[Rolacoy]

I will be very brief, i only have one working arm.

I had been having slight shoulder pain (level 2) for a year or so, I think it was from back & neck problems. Aug 22 I was working in the yard and strained my neck and left shoulder. Later that evening the pain level 8. It has got some better, pain avg 3.5 with about 25 mg of Loratab per day. It seems to be pinched nerves. I have been to 5 doctors, family dr, nerve dr says that two nerves are pinched, C-5 & C-6. Neck dr, shoulder dr, and neurologist find nothing that is causing the problem. They have done MRI's and CT scans of my shoulder, neck and head.

I am 71 years old. I don't know if this has anything to do with PsA or not. I was diagnosed with Psoriatic Arthritis about 3 yrs ago. I took MTX for about 1 1/2 yrs. My PsA was light enough that I was able to get off MTX according to blood work every 2 months.

My Arthritis immediately checked for symtoms of Reflex Sympathetic Dystrophy Syndrome when I told her what had happened. Later that day the neurologist also said that it must be Reflex Sympathetic Dystrophy Syndrome. So what do I do now?

[keep smilin]

Originally Posted by Rolacoy

I will be very brief, i only have one working arm.

I had been having slight shoulder pain (level 2) for a year or so, I think it was from back & neck problems. Aug 22 I was working in the yard and strained my neck and left shoulder. Later that evening the pain level 8. It has got some better, pain avg 3.5 with about 25 mg of Loratab per day. It seems to be pinched nerves. I have been to 5 doctors, family dr, nerve dr says that two nerves are pinched, C-5 & C-6. Neck dr, shoulder dr, and neurologist find nothing that is causing the problem. They have done MRI's and CT scans of my shoulder, neck and head.

I am 71 years old. I don't know if this has anything to do with PsA or not. I was diagnosed with Psoriatic Arthritis about 3 yrs ago. I took MTX for about 1 1/2 yrs. My PsA was light enough that I was able to get off MTX according to blood work every 2 months.

My Arthritis immediately checked for symtoms of Reflex Sympathetic Dystrophy Syndrome when I told her what had happened. Later that day the neurologist also said that it must be Reflex Sympathetic Dystrophy Syndrome. So what do I do now?

Welcome.... If your neurologists is knowledgeable about RSD, please ask about doing nerve blocks..soon. Time is of the essence... Better success rate... And remember do not use ice.. That will only aggravate your condition.. Otherwise turn to us with questions and concerns...

Take good care, Kathy

[Russell]

Welcome Rolacoy,
Don't just visit join the family. As far as what Kathy said I second that. Please let us know how it goes.
Best of luck to you...

[Rolacoy]

I have been using ice all of the tine. It feels good, how does it harm the healing process? I think my neurologist knows very little about this. My next appt is not for 2 months. I agree I need a different doctor. Who should we see, we live just west of Shreveport, LA?

Also how can I be sure I have Reflex Sympathetic Dystrophy Syndrome. I know the neurologist was guessing. Here is the meds they have me on.

Dairy Digestive Supplement - at least one a day

St. Joseph 81 MG - 1 each day

Omepraxole 20 MG - 1 per day ( anti-acid)

Meloxicam 15 MG - 1 each day (anti-inflammatory)

Hydrocodon Acetaminoph 7.5-500 (1/2 tablet every 4 hours for pain)

Methocarbamol 750 MG (1/2 tablet every 4 hours muscle relaxer)

LYRICA 75 mg Capsule for Nerve pain, (2 in am, 1 lunch and 2 in pm)

Fanasteride 5 mg (replaces Avodart for prostrate)

Cymbalta 30mg (to heal nerves)

It's a bunch of drugs and I don't like taking so much. I am in physical therapy twice a week. If this is what I have I need som help soon.

[Jomar]

Can you describe your pain and any odd skin sensations in more detail?
do any of these fit?
burning skin
skin color changes
swelling
extreme sensitivity to touch or breezes

these are just a few of the main RSD symptoms that are usually mentioned.

If not many fit, you may want to read on our Thoracic outlet syndrome forum (TOS) - to see it it fits.
I thought of it because of your comment -
"strained my neck and left shoulder."
here's the link to the useful sticky thread there-
http://neurotalk.psychcentral.com/thread84.html

[catra121]

RSD affects everyone differently, some people have all the symptoms, some only a couple, some symptoms come and go, some things come after a long time. Unfortunately there is no test to find out if it is or is not RSD...the symptoms have to fit and a certain number need to be observed by the doctor to give the diagnosis of RSD. This stinks because often times you end up getting a lot of testing to rule out other stuff before the diagnosis of RSD comes into play and by then you have lost a lot of time.

