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Old 04-13-2008, 11:28 AM   #1
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Need your advice - severe pain in arms/hands

Hello to all of you
I hope you had a nice weekend!

I still have the same question and no answers...
I am a CP patient due to 2 spinal fusions with complications. But the new symptoms started after my second fusion, about 2 month ago.

I developed severe pain in shoulders/arms/hands/elbows. Not much of a neck pain. I suffer 24/7 from it, but when I lay down the worse pain comes. During the night I get up and walk in a room to come it down a bit.

My right hand is pretty weak, I don't feel much tingling or numbing, but pain is inberable. Now i started to have problem to hold things in my right hand and break a lot of dishes...
Recently I had Cervical MRI and it does show arthritis, bone spurs, C-6 T-1 herniation, but my Neurologist doesn't think it can cause such a severe pain in my arms and hands. He performed an EMG test and it didn't show any nerve
damages.
I take pretty strong PK (LA and BT) for my spinal issues and believe or not, helps some of of my back-leg pain, but doesn't help even a bit my upper extremidies pain.
I am really lost and have no idea what can cause it. I did a lot of research on Internet, but still can't find answers.
Anybody, Please......

Thank you in advance for your support and God Bless

 
Old 04-13-2008, 11:45 AM   #2
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Re: Need your advice - severe pain in arms/hands

Hey Moldova: Sorry you have been going through this. The only things that come to my mind are fibromyalgia and chronic myofascial pain. (I have CMP)

I know with me, it causes major stiffness and pain in my shoulders, arms and hands. And I also have lost a lot of arm and hand strength. Have any of your docs suggested these? There is quite a bit of info on the web, about both fibro and CMP. They share some symptoms, but not all.

I don't know if this is what is going on with you, but thought it might be an idea. God Bless and keep us posted. cmpgirl

 
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Old 04-13-2008, 11:59 AM   #3
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Re: Need your advice - severe pain in arms/hands

Thank you, girl for your respond.
I do have Fibromoylga, osteo and RA, but i have this for so many years and on meds for it for many years too.
Why all of sudden I got this couple month ago and why my PK don't help the pain? Why do I loose strenght in them?
My Neurologist mentioned something about pain meds. He said that sometimes some medication can cause severe muscle damage and he wonders if this can be my case?
But nothing is confirmed so far. Meanwhile I can't sleep and even typing on computer gives me problems. I don't like not knowing; i would rather know and deal with it.
Thank you so much and feel better, please!

 
Old 04-13-2008, 12:13 PM   #4
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Re: Need your advice - severe pain in arms/hands

Moldova, I sure wish I had some answers for you, I feel so bad for you with the whole not be able to lay comfortably at night. Gosh, you have got to be awfully tired at times if not all the time. I know I don't sleep well yet with the surgery deal & I really feel it.
I did want to say I have heard conflicting opinions with the cervical area you mentioned. I myself have issues in that area, but my daughters friends mom called a few weeks ago with a diagnosis of problems such as DDD in the same cervical area & she said her one shoulder hurt like heck & the other was starting to act up. She could not believe how much it hurt, now she was told that was due to the problems with in the cervical area. Now whether it would go into the arms & hand I am not sure. I swear sometimes I think there are compound problems & that is why these doctors can't seem to always find what is wrong. I am learning that they can run test after test & not everything shows. My pt just told me that about the MRI's.
You keep asking & hopefully someone will come along with a clue at least.
To me it is the absolute worse when you do not know what is wrong, it is the hardest thing to sit & wonder. I have had the same where the pain meds just don't touch a certain pain, makes you wonder why & feel alittle desperate. There has to be a reason why. I will keep my ears open for you. Good luck & hand in there. Sammy

 
Old 04-14-2008, 09:19 AM   #5
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Re: Need your advice - severe pain in arms/hands

hi moldova, just had a couple of questions for ya. what exact areas have you had fused? did you have any hardware placement done at all? this really does sound like radiculopathy to some degree meaning it IS stemming from your c spine area in some way. the EMG results really don;t have a whole lot of impact if your pain and symptoms are not actually stemming from direct impingemnt or some other issue that is actually impeding nerve flow. there are just ALOT of possible issues that you could have going on up there that would give you the types of symptoms you are having and show a perfectly normal EMG.

