Patient: I have continual left shoulder pain and spasms. My arm, thumb, index finger will go numb instantly in certain positions. I have see a chiropractor twice a week for 3 months to fix this problem without results. What should I do?
Doctor: According to your description, a cervical nerve compression must be ruled out in your case also an inflammation of the peripheral nerves at the level of the arm and hand, for example a Carpal Tunnel Syndrome. In the younger patients, cervical radiculopathy may be a result of a disc herniation or an acute injury causing impingement of an exiting nerve. In the older patient, cervical radiculopathy is often a result of spinal canal narrowing from bone (osteophyte) formation, decreased disc height and degenerative changes due to aging process. The treatment strategy usually includes: physical therapy program aimed to reduce pain and inflammation, and the use of anti-inflammatory drugs (as “motrin”, “advil”),TENS, also a re-education of habits and posture to improve quality of life. You should be independent in a stretching and strengthening program and continue with these exercises under the periodic supervision of a physical therapist initially and then completely on your own. Patients whose condition fails to improve with a comprehensive rehabilitation program and selective injections (medrol dose kit) should be presented with a surgical reevaluation. Often, patients should show progressive improvement over the first 6-8 weeks with conservative treatment.
Comments / Follow Ups
Guest: My partner is going through depression because of his chronic shoulder pain and he is on the waiting list for surgery (impingement of the nerve). He has isolated himself and sent me away because he ‘doesn’t want to lose me’ but he has lost hope in his future altogether. Will his depression stop when his shoulder is better? How long will it take for recovery from surgery?