Brief Answer:
Cervical (neck) osteoarthritis pinching C6 goes right to thumb base

Detailed Answer:
Good morning and thank you for your question.

Your symptoms as described are most consistent with a pinching of the C6 nerve on the left in the neck due most likely to OSTEOARTHRITIS which could be causing either a compression of this nerve as it EXITS the spinal cord or there could be a narrowing of the spinal canal in that area or the presence of some calcified buildup of bone where that nerve starts tracking down the neck. Any one of those scenarios would give you the type of pain as well as numbness and tingling (called PARESTHESIAS) IN THE LEFT SHOULDER and into the thumb base. Tingling in the fiingers could also be due to some arthritic degenerative changes in the C8 or T1 nerve roots...just a bit further south from the C6 nerve. If 2 separate locations were involved one could hypothesize a spinal canal stenosis though you don't seem to have any C7 complaints.

Lying on the left side of the body simply increases the pressure on the C6 and other involved nerves and that's why the symptoms of pain are aggravated while sleeping.

The fact that you are a recovering alcoholic always means that if I were your treating doctor I would certain that the following things have been checked (which also contribute to some of your symptoms) Vit. B12, Thiamine, Folate, Vit. D, FT4, TSH (thyroid hormones). Be sure the vitamin B12 is at least in the 400-450 range and that Vit. D is 60-80. Many primary care docs will simply take the lowest laboratory values as adequate and for people who have symptoms of neuropathy or radiculopathy or other neuirological problems that is usually too low. I will also point out that for thyroid screening although most practitioners feel the TSH is adequate to screen....in someone who has had problems with alcohol and who may be harboring other systemic issues secondary to that a FREE T4 gives the TSH much more OOMPH....in order to make a decision as to whether you are actually treating a real HYPO/HYPERTHYROID state or a latent condition....which nowadays the XXXXXXX Endocrinological society is not as enthusiastic at treating aggressively as before.

If you were my patient I would also be sending you for imaging studies of the neck (probably an MRI since you are having neurological symptoms). BTW, I would also EXAMINE your left arm to how if there is any evidence of neurological weakness because then, you may have not only a sensory type of problem but if motor is also involved then, you have a RADICULOPATHY...and that is very possibly the case since you are complaining of pain in the thumb.

And finally, you'd get a script from me for AQUATHERAPY if you have access to that form of exercising of the neck. It would be the gentlest form of manipulation and you'd get the most bang for your buck compared to regular physical therapy.

In terms of the pain and tingling sensations I would possibly try you on either nortriptyline (low dose start with slow incremental titration upward to a XXXXXXX of 50mg. nightly), straight up ibuprofen at a reasonable dose of maybe 400mg. to be taken with food and also slow escalation upward to about 600 or maybe 800 depending on the severity of pain WITH THE CAVEAT that we know this can mess with peoples' stomachs so I'd be cautious and have a low threshold to stop the drug if you started complaining of GI upset too much. The 3rd possible medication to think about is gabapentin...again, low doses of 100mg. maybe once daily to start just to see how you tolerate it but then, a slow escalation to a target of about 300mg. 2-3x/day to see how that does for your symptoms.

If I've provided useful or helpful information to your questions could you do me the utmost of favors by CLOSING THE QUERY along with a few positive words of feedback and maybe even a 5-star rating if you feel it is deserving? I am definitely interested in getting updated information on your condition if you'd care to drop me a line at www.bit.ly/drdariushsaghafi and let me know how things turned out.

You can always reach me at the above address for this and other questions. I wish you the best with everything and hope our discussion has aided in your understanding of a few concepts related to your concerns.

CHEERS!

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