Folks,

I'm wondering if I'm a good bet for some kind of neuropathy. I've been battling shoulder and now elbow pain for a year + and have seen several orthos, physiatrists, chiropractors, etc. with no help or relief. It's just now, one year later, that a recent shoulder specialist indicated that I may have "nerve" issues.

Here's a little history:

* Initial Injury: About a year ago, I felt something "give way" in what I thought was my back or traps. I felt like it was a muscle pull in my trap area. Didn't think much of it and ignored it for 2-3 months. This then morphed into more of a posterior shoulder pain.

* MRI Results: Got an MRI which showed posterior partial tears in my capsule ligaments. Orthos didn't think much of it.

* Original Diagnosis: "Scapular Diskinesis." Something that PT should solve they said. Given a very low "significance score" in terms of the injuries.

* Physical Therapy: Made it worse. New burning type pain on my scap and armpit joined the party. This pain seemed to seep into my upper arms at times. I also felt some wierdness in my fingers. This drove me to get both a cervical MRI and EMG.

* MRI/EMG Results: Zippo. As a result, Neurosurgeon's continue to boot me out of their office.

* New Symptoms Soon After: Twitching muscles around the scap. This then blew up all around my body (after searching the internet and finding that this is a symptom of ALS...great), but was most prevalent around my right shoulder blade and mid back area.

* New Symptom Most Recent: Severe, ACUTE elbow pain. I was about to have arthoscopic surgery on my shoulder and all of a sudden I couldn't bend my right elbow without getting excruciating, debilitating pain. Funny though, it's fine if I have my elbow at my side, but if my elbow is positioned away from my body and I bend the arm...BAM! This pain petrifies me. This pain is located above the elbow, not below which makes me believe it is NOT tendonitis related. I also believe it is more towards the inside of the elbow, but the outside of the elbow (and tricep) get into the act.

* Latest Diagnosis: Went to a shoulder specialist at Beth Israel in Boston and he didn't think anything was structurally wrong with my shoulder and thought my issues were more nervy. Now I'm on neurontin and seeing some improvement in the elbow issue.

After doing some research online, it seems like a lot of what's going on could line up with Thoracic outlet syndrome or maybe ulnar or radial nerve entrapement. At minimum, I feel like there's got to be something going on in terms of nerve compression.

Does this at all lign up with anything specific?

Do any of you share the same symptoms I have?

I'm really at a loss. I feel like I need to start over. I was just about to have shoulder surgery, and now with this new elbow pain I'm thinking that's a rotten idea. Who should I seek out at this point? A neurologist?

I need to start "Book 2, Chapter 1" of this ongoing saga.
Thanks.

KY

I have long standing shoulder issues. In the course of seeing numerous doctors, some have suggested Brachial neuritis. At the same time, the ortho who did surgery on my shoulder also tells me that there is a nerve bundle associated with the shoulder. I have had the excrutiating elbow pain which appears on the outside of the elbow. It hurts so much that I can't bend it when its flaring up or even if its just doing nothing, like in a neutral position, and then at other times its fine. Bizarre to say the least, but its been happening to me for over ten years now. I also get a lot of nerve pain of a burning nature in the upper part of my arm of the affected shoulder. After reading your post, this hit home with me, FWIW, I had glenoid labral tears with shoulder instability and my shoulder would dislocate and render my arm useless. This came from a car accident and I guess that is why the nerves are all messed up, but this is what I've been able to deduce from all the doctors whom I've seen. I seriously went through a bunch of doctors before getting the proper diagnosis and a competent doctor to get it fixed, but I had a long time of suffering with this before they got it right. I don't know if my story helps you any, but its something for you to research ref. the brachial neuritis. Best of luck to you and take care.

I saw a number of neurologists, none of whom diagnosed my neuropathy correctly, and it turned out to be fairly standard SFN in feet and arms, so just seeing any neurologist might not be the best way to go. I would recommend a centre that specializes in neuropathy. If you go to the Neuropathy Association website they list a number of centres that specialize in neuropathy.

Hi I am sorry about your pain and also left without a dx. It can time to get a dx which I know is frustrating. I was going to also suggest RSD. I have PN and RSD. Some of the symptoms and how you developed this lean to RSD. I am no expert but you may want to read up on that as well. Yes I would see a neurologist. Who is rx the neurontin and what type of specialty sent you for the other tests? The neurosurgeon? I am glad you are feeling benefits from the neurontin.

EE,

What did they diagnose you with?

I've suspected a shoulder problem, maybe a labrum tear, but so many orthos and other have evaluated me and can't find much wrong with my shoulder. There's some partial tears in there, but most say "nothing abnormal for a 42 year old."

The funny thing is that I was scheduled to have shoulder surgery in less than a week. Reading up on some of these conditions, if I indeed have one, it sounds like surgery could make them worse.

I feel like I'm in the early stages of...something. It's been two weeks with this elbow pain and no sign of it letting up. The neuontin has cut the edge off, but I know it's still there.

