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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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I am 65 years old female. In the last 10 years I have

Customer Question

Hello,
I am 65 years old female. In the last 10 years I have had two rotator cuff repairs, one from a fall left shoulder, one from a burr tear in the right shoulder. Both times the symptoms were pain fluctuating from the shoulder to the elbow area, with inability to raise my arm up, or across the front of my body. Now here is my question, I am presently having the discomfort from my shoulder and sometimes down to the hand (very occasional numbness and tingling in some fingers) - the only relief I receive is having my arm over my head - this stops all the symptom. Please note that this time I am not in excruciation pain like the last two rotator cuff incidents, at this point it is like a bad tooth ache. This time it is in my right shoulder. Not sure if it is rotator cuff or pinched nerved??? Thanks Shirley
Submitted: 1 year ago.
Category: Neurology
Expert:  Dr. Frank replied 1 year ago.
Hello. welcome to JA. Your situation is complicated by the rotator cuff tear. There are sensory nerve fibers as part of the SITS tendon complex, so a tear may cause localized pain, and radiate to the brachial plexus to get "referred" pain that is perceived down your arm. OR, it can be entrapped nerves as they pass through the axilla (armpit) into the arm and hand, or more superiorly and laterally to the upper arm. The only way to tell neurologically is to do the EMG test looking at the electrical properties of the nerves possibly involved, or to do a MR Neurogram looking at the anatomy of the brachial plexus, a bunch of nerves that sit between the neck and the shoulder, and send the nerves to the arm.
Expert:  Dr. Frank replied 1 year ago.
So to answer your question if this is a shoulder specific pain problem, or more about the nerves that pass in the area, you need a neurologist to look closely at your neurological exam into the arms, testing strength, sensory, reflexes. Then an EMG or MR Neurogram to confirm a suspicion. A third alternative is that this is vascular, from damage to the shoulder and a reduction in motion (frozen shoulder syndrome) and with that involvement of the subclavian artery which passes by and gives blood supply to the arm and to the brachial plexus. That needs a vascular study and a few tests by your doctor, like the Adson's test for shoulder and arm perfusion to exclude thoracic outlet syndrome. I hope that answers your question We can go into this in more detail over the phone if you wish. I will put out the phone option box. If interested, put your number and a time to call if not now into the box. JA charges extra for this premium service, but if interested just let me know. Or write back. If satisfied with this answer, please remember to rate this service by clicking on the rating stars, as that is how I am compensated for this work thanks *****