition & carpal tunnel syndrome together (I am not telling you have both, just mentioning the possibility). If CTS is identified then the treatment for that will include wrist splint, physical therapy/occupational therapy to the hand, reduction in excessive repetitive movements of the hand etc.

I recommend you to see a neurologist in the clinic for the further needful that will include a thorough clinical evaluation/examination, investigations (MRI, EMG etc) & treatments as discussed above.

The above are my opinions & recommendations regarding the diagnosis and management of your symptoms and please ask me if there are any further questions.

Best regards

Dr Sathya.

Dr Subbanna MD
Dr Subbanna MD, Neurologist (MD)
Category: Neurology
Satisfied Customers: 5,821
Experience: American Board Certified Neurologist, Internal Medicine
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