Is there a doctor in the house? OUDoc? Achiro?

[Soonerbabeinbama]

I've got this shooting pain in my shoulder blade - the pain radiates from my shoulder to my arm to my hand. (right side) I am also eperiencing numbness in my arm and hand - particularly between my thumb and index finger. I've had this for about two months now - got a cordisone shot and muscle relaxers, but hasn't helped. The numbness is getting worse and this morning i even dropped a coffee cup - couldn't feel it. First comes the pain, then the pins and needles sensation and then the numbness.

I've got an appointment with my neurologist on Thursday. Would he be the one to talk to about this? Thanks!!

[OUDoc]

I've got this shooting pain in my shoulder blade - the pain radiates from my shoulder to my arm to my hand. (right side) I am also eperiencing numbness in my arm and hand - particularly between my thumb and index finger. I've had this for about two months now - got a cordisone shot and muscle relaxers, but hasn't helped. The numbness is getting worse and this morning i even dropped a coffee cup - couldn't feel it. First comes the pain, then the pins and needles sensation and then the numbness.

I've got an appointment with my neurologist on Thursday. Would he be the one to talk to about this? Thanks!!
Yes, probably. I would have done an MRI on your neck first, but it most likely involves a pinched nerve, with the symptoms you described (as long as it's not cardiac-related, which it shouldn't be after 2 months). See the neurologist, he'll get an MRI and go from there. Take something for the pain until you see him/her.

[OUinFLA]

If you were a guy, I know what I would tell you to quit doing.
Kittens around the world would appreciate the advice as well.

[achiro]

I would start with x-rays first, also would start with a chiro over a neuro but I'm a little bias.:D
You've already dealt with it for 2 months so another couple of weeks wouldn't be a big deal in the scheme of things(usually). Keep your neuro appt. figure out what he/she has to say but you could probably get into a chiro between now and then and at least find out what they have to say. A good one will let you know if they can'T help you and offer suggestions.
In all seriousness, this is something I see very often. Most times I can help, usually within just a couple of visits. Most of the time I will know if I can help just with the history and exam.

Good luck and keep us informed.

[crawfish]

SMACKDOWN!!!

[achiro]

MRI? X-Ray?
Finally! The medical debate we've been looking for. I'm with OUDoc.
Xray-$20-$200
Find out structurally what you are dealing with, x-rays can tell us a bunch. You can usually tell from the disc spacing and bone structure what is going on. With her symptoms, we already know that if it's not structural, then it is gonna be disc or some other soft tissue variant(cyst, tumor), some of which would show on xray as well. If it's disc, the only questions I have are is the disc herniated or fragmented. If it's herniated the adjustments will often help. If its fragmented, the adjustments can help but it becomes more temporary relief. If I have a patient that has not responded in the time frame that I expect, usually a week or two depending on the issues then I would move to the next step. That would probably be an MRI. That couple of weeks will not compromise anyones health in the big picture.
Depending on the findings of the MRI we may continue care, we may refer, or we may co-manage.

MRI is a great test. BUT...I always have to ask the question that based on the history, what are the differential diagnosis'? Based on the dd list, what findings would I have from that test(mri) that may alter what I would do for care. Most of the time, it wouldn't change what I do so I move on without it. I will not hesitate to order an MRI though if conditions warrant it.

Believe it or not the good old history and physical exam still give most answers, the x-rays, mri, etc are to fine tune those answers to give us t

[achiro]

I should add that I don't think that doing the MRI first is wrong. Just not the order that I personally would do thing most times.

[Soonerbabeinbama]

Xray-$20-$200
Find out structurally what you are dealing with, x-rays can tell us a bunch. You can usually tell from the disc spacing and bone structure what is going on. With her symptoms, we already know that if it's not structural, then it is gonna be disc or some other soft tissue variant(cyst, tumor), some of which would show on xray as well. If it's disc, the only questions I have are is the disc herniated or fragmented. If it's herniated the adjustments will often help. If its fragmented, the adjustments can help but it becomes more temporary relief. If I have a patient that has not responded in the time frame that I expect, usually a week or two depending on the issues then I would move to the next step. That would probably be an MRI. That couple of weeks will not compromise anyones health in the big picture.
Depending on the findings of the MRI we may continue care, we may refer, or we may co-manage.

MRI is a great test. BUT...I always have to ask the question that based on the history, what are the differential diagnosis'? Based on the dd list, what findings would I have from that test(mri) that may alter what I would do for care. Most of the time, it wouldn't change what I do so I move on without it. I will not hesitate to order an MRI though if conditions warrant it.

Believe it or not the good old history and physical exam still give most answers, the x-rays, mri, etc are to fine tune those answers to give us t
did you say tumor?:eek:

[JohnnyMack]

I like to play Dr.

