[34F] With left arm and shoulder pain, neck pain, and sore throat

Patient Description

A 34-year-old female presents with a constant, stiff, and pulsating pain in the left arm and shoulder, rated as 8 out of 10 in severity. The pain is accompanied by numbness and weakness, affecting her ability to perform daily tasks. She also reports a throbbing headache for the past two days, neck pain that developed gradually, and chest pain with a sore throat when taking a deep breath. The patient has a history of carpal tunnel-like symptoms in both hands for about six years, although she notes that this current issue feels different. She vapes daily but is unsure of the nicotine strength. There is no history of heart disease, high blood pressure, high cholesterol, or recent infections. No known allergies and not currently taking any medications.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

  • Cervical Radiculopathy: This condition occurs when a nerve in the neck is compressed or irritated where it branches away from the spinal cord. This can cause pain that radiates into the shoulder and arm, as well as numbness and weakness. The fact that your neck pain developed gradually and you have arm weakness and numbness aligns with this condition.

    • Treatment typically involves physical therapy, pain management with medications, and sometimes corticosteroid injections. In severe cases, surgery may be considered.
  • Thoracic Outlet Syndrome: This condition involves compression of nerves or blood vessels just below the neck, which can lead to pain, numbness, and weakness in the arm and shoulder. Your symptoms of arm pain, weakness, and difficulty with tasks could be related to this.

    • Treatment often includes physical therapy to improve posture and strengthen muscles, pain relief medications, and in some cases, surgery.
  • Carpal Tunnel Syndrome: Although you mentioned this feels different, it's worth noting that carpal tunnel syndrome can cause numbness and weakness in the hands and arms. However, it typically doesn't cause shoulder or neck pain.

    • Treatment involves wrist splinting, avoiding activities that worsen symptoms, and sometimes corticosteroid injections or surgery.

What you can do

While it's important to consult a healthcare professional for a formal diagnosis and treatment plan, here are some steps you can take in the meantime:

  1. Rest and Modify Activities: Avoid activities that exacerbate your symptoms, especially those involving repetitive arm or neck movements.
  2. Apply Heat or Cold: Use a heating pad or ice pack on your neck and shoulder to help reduce pain and inflammation.
  3. Practice Good Posture: Ensure your work environment is ergonomically friendly, and maintain good posture to reduce strain on your neck and shoulders.
  4. Gentle Stretching: Engage in gentle neck and shoulder stretches to help alleviate tension.
  5. Symptom Tracking: Use MDandMe to journal your symptoms, track your progress, and share this information with your healthcare provider.

What you should look out for

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

  • Sudden or severe increase in pain
  • Loss of coordination or difficulty with fine motor skills
  • Symptoms that do not improve with rest or over-the-counter pain relief
  • Any new or worsening symptoms, such as difficulty breathing or chest pain

Remember, while I can provide information and suggestions, it's crucial to consult a healthcare professional for a comprehensive evaluation and appropriate treatment.

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7 mo ago

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People Also Ask


What is cervical radiculopathy and how is it treated?

Cervical radiculopathy occurs when a nerve in the neck is compressed or irritated, causing pain that radiates into the shoulder and arm, along with numbness and weakness. Treatment typically involves physical therapy, pain management with medications, and sometimes corticosteroid injections. In severe cases, surgery may be considered.


What are the symptoms and treatment options for thoracic outlet syndrome?

Thoracic outlet syndrome involves compression of nerves or blood vessels just below the neck, leading to pain, numbness, and weakness in the arm and shoulder. Treatment often includes physical therapy to improve posture and strengthen muscles, pain relief medications, and in some cases, surgery.


How can I differentiate between carpal tunnel syndrome and other similar conditions?

Carpal tunnel syndrome typically causes numbness and weakness in the hands and arms, but not shoulder or neck pain. It can be differentiated from other conditions by its specific symptoms and the fact that it often worsens with activities involving wrist movements. Diagnosis may involve nerve conduction studies.


What lifestyle changes can help alleviate neck and shoulder pain?

Lifestyle changes that can help alleviate neck and shoulder pain include practicing good posture, ensuring an ergonomically friendly work environment, avoiding activities that exacerbate symptoms, applying heat or cold to reduce pain and inflammation, and engaging in gentle neck and shoulder stretches.


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