Could the hand/arm issues be work related, an RSI of some other sort?

You might want to read on our thoracic outlet syndrome forum (TOS) for short...
What you describe sounds very familiar to the symptoms of TOS>...
here is the useful sticky thread on the TOS forum- post #1 there is a crash course of info links.. and some related things.
http://neurotalk.psychcentral.com/thread84.html

Many drs do not fully recognise TOS or the symptoms... so be aware of that...