[BoogercountySooner]

Possible bulging disc in your neck Babe. The MRI will tell you. No I'm not a doctor nor did I sleep at a Holiday Inn Express last night. I had the same symptoms and that was my diagnosis.

[BeetDigger]

did you say tumor?:eek:


He also said it could be a lot of other things Ms. Glass Is Half Full. Think pinched nerve.

[Soonerbabeinbama]

what can be done for it - other than chiropractic adjustments? Stop drinking coffee?

[Soonerbabeinbama]

He also said it could be a lot of other things Ms. Glass Is Half Full. Think pinched nerve.


sorry beet, paranoia is my middle name "Soonerparanoiababeinbama".
I try to steer clear of doctors if at all possible. they skeer me!!!:eek:

[BeetDigger]

sorry beet, paranoia is my middle name "Soonerparanoiababeinbama".
I try to steer clear of doctors if at all possible. they skeer me!!!:eek:


Understandable. I don't trust doctors either. Just look at the one's we have on the board. Would you trust them?


:D

[OUinFLA]

Would you trust them?


:D

Apparently, Yes.
At least enough to fuel her paranoia.

[Penguin]

http://img105.imageshack.us/img105/6563/arnold7wh.jpg


It's not a tu-ma!

[GottaHavePride]

what can be done for it - other than chiropractic adjustments? Stop drinking coffee?

I seriously doubt coffee-drinking or lack thereof will affect it if it is a peenched nerve.

[Soonerbabeinbama]

I seriously doubt coffee-drinking or lack thereof will affect it if it is a peenched nerve.
actually i was referring to my not being able to hold a coffee cup. if i don't drink coffee, then i won't have to worry about dropping my coffee cup.:D

[GottaHavePride]

Ah. Gotcha.

[StoopTroup]

Drink coffee with your left hand.

YWIA :D

[Soonerbabeinbama]

[QUOTE=StoopTroup]Drink coffee with your left hand.

YWIA :D[/QUOTE

thank you stoop - but i prefer to drink coffee with my mouth!;)

[StoopTroup]

Fine...

Then drink it out of your hand with your mouth...lol

[12]

A person asking for medical advice on a message board just caused my premium to jump 29 bucks.

Gee thanks!:)

[12]

Hey OUDoc, my left femur really hurts and I have a nosebleed when I pee. Can you give me a diagnosis?

[OUinFLA]

actually i was referring to my not being able to hold a coffee cup. if i don't drink coffee, then i won't have to worry about dropping my coffee cup.:D


these might be fun and solve your problem :D


http://www.toyconnection.com/Merchant2/graphics/00000001/straw.jpg

[Soonerbabeinbama]

these might be fun and solve your problem :D


http://www.toyconnection.com/Merchant2/graphics/00000001/straw.jpg
they might be fun for some things, but sucking hot coffee through a straw is never a good idea!!:eek:

[Soonerbabeinbama]

A person asking for medical advice on a message board just caused my premium to jump 29 bucks.

Gee thanks!:)
relax, i've already peemed OUDoc and Achiro and told them i would pay on my way out!!:rolleyes:

[12]

Yippee!

[crawfish]

Worst smackdown EVER.

[BeetDigger]

they might be fun for some things, but sucking hot coffee through a straw is never a good idea!!:eek:


It's probably good practice however. :D

[batonrougesooner]

I would think weakness such as yours resulting in dropping a cup would indicate an MRI. But I'm no chiropractor.;)

[achiro]

I would think weakness such as yours resulting in dropping a cup would indicate an MRI. But I'm no chiropractor.;)
Why? Seriously. Based on the History, I can already tell you basically what is going on. Unless she thinks surgery is the only thing she would want to try, I don't think an MRI is needed as the first step. LIke I said before, why not try something a bit more conservative for a week or two, see how things go, then move on if needed. If it's not working then do an MRI to check things out and go from there.
I just went through this with 2 patients in the last three weeks, low back pain with radicular symptoms both almost identical symptomatically. Both had no trauma and no history of similar problems. I did x-rays and a physical exam, both had similar findings. Explained pretty much what I have in this thread to both. One responded wonderfully and is already symptom free using only chiro care. The other responded some but not like I wanted so we sent for an MRI. His disc was fragmented so we discussed his options. Option 1 was to continue and maybe get slightly better but probably not permantly, Option 2. Talk to a neurosurgeon about options, outcome probabilities, side effects, and dangers. Option 3 was to do 1 while waiting on 2(my suggestion) which is what he chose. Which moved to either sticking with 1 or going ahead with the surgery. He has chosen surgery, which I also recommended based on the MRI and discussion with the neuro.
Although I am "just a chiro" I am happy with what we did in both cases. IN one, we saved him a bunch of money and he is doing great, in the other we tried to handle it conservativaly and moved on when he didn't respond as well as hoped. It delayed things by a whole 2 1/2 weeks...I think its worth it, so did he.