just what were your 'complications' all about and where were they? are these more intermittant symptoms or a more constant? do you have any types of symptoms that actually go down to your fingers in any way? if so,which ones are affected? do you know if your fusion is actually taking up there yet? have they done a flexion and extention x ray on you at this point just to check fusion status?

this particular type of x ray really IS the very best possible way to actually check whether or not you have fused,in both surgeries actually. i had a huge non fusion issue but the MRI said 'inconclusive' recommended a CT,and the CT stated i was defintiely fused when i knew without a doubt,and so did my primary,that i was not,not with the ongoing symptoms i was having along with horrid pain. it took that simple type of x ray to finally proove to my surgeon what i had been telling him and his so called 'nurse' for over nine months,i was NOT fused at both endplates,only one. this was despite that stupid CT saying otherwise.

there just has to be some real reason for what you are experiencing,unfortunetly it is a matter of testing and ruling out to find the culprit. tracking it back from where your issues start to the direct nerve root and dermatome really is the best way to get to that source.

do you actually 'hear" anything when you move your neck? any noises like grinding or popping? just how recent was that MRI? why are you only seeing a neurologist when the surgeon should be handling this and finding out why HIS surgery 'did' or is doing something to you? your surgeon just has a certain level of responsibility here in making certain HIS surgery did not actually cause you problems or even further damage during your surgery. he just should be the one trying to find this all out for you,thats all. he has an obligation to you after you get any surgery from any suregon to make certain you are okay and not worse post op ya know?

sorry for all the questions tho.believe me,if they were not important,i wouldn't have slammed you with so may. but they DO matter just knowing the answers to the questions in helping to find whats causing your symptoms.

just wondering if YOU actually read your own MRI report or have actual copies of all reports from all testing that has been done on you? if not,you really DO need to obtain all of this and also the hospital medical records with the "op notes" from both your surgeries. getting all of your medical records from your surgeon will help too. but YOU personally really need to see that MRI and read thru it for yourself if you have not yet done that. you would be shocked at just how much,mostly specialists,will leave out or not tell you about. its really sick,but it happens everyday. and it happened to me with very crucial Dx info and other important things i just had a right to know was going on inside my own body.

hang in there moldova,i know this has not been an easy time for you recently. but hopefully we can help get to the culprit here soon. marcia
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3-22-01,herniated C-6-7
11-20-01,placement of hardware for failed fusion
9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.

 
Old 04-15-2008, 09:47 AM   #6
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Re: Need your advice - severe pain in arms/hands

Thank you so much for your replies and suggestions... I wish you all a better day tomorrow...

Marcia,
my first fusion was on L-4, L-5 S-1, decompression/lami, screws, rods, etc. I have metal plate and metal clips in pelvic area as well. Bone growth stimulator was inserted during surgery and it was surgically removed 11 month later. My levels fused nicely that time. Bone was harvested from my hip. (03/06)

12/07 I had fusion L-3, L-4 with hardware again and old hardware were removed. Showed my first fusion fused completely. Also had decompression, lami, PLIF 360. Some other work, but minor to compare to fusion itself. Again bone was from my own hip.

After my first surgery i was doing very nicely for about 4-5 month. I was in pain, but was improving and pre-op pain was gone. I started walking, i had so much hope.
The only thing was bothering me is increasing pain in my legs, tingling, burning; 8 month later i was diagnosed with failed back surgery syndrome.
Everything went wrong: dropped foot, weakness in legs/feet, pain in bottocks, hips, etc. And so on.
I got to the point that i couldn't walk at all, i was dragging my legs, and needed to go back to wheel chair and walker.
I got condition calls Arachnoidities - this is the worse what could happen to people (you can read about it on Internet). I know this is causing severe pains and not curable or treatable...

After second surgery I got more legs/feet pain. I have so much pain in my legs, feet, bottocks, hips, knees. I can't walk for long, walk with cane, sitting or standing for long time is unbearable too. Legs are very weak.

But my arms/hands pain is new one and very severe: PK don't even touch the pain. I had MRI resently, shows some C-6 hernitaions, bone spurs, arthrities, bulges - but nothing to cause that much pain and severe symptoms.
Hard to lay down, pain starts from shoulder area and goes down to the whole arm and hands. Pinky and next to it finder is the worse pain. I know it's nerve related, but nothing MRI showed to be compressed... so confusing.

My second fusion so far so good, fusing the way it suppose, i did have same ex-rays as well.