Any advice anyone can give me to help diagnose what's going on would be of great help. I'm going to see a local neurologist in the southeeastern MA area. Also going back to my ortho to explain the situation and have the elbow checked out.

Should I look into some other type of doctor?

What's really annoying about this situation is that for months I've been trying to explain this "other" type of pain I have on the scap/armpit/upper arm along with muscle twitching and spasms. Pretty much ignored. It wasn't until I basically can't move my arm that I'm getting attention.

Really hoping my initial injury caused some nerve entrapement of some kind that needs to be released.

Thanks.

KY

SFN? What's that? I don't see it listed.

The closest neuropathy center is in NYC, not too close. Was hoping there was one in MA.

Any other avenues that make sense?

I've seen on the TOS thread that many get diagnosed by cardiac surgeons.

I just want to waste as little time as possible. God knows I'm going to walk into this neurosurgeon's office and get about 10 minutes of their time...where they don't actually listen to me...and probably recommend an EMG that doesn't detect anything.

I want to walk in there with a list of diagnostic demands. Understanding what you've been through, what would you ask right away? What would you have them do? I feel like I almost need to slap these doctors to wake them up so they will listen and go the extra mile.

KY

Ugh. Just read up on RSD. The one thing that hasn't emerged or doesn't present is any kind of hand symptom. And that seems to be what everyone checks...see if I have cold hands...discoloration...strength issues. Nope. Although, maybe it will progress that way. I have been getting a jolt now and then to the thumb.

I recently got a 3rd opinion from a shoulder specialist at Beth Israel. He's the one who said a) shoulder seems fine, and b) you're symptoms are more nervy. So, he said go neurontin. Thinking back on this, I'm now wondering, "why the heck didn't he refer me to a neurologist?"

As for the other tests:

* MRI Arthogram of shoulder -- ortho sent me.
* Cervical MRI -- Neurosurgeon. This neuro actually indicated that TOS is a possibility, but he didn't think so.
* EMG -- 2nd ortho. Came up clean. (Of course).
* MRI of chest / Lat area -- Clean. Did this because of the burning scap/armpit pain that also seems to extend down below my armpit into my rib area.

So frustrating. What started out as a discomfort or annoyance in the trap area migrated to the posterior shoulder, then midback/armpit, then upper arm, now the elbow.

I need to stop this in its tracks. I feel like I'm at the beginning stages of ONE of these neuropathies based on initial research.

KY

Ky, I messed up the other reply. I should have written Brachial Radiculitis. Search for that and read up on it. My diagnosis was Glennoid Labral tear. The dislocation happened when I was trying to get a diagnosis. It wasn't provoked, it just happened. A neurosurgeon gave me the Brachial Rad. diagnosis several years back. I have burning pain in the scapula, the posterior shoulder, and the upper arm. The elbow comes and goes. When its bad, it can stay bad for several weeks before it calms down again. Then it eases up for awhile before the cycle repeats. I've been seeing a pain management doctor who has performed some radio frequency ablations to try to control some of the pain, but I still get the upper arm, elbow, scapula, and posterior shoulder pain. It seems as though its difficult to control. I use a tens unit and I'm on meds, but none of the anticonvulsants.

EE,

Thanks.

There are certainly some things I have in common with brachial radiculitus:

* Sudden onset of symptoms.
* Right shoulder primarily.
* Trauma: Think this is my original injury.

The wierd thing is, I have pretty good strength still in certain movements. For example:

* Bicep curl with elbow at side: Did 25 lbs x 10 reps yesterday
* Lateral Raise: Did 15 lbs x 10 reps.
* Narrow Grip Press Machine: Scared as hell to do this because I bend my elbow, but it's in tight to my body, but could do a low weight (70lbs).

So there's strength, but then there is EXTREME pain when I a) move the elbow away from my body, and b) Bend the arm at the elbow. I also have a low level, irritating, somewhat burning pain on the shoulder blade/in armpit/down rib.

Now this elbow pain just emerged two weeks ago so it may be that other symptoms may emerge. Based on everything I'm reading, it seems like a no-brainer that I have something fouled up in the brachial nerve complex.

Are there any specific diagnostic tests I should push for to get this diagnosed? Besides an EMG?

Thanks.

KY

I don't know. I also have neck issues so its hard to discern which tests are for what. I've had multiple MRI's, multiple EMG's over the years, and a discogram. I've seen an orthopedic doctor and a neurosurgeon and it was the neurosurgeon who arrived at the diagnosis. I exercise my arm and shoulder daily, but certain movements will aggravate the pain. I do these exercises to maintain use and prevent a frozen shoulder and muscle atrophy. Its been stressed by all the doctors I've seen and I can't do any overhead lifting. If it were me, I'd go back to a good orthopedic doctor and discuss it with them and see if seeing a neuro surgeon might be the way to go or look for an orthopedic doctor who specializes in shoulders.