The important thing though is that if there is even a suspicion that you have RSD you should not be waiting 2 months to see a doctor about what to do next. Acting on it FAST is SO critical if it is RSD. If is not, then nothing hurt by seeing a specialist quickly. Try to find a doctor who specializes in RSD/CRPS and get in to see them as soon as possible.

I pray for your sake that it is not RSD. If you let us know more about your symptoms or any specific questions we can try to help you.

Some of the meds you are taking would be given if it is RSD...some not. Do you know if there are any that are particularly helpful or which ones are not? Everyone is different with meds...but I know that Hydrocodone was of ZERO help to me and I remember reading somewhere that it's not effective for RSD pain (but everyone is different so that's not a definite by any means). I also know that with RSD ice and cold are usually aggravate the pain, with heat generally helping with the pain.

If some of the things you read don't seem to fit then that may be a good sign that it is NOT RSD (and that would be wonderful news). Good luck, and I hope that you find the answer about what is causing your pain soon so that you are able to get some relief.

[Rolacoy]

I subscribe to a web site called "Visible Body". On the site subscribers can view the whole human body in 3-D. It can be rotated to any angle, zoom in or out. Body parts can be made visible or invisible. I used it to turn off everything but the bones and nerves in the arm and shoulder. The nerve from C-6 goes right to the four finger and thumb. It feels as if my problem is only on that nerve. Also that nerve is very sensitive. Several times recently I have caused my arm to go numb by laying or leaning back in a chair, putting pressure on the nerve under my shoulder blade.

burning skin -------------------- Yes, at first my whole thumb and four finger felt as if they had been scalded, that has improved, now only when I wear wrist support that binds them. They always seem warm to the touch. At first my four arm and upper arm burned, that is much better. It seemed to improve from the top down.

skin color changes --------------- I don't think so.
swelling --------------- I don't think so.

extreme sensitivity to touch or breezes --------------- very much so, maybe not a breeze, but any place along the nerve that I referenced above.

As far as the meds, I have been on 15mg per day, that two pills, for more than two years for back problems. Since this happened I am taking 3 pills per day. I think they help. Sometimes, not often I take a 7.5mg Hydrocodone and I feel pain relief in about 30 minutes. As far as I can tell the LYRICA and Cymbalta, I see no difference. I think they were prescribed for "maybe these will help".

[LIT LOVE]

Ice can can cause nerve damage. Do not use it at all until RSD is ruled out.

My best explanation of what RSD pain is like for me, is when you stub your toe, and have that intense burning pain for a few seconds? It's like that, but it doesn't go away. It's much worse than post surgical pain (except for the day of surgery.)

Having someone lightly graze the RSD effected area will be more painful than if normal pressure is applied. You can test this by skimming a cotton sheet over the painful area.

If it is RSD, you must get URGENT CARE. You need a new doc for sure, if he believes you might have RSD, you should have a follow up appointment in a week! He's also throwing you on too many new meds at one time...

[Rolacoy]

How do I find a neurologists that is knowledgeable about RSD? Are they listed that way?

I did not use ice lasgt night and my arm feels no worse so I will leave the ice alone till I learn more.

I really thank all of you for the help.

[mrsD]

Originally Posted by Rolacoy

How do I find a neurologists that is knowledgeable about RSD? Are they listed that way?

I did not use ice lasgt night and my arm feels no worse so I will leave the ice alone till I learn more.

I really thank all of you for the help.

I have a suggestion based on your drug list.

Omepraxole 20 MG - 1 per day ( anti-acid)

Drugs that lower acid in the stomach when taken over a long period of time, (months) will block your body's ability to absorb B12 from food. They also block, magnesium, calcium, zinc, folate, and iron absorption.

All people in the US are now recommended 50 yrs and older to take B12 supplements separately from food and other vitamins.
This is because the older we get the less we make acid anyway.

I would get tested for B12 level, and it should be over 400 (US units). The lab ranges in US are still reported using the old scale, where 200 is considered "normal". In the 200's you can have significant nerve damage. The new scale starts at 400. When your B12 falls, nerve functions become impaired, and if not fixed, and raised, properly, you can suffer permanent impairement. This is a simple blood test.
While you are there get a Vit D too.

Here is my B12 thread:
http://neurotalk.psychcentral.com/thread85103.html
There are medical links with diagrams in it...one is to American Association of Family Physicians.

Regarding the Visible Body... that is a great site, but it some of our members may not be be able to afford its monthly charge.

This link offers a similar 3D body view.... for free.
http://www.healthline.com/human-body...ous-system#6/5

It is not quite so stunning, but maybe useful still for some here.