Sorry for a long post and thank you so much for all your support!

Last edited by Moldova; 04-15-2008 at 09:49 AM.

 
Old 04-24-2008, 09:01 AM   #7
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Re: Need your advice - severe pain in arms/hands

so sorry it has taken me this long to get back to you moldova. things have just been too busy and painful. i am just wondering since you did mention that this pain actually runs down into the ring and pinkie fingers,what exactly did your MRI show between c 7 and T 1? this would be the area that those two fingers would correlate to up in the c spine? its actually something affecting your c 8 nerve(the ulnar).tho you do not actually have a c 8 vertebrae,you DO actually have a c 8 nerve. believe me,this IS the area where my spinal cord damage is exactly. my ulnar and median nerves took one heck of a huge hit in my left after that cord surgery was done. my last tweo fingers on that left hand have been just buzzing? like constatly since the damge/surgery back in 2003.

did you actually read thru your own MRI report or have a copy in your possession? if not get one,if you do,look at what the report actually states in that one area i mentioned. it sounds like from what you stated this is actually on both arms, or just one? if this is actually both arms to some degree,whatever is affecting this up there would have to be more 'centrally" located in order to be giving you the bilateral types of symptoms you are having. like i mentioned before,an EMG really wouldn't show posistional compression going on or inflammtion from irritated nerves or from just spurs. only true nerve flow impairment of some degree will get picked up on an EMG. tho it is a good test for some things,when there is no real compression going on,it is pretty useless.

was your MRI with or without a contrast? that could also make a difference injust what actually gets picked up on any imaging type of scan really. just how old is that last MRI?

i really do think what you are describing IS some level of radiculopathy that would be stemming from your c spine. if you have other conditions as well,it could all be also contributing too. one big thing you have to always keep in mind here is that not everything that is there will always be picked up on any real scan. it is not an actual 'picture' of an area,only a scan of an area,you know what i mean? but i really do think your c 8 area is the most dominantly involved in this or you would not be having those two fingers involved.

the factthat your narcotics are not doing anything for you also makes this sound more radiculopathic,or 'nerve pain'. historically,narcotics just do not always work really well for this type of pain. the pain generated by inflammed or irritated nerves usually respond much better to the anti siezure type of meds or some other of the more 'icky' meds. i personally have not had good luck with these types of meds. the side effects do me in worse than the pain does. have you ever tried like lyrica or neurontin? any of those classes of drugs for this particular pain? how about any level of anti inflammatories? some are good ones. when my herniated disc started to show itself but i couldn;t get it addressed becasue my son was actually going thru liver failure at the time this started,i lived on aleeve for me c spine crap til i could get it fixed. just a thought. it did actually help and only had to be dosed twice a day. just some suggestions that helped me.

but i would really look hard at that area and see what actually is there right now. depending upon how old that MRI you had done actually is or if you used contrast,you may need another. again,sorry it took me this long hon,marcia
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3-22-01,herniated C-6-7
11-20-01,placement of hardware for failed fusion
9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.

 
Old 04-24-2008, 11:56 AM   #8
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Re: Need your advice - severe pain in arms/hands

Marcia,
thank you so much for your time, very kind of you.

I had MRI done 2 weeks ago. It showed C-6 - T-1 herniations, bulges, DDD, stenosis, bone spurs and stenosis (full house :-).
Yes, my both arms and hands very painful, especially right one and especially around elbows area. Neck hurts too.
I have L-3, L-4 L-5 S-1 fused during 2 fusion surgeries and L-2, L-1 is 50/50

I wonder if fusion and hardware doesn't do damage to upper levels; my second surgery was exactly due to this.
I have my reports and exrays with me (I always keep it for my records).
I was on Lurica, Neurontin and Keppra, but did not get much help from it.

This is what I am going through now becides my lower back and damaged nerves in my legs and feet.

How are you doing? How do you feel?
Best of wishes to you.

 
Old 04-24-2008, 02:29 PM   #9
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Re: Need your advice - severe pain in arms/hands

You might want to try some of the other nerve pain meds. I would think the next step may be: Topomax, Tegretol, or Trileptal. And of course there are plenty of more to try. What about Cymbalta or Effexor? Even though they are SNRI anti-depressants they have been shown to be excellent for nerve pain control. Just some suggestions in case you haven't tried them yet. Is the Oxycontin doing anything for the nerve pain do you think? Has it dropped your pain levels at all?

brian

 
Old 04-24-2008, 04:49 PM   #10
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Re: Need your advice - severe pain in arms/hands

Thank you, Brian for asking.