[Soonerbabeinbama]

Achiro, are you saying the only alternative to maybe some kind of therapy or adjustment would be surgery? Uh-uh - no way I'm having surgery. I'll be gimpy-handed the rest my life before i get cut on!!!

[OUDoc]

I mention MRI because 1) it's available and 2) it will tell you exactly what's going on.
It's not the cheapest or always necessary, but it's what I'd do for my family if I was given the choice.


Hey OUDoc, my left femur really hurts and I have a nosebleed when I pee. Can you give me a diagnosis?

Your testicles never dropped. You probably should have noticed that before now.

;)

[IB4OU2]

Achiro, are you saying the only alternative to maybe some kind of therapy or adjustment would be surgery? Uh-uh - no way I'm having surgery. I'll be gimpy-handed the rest my life before i get cut on!!!

What does a gimpy hand have to do with a lobotomy? :confused:

[achiro]

Achiro, are you saying the only alternative to maybe some kind of therapy or adjustment would be surgery? Uh-uh - no way I'm having surgery. I'll be gimpy-handed the rest my life before i get cut on!!!
You've already tried the injections?
then I would say that the answer would be probably. I don't think anyone WANTS surgery, and a good surgeon would tell you if there are alternatives but many don't.
There may be other options but of the top of my head, some(in order of aggressiveness) would be:
Do nothing and live with it
Massage
Adjustments
PT/Ultrasound/muscle stim
Decompression
Acupuncture
Anti-inflamms
Corticosteroids
Surgery

Many of those could be used together. (massage, chiro, and pt work great together for many issues)

Just to be blunt, based on what info you've given(I'd want to do an exam first to verify my thoughts) I'm pretty sure that I could give you some relief on your first trip into my office. I've seen it happen way to many times to think otherwise.;)
I would say this, whatever you decide, do it soon because there is nerve involvement and if you let it go too long, it can damage the nerve.

[Sooner_Bob]

Mmmmm. Massages . . .

[achiro]

Mmmmm. blunt . . .
:eek:

[Soonerbabeinbama]

You've already tried the injections?
then I would say that the answer would be probably. I don't think anyone WANTS surgery, and a good surgeon would tell you if there are alternatives but many don't.
There may be other options but of the top of my head, some(in order of aggressiveness) would be:
Do nothing and live with it
Massage
Adjustments
PT/Ultrasound/muscle stim
Decompression
Acupuncture
Anti-inflamms
Corticosteroids
Surgery


Many of those could be used together. (massage, chiro, and pt work great together for many issues)

Just to be blunt, based on what info you've given(I'd want to do an exam first to verify my thoughts) I'm pretty sure that I could give you some relief on your first trip into my office. I've seen it happen way to many times to think otherwise.;)
I would say this, whatever you decide, do it soon because there is nerve involvement and if you let it go too long, it can damage the nerve.
Can you give me directions to your office please?:O
I do have a friend here who is a chiropractor. Uh, just how involved are these massages. I don't know that i would feel comfortable with him giving me a massage - you know. Of course, I don't have to go to him. He would probably give me a better deal though - money wise!! All I've done is go to an MD and have a cortisone shot and he gave me muscle relaxers. He basically told me that it was probably a crick in my neck and he called it the "It's a bitch backing out of the driveway" syndrome. Sigh. The muscle relaxers relaxed everything but my shoulder / arm / hand. They just make me very sleepy. Is this like carpal tunnel syndrome?

[achiro]

Can you give me directions to your office please?:O
I do have a friend here who is a chiropractor. Uh, just how involved are these massages. I don't know that i would feel comfortable with him giving me a massage - you know. Of course, I don't have to go to him. He would probably give me a better deal though - money wise!! All I've done is go to an MD and have a cortisone shot and he gave me muscle relaxers. He basically told me that it was probably a crick in my neck and he called it the "It's a bitch backing out of the driveway" syndrome. Sigh. The muscle relaxers relaxed everything but my shoulder / arm / hand. They just make me very sleepy. Is this like carpal tunnel syndrome?
The massage I was refering to would be from a licensed massage therapist.
It's not like carpal tunnel at all, although many people with issues like yours are misdiagnosed with cts. The carpal tunnel is in the wrist.
"It's a bitch backing out of the driveway syndrome" heh, never heard of that one, wonder what code I'd have to bill the insurances for that one.

[Soonerbabeinbama]

The massage I was refering to would be from a licensed massage therapist.
It's not like carpal tunnel at all, although many people with issues like yours are misdiagnosed with cts. The carpal tunnel is in the wrist.
"It's a bitch backing out of the driveway syndrome" heh, never heard of that one, wonder what code I'd have to bill the insurances for that one.
Well mine definitely starts with the upper right side of back (shoulder blade I would guess) and then down the arm and to the hand. The doctor told me it was probably from too much computering. Heh!!

BTW - that code is BBOODS. :D