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Dr. Frank
Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 9000
Experience:  Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
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Left side of neck along top to shoulder, 24/7 pain. left arm

Customer Question

Left side of neck along top to shoulder, 24/7 pain. left arm weakness, itching, tingling. Cannot raise arm above shoulder height while holding anything, i.e. cannot put a dish on second shelve of cabinet. My orthopedic doc the MRI did not show anything that he would be able to help me with and that I should see a neurologist, said there is a chance of a pinched nerve could be as bad as Parkinson, I have been living with this for more then 6 months, pain 3 -4, strength good. It has progressed to 7-8 pain and strength almost none when lifting above shoulder. what do you think? I have had 6 weeks with PT, it seemed to ease pain but not strength.
Submitted: 1 year ago.
Category: Neurology
Expert:  Dr. Frank replied 1 year ago.

Hello. Welcome to JA. I will review your question and leave you a preliminary answer and probably ask some questions, you can then reply

Expert:  Dr. Frank replied 1 year ago.

With that degree of pain, and no orthopedic injury (I assume a rotator cuff tear or impingement is out of the question?) then I would suspect you have either a C4 or 5 cervical radiculopathy from cervical stenosis in the spine at that level, something called spondylolysis or a series of bone spurs which are trapping the nerve, and/or you have involvement of the upper portion or trunk of the brachial plexus, something called a brachial plexopathy, or parsonage turner syndrome. To figure that out, I wanted to ask some questions. Do you have any numbness anywhere on your shoulder or hand? The weakness you said involves elevation of the arm (with the arm straight to the side or in front?) and do you have weakness in your biceps (curling with your arm)? What about your grip strength, wrist movements flexor and extensor? all normal? Do you have pain increasing when you cough or sneeze or move your neck in any direction? Please get back to me, have you had any imaging of your neck/cervical spine? Dr Frank

Customer: replied 1 year ago.
entire arm tingles and and gets numb. can do side and front straight up is difficult, so both. no weakness in biceps grip and wrist normal strength. pain increases with movement. MRI on shoulder and back, thanks
Expert:  Dr. Frank replied 1 year ago.

HI. So this problem suggests an upper trunk brachial plexopathy if both the shoulder and neck issues are resolved based on MRI findings. What I would suggest is you request a special MRI called a MR Neurogram, which looks at the nerves of the brachial plexus to identify the injury. You might need a series of sophisticated blood studies to see if you had an autoimmune response with elevations of IgG antibodies like anti GAD antibody, etc. A Neurologist will do these tests, and also a EMG/NCV test to look at the electrical properties of the plexus.

Expert:  Dr. Frank replied 1 year ago. Here is a webpage that shows the MR neurography concept. This is done primarily at academic centers. Please get back to me with questions, or if you see a neurologist, come back with the results if you do not understand them and I can explain it to you. Please remember to rate my answer as that is how I am compensated for my work. Dr Frank