Oxy helps with pain, but like someone said definitely is not strong for 12 hours. And even though I take 20mg every 12 hours as LA, I still need 2 times at least BT meds.
What would you say: means it working well or not? Still with all this i am never pain free.
My PM is not of favor of Cymbalta, he does not prescribe it to his patients.
I wonder about Tramadol - do you know something about it? What is your opinion about this meds?

Have a good day!

 
Old 04-24-2008, 05:01 PM   #11
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Re: Need your advice - severe pain in arms/hands

Quote:
Originally Posted by Moldova View Post
My PM is not of favor of Cymbalta, he does not prescribe it to his patients.
I wonder about Tramadol - do you know something about it? What is your opinion about this meds?
A PM doc that does not prescribe Cymbalta that is a new one for me. I can't believe it considering how much it helps with some people's nerve pain although it was not a good med for me.

As far as the tramadol, that is what I just got off of and I was taking it for over 2 years. I'm not going to put it down because I am sure it helps some people but I will warn you that it can be extremely difficult to get off of. I would suggest trying it and if it does no good then get off quickly. The longer you stay on it the harder it is to quit.

brian

 
Old 04-24-2008, 06:35 PM   #12
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Re: Need your advice - severe pain in arms/hands

Quote:
Originally Posted by Moldova View Post
Oxy helps with pain, but like someone said definitely is not strong for 12 hours. And even though I take 20mg every 12 hours as LA, I still need 2 times at least BT meds.
What would you say: means it working well or not? Still with all this i am never pain free.
I know that you can't use the patch due to what happened, but one of the reasons it works so well (in general) with people is because it delivers a fairly precise amt of med each hour, 24 hours per day. Therefore, the patients BPL stays elevated, and BT meds are only needed for real flare-ups. Those who must change every 48 are the result of the med simply not lasting for 72 hours.

Conversely, the problem with OC is that it doesn't last 12 hours. Additionally, it doesn't deliver a steady hourly dose like the patch. As a result, it just doesn't work as well, IMO. Honestly, your BT meds are probably needed just to keep your BPL up....And you probably don't even realize it.....Or maybe you do.

It sounds as if you need to take your LA med more times daily....Who knows, you may not need as much per dose, but more often. I think as a minimum, you need 3 X day, maybe even 4 X. I would try 10 or 15mg, but 3 or 4 X. For example, 8am, 4pm, and right before bed, no later than midnight. If 4 X, then it would be something like 8am, 2pm, 8pm, and again at bedtime.

Your BPL can't stay elevated because the med isn't lasting 12 hours. I'm willing to bet that you're not getting much, if any med in hours 8-12. Again, that's why you need the BT meds during those time periods (speculation on my part).

Hope this helps.

Ex

Last edited by Executor; 04-24-2008 at 06:37 PM.

 
Old 04-24-2008, 07:31 PM   #13
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Re: Need your advice - severe pain in arms/hands

Moldova, Executor is talking about what my doctor did for me. It has helped my pain tremendously up until this past weekend when I over did.

 
Old 04-24-2008, 10:33 PM   #14
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Re: Need your advice - severe pain in arms/hands

Moldova, My doc did the same thing as Pepper's. Upping me to 3x/day made such a difference. I was even able to take one less BT per day. I take the 20mg Oxycontin, but he actually wants to go up to 30mg 3x/day next time I see him and see if I can take even less BT.

My PM said he has discussed the Oxycontin dosing with other PM's and they all agree it does not last 12 hours for any of their patients.

I hope your doc is open to this. I will be praying that he is. God Bless, cmpgirl

 
Old 04-25-2008, 05:56 AM   #15
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Re: Need your advice - severe pain in arms/hands

Moldova,

I dont know why and you can totally disregard it...... but this thought is stuck in my mind, and it might be completely off the wall thought......... but would it be heart related? You know the way some people complain about pain running up and down the shoulders and arms and loss of power, and tingling?.. it is just a thought, and you can either say now way its not that or maybe......... dont mean to be dramatic or anything but it just kind of entered my head, but my head is rather fuzzy at the moment
I upped the oxycontin last night and boy am i in an other world.

Take care
Round 1

 
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