Brief Answer:
To rule out thoracic outlet syndrome

Detailed Answer:
Hello,
Thank you for your query.
I'm Dr. Shuba Hariprasad and will be answering your query today.

Based on your symptoms and medical history, I would like to rule out thoracic outlet syndrome due to a cervical rib

Would you clarify a few things for me, please?
# how long have you had these symptoms? Were there any triggers that you noticed or can remember such as an illness or accident or lifting something heavy?

# did the symptoms increase gradually?
# which arm is affected? Any skin changes that you noticed?
# are you able to do your usual activities or do you drop things from the affected arm's hand?
# are your sugars under control? What are your latest values?
# any other medical issues or medications that you take?
# any family history of neurological disorders?
# what tests or procedures have you done so far? Can you send me the reports?
# do you do any kind of repetitive activity that uses you arm a lot?
#do you have a heavy upper body? Do the symptoms seem worse at night or when you lay down?
# does your arm feel cold?

I recommend :
-a neurologist consult
-a chest xray
- MRI of the cervical and thoracic spine
- blood tests (complete blood count, blood glucose panel, lipid profile, kidney and liver function tests)
-urine analysis
-avoid any activity that makes the symptoms worse.
-elevate your arm on a pillow at night to promote blood flow from your arm to the heart.
-avoid tight fitting clothes.
-an angiography to check for blocks in blood flow to your affected arm (if clinically indicated).
-an ENT as planned to check for neuropathy
-monitor posture, activities that worsen the pain/numbness

Based on this we can arrive at a proper diagnosis and initiate treatment.
Hope this helps
Please let me know if there is anything else I can help you with.

Wish you good health
Regards,
Dr. Shuba Hariprasad

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