[34F] With chronic left arm pain, numbness, and spasms exacerbated by cold

What might be happening

Based on your symptoms and history, here are the most likely explanations for your condition:

1. Ulnar Nerve Compression (Cubital Tunnel Syndrome):

   • The numbness and tingling in your ring and pinky fingers, along with weakness in your hand, strongly suggest compression or irritation of the ulnar nerve. This nerve runs from your neck, through your shoulder, and down to your hand. Cold weather and overuse can worsen nerve-related symptoms, which aligns with your experience of worsening symptoms in winter or with activity.
   • Typical treatments include physical therapy, bracing, anti-inflammatory medications, and in severe cases, surgery to relieve nerve compression.

2. Chronic Nerve Damage or Brachial Plexus Injury:

   • Your history of a severe arm injury at age 13, combined with ongoing symptoms, suggests possible long-term damage to the nerves in your shoulder or arm. The brachial plexus, a network of nerves controlling the arm and hand, may have been affected during your accident. Muscle atrophy and spasms further support this possibility.
   • Treatment often involves physical therapy, nerve stimulation, and sometimes surgical intervention if nerve damage is severe.

3. Cervical Spine Issues (e.g., Herniated Disc or Arthritis):

   • Pain extending from your shoulder up your neck and down your arm, along with headaches, could indicate a problem in your cervical spine, such as a herniated disc or arthritis. These conditions can compress nerves that travel to your shoulder and arm, causing pain, numbness, and weakness.
   • Imaging studies like an MRI can help confirm this, and treatment may include physical therapy, medications, or injections.

4. Thoracic Outlet Syndrome (TOS):

   • This condition occurs when nerves or blood vessels are compressed between your collarbone and first rib. It can cause pain, numbness, and weakness in the arm and hand, especially during certain movements or in cold weather.
   • Treatment typically involves physical therapy to improve posture and relieve compression, and in some cases, surgery.

What you can do

For Pain, Numbness, and Weakness in Your Arm and Hand:

• Apply Heat: Continue using heat therapy, such as heating pads or warm compresses, to relax muscles and improve blood flow. This is especially helpful during cold weather.
• Avoid Overuse: Limit activities that strain your left arm, such as heavy lifting or repetitive motions, to prevent worsening symptoms.
• Wear Gloves in Cold Weather: Insulated gloves can help keep your arm and hand warm, reducing nerve irritation and spasms.
• Stretch and Strengthen: Gentle stretching and strengthening exercises for your shoulder and arm may help improve mobility and reduce muscle atrophy. A physical therapist can guide you on safe exercises.
• Use MDandMe: Track your symptoms, pain levels, and triggers in the MDandMe journal. This can help identify patterns and provide valuable information for your doctor.

For Headaches and Neck Pain:

• Neck Support: Use a supportive pillow while sleeping to maintain proper neck alignment.
• Gentle Neck Movements: Avoid sudden or extreme neck movements that worsen your pain. Gentle range-of-motion exercises may help.
• Over-the-Counter Pain Relief: Medications like ibuprofen (Advil) or acetaminophen (Tylenol) can help manage pain, but avoid exceeding the recommended dose.

For Muscle Atrophy:

• Physical Therapy: Request a referral to a physical therapist who can design a program to rebuild strength and improve function in your left arm.
• Daily Use: Try to use your left arm for light, pain-free activities to maintain some level of function and prevent further atrophy.

What you should look out for

Seek medical attention promptly if you experience any of the following:

• Sudden or worsening weakness in your arm or hand.
• Complete loss of function or inability to move your arm.
• Severe, unrelenting pain that does not improve with heat or rest.
• New symptoms, such as swelling, discoloration, or changes in skin temperature in your arm or hand.
• Fainting, dizziness, or vision changes accompanying your headaches.

Chelsea, your symptoms are complex and may involve multiple factors, including nerve compression, chronic injury, and possibly cervical spine issues. It’s important to follow up with a neurologist or orthopedic specialist for further evaluation. If you need help preparing for your next appointment or summarizing your symptoms for your doctor, let me know!