I have been having shoulder problems for many years. For the last couple of months, the top of my shoulder blade hurts. I can push in between the joints and feel the pain. But, the last couple of days the pain runs from my shoulder to by elbow and into the joints of my fingers. Coughing causes the pain, it hurts when I sleep, and both of my hands and arms go numb when I sleep, hold the phone too long, etc. I was checked for carpal last year, but dr said it wasn’t too bad, wear a brace. Well, I now feel like I’m falling apart. What do I do? And is Ibuprophen the best pain killer? Thanks.
Dr.Sinuhe Answers:
Thanks for your question. Please understand that I am speaking in general terms. Possible physical causes include but are not limited to shoulder pain, pain from nerve compression in the neck and at the level of the wrist. These are sometimes difficult to tell apart. A hint comes form the fact that shoulder pain usually does not radiate that far from the shoulder, not all the way to the fingers. Carpal tunnel syndrome, in turn, mainly affects the hand, often causing nighttime numbness in several fingers. Nerve (root) compression in the neck starts from the neck, radiates to 1 or 2 specific fingers (depending on the level of the compression in the neck) and is often worsened by neck deviation.
From your question it is impossible to say what is causing the pain, although the shoulder obviously is the first guess (despite the fact that the pain should not reach fingers), since you start your letter by telling “you have been having shoulder problems for many years”. Second guess is carpal tunnel syndrome, since it has been revealed already. However, a thorough history and a physical examination is needed, often followed by a shoulder ultrasound or MRI (if a shoulder problem is clinically found), cervical spine MRI (if nerve compression in the neck is suspected) or ENMG (if carpal tunnel syndrome is found). Orthopedic surgeon or a neurosurgeon can differentiate between these (and other possible) causes of your pain.
Ibuprofen is a good, a wellknown, basic pain killer which often has beneficial effects in a case like yours.
Please do also see Dr Joshua’s answer which deals with partly similar symptoms as the ones you’re describing:
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