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What Causes Pain In Neck Radiating To Arm And Fingers Post Shoulder Injury?

Posted on Mon, 7 Dec 2015

Question: Hi my daughter suffered a shoulder injury more than a year ago (a horse slammed its shoulder against hers as she was grooming the animal). She complained off and on for a few months about the shoulder before we were able to start physio for it. The physio went on for 3 to 4 months, and seemed to resolve most of the issues. She re-injured the shoulder in August, and has been dealing with some numbness as well as pain that extends into the neck sometimes, and from the shoulder socket down the inside edge of her arm to her hand. In her hand, it is her thumb and pinky which are most painful. Some pain in the second and fourth fingers as well. These are burning pains which seem to be associated with standing for any extended period of time. She also has some weakness on that same side.

Answered by Dr. Aashish Raghu (46 minutes later)

Brief Answer:
Cervical spine, Brachial plexus injury likely. Needs further investigations

Detailed Answer:
Hi there.

Welcome to Healthcare Magic.

Thanks for the query.

Does she have tingling or numbness in the palms or fingers?

Does she have pain radiating from the back of the neck to the arm?

According to the history you have provided, it appears to be a damage to the nerves around the back of the neck which go to the arm and fingers. Also local shoulder damage cannot be ruled out.

Of she has radiating pain from the back of the neck to the hand or fingers, it goes in favour of nerve stretching or compression either in the spine or in the neck.

It is advisable to get a few years done to be sure of what we are dealing with. Tests like Nerve conduction velocity or NCV to look for nerve damage of the arm can be done. Also am MRI of the cervical spine and brachial plexus can be done to look for the site of damage.

Of she has pain only around her shoulder, which aggravated when she lifts the arm overhead, then it could be a Rotator cuff injury which requires MRI as well.

As if now, warm packs, avoidance of lifting weights, Physiotherapy and medication like Gabapentin can help with the pain and burning sensation. Kindly get these investigations done for a clear picture on the problem and then the right path of treatment can be decided according to the cause and site of injury.

Kindly answer my queries for me to be in a better position to help you.

I hope I have answered your query.

I will be available to answer your follow up queries.

Regards,

Dr. Aashish Raghu

Above answer was peer-reviewed by : Dr. Sonia Raina

Follow up: Dr. Aashish Raghu (10 hours later)

Hi, yes, she has tingling off and on, and has had some numbness (but less than the tingling) in her hand. The pain has extended up into her neck; she has complained more about the side of her neck pain but has indicated that it does seem to extend partially into the back of her neck. She also has reduced sensation on the outside upper part of the arm which has been present for about 8 weeks. She was seen by an osteopath last month. That person suggested checking for a labral tear. We have not pursued this possibility yet b/c we were focused on trying to strengthen and resolve her back issues. It is just now that the shoulder issue has come to the fore again as it starts hurting a lot once she has been up for more than 50 minutes. She has been partially bed ridden for the last 8 weeks, lying on her back for an hour to an hour and 30 min. at a time during the day. She is up walking around for intervals of 30 to 70 minutes each time. She has recently started back exercises prescribed by her physio for up slip, and suffered a bulging disk at L5/S1 as well. With being partially bed ridden, she has lost some muscle mass and one of the exercises involves her lying on her stomach and attempting to lift her upper body with her arms. This has been painful for her shoulder, but she was told it's just because she hasn't been moving it much.

Answered by Dr. Aashish Raghu (8 hours later)

Brief Answer:
Needs NCV, MRI, Physiotherapy

Detailed Answer:
Hi there.

Tingling and numbness goes in favour of nerve damage.
If its best to get the NCV to look for extent of nerve damage. The MRI Brachial plexus will also be useful to quantufy the nerve damage in the neck.

Physiotherapy needs to continue. Healthy balanced diet is important. Kindly follow up with me on her progress with physiotherapy and her reports.

Regards,

Dr. Aashish Raghu

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Yogesh D