Dr. Hitesh Kumar
Neurology
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Patient's Query
Hello doctor,
I have been experiencing numbness and an uncomfortable pain-like feeling in my left arm for more than one month or so. It used to happen very rarely before but is more regular now. The pain is present almost daily. The feeling is from the top of the arm to the elbow. Sometimes it is acute, though not unbearable. I do not have any other symptoms like dizziness, chest pain, vomiting, imbalance while walking, anything. I got my annual heart check-up done last month, and all seemed fine. I thought it might be because of sleeping on one side, and I mostly avoid that side now, but the feeling continues.
Hi,
Welcome to icliniq.com.
I would like to know some details of your symptoms. For example-
1. what type of pain do you feel in your left arm?
2. Do you feel heaviness, stretching, current-like or tearing-type pain, or something else (please describe)?
3.What do you feel in numbness: decreased sensation to touch, burning sensation, pins & needle sensation, electric currents like sensation, or something else?
4. Does it happen intermittently?
5. Have you noticed any particular situation when symptoms occur, like walking, going upstairs, running, neck or arm movement, lifting any object on hand, or something else?
6. Do you have any neck pain or shoulder blade region pain?
7. How is your sleep?
8. Did you also undergo a treadmill test (TMT) during the heart check-up?
In my opinion, the probable diagnosis are angina and radiculopathy. I would also suggest you get magnetic resonance imaging (MRI) spine, echocardiogram, nerve conduction velocity (NCV) of upper bilateral limb, blood tests for vitamin D and B 12 testing performed.
Revert back later.
Thank you.
Patient's Query
Hello doctor,
Thank you doctor.
Heaviness and an intense, slightly painful tingling sensation are there. It is more of heaviness, not numbness. It is more of uncomfortable pain. Not like an electric shock but a little like pins and needles. When I lift and bend my hand, I feel the pain is more. If I leave my hand loose, the feeling is less. I sleep well. I had done TMT two months back. It was comfortable, with no issues, and the cardiological consultation was done two months back. The Echo was also done, all good. Vitamin B 12 test was done and was within the normal range. Vitamin D test was in the normal range. I do not feel any pain or heaviness in my chest. I did not get MRI and NCV done.
Hi,
Welcome back to icliniq.com.
As per your description, possibility may be that the pain is due to some nerve compression in neck region. Though it is also suggested to look for cardiac factor too because many a time heart pain can be felt in left arm. You underwent treadmill test (TMT) about two weeks ago, but pain started since one month.
I would suggest you go for magnetic resonance imaging (MRI) cervical spine and nerve conduction velocity (NCV) of bilateral upper limbs.
I would also suggest you tablet Gabapin (Gabapentin) 100 mg, thrice daily for a week.
Consult your specialist doctor, discuss with them and take medicines with their consent.
Revert back after a week.
Patient's Query
Hi doctor,
I have attached the reports of the MRI cervical spine and brain scanning. The neurologist I consulted suggested the same tablet and the Rejunex CD 3 tablet, both once daily for one month. The sensation in my hand is almost gone, but it still feels a little weaker. I also forgot to mention last time that occasionally, I get a feeling of being pulled in my left leg (back of my left knee), which has also reduced.
My doubts are:
1. Will the problem be resolved completely by medication only?
2. Do I need to undergo NCV bilateral upper limbs test?
3. Can I start strength training exercises?
4. Do you suggest any specific exercises?
5. What precautions do I need to take to resolve this problem?
Kindly help me.
Hello,
Welcome back to icliniq.com.
I saw the pictures of your MRI report, it seems unlikely to require any surgery (attachments removed to protect the patient's identity). You told me you feel much better on medicines, so keep hope. But no one can predict how the future will be. Therefore, I suggest you undergo a nerve conduction velocity (NCV) test. I also suggest you directly consult a physiotherapist to practice muscle strengthening exercises under his guidance once the pain is gone. I suggest you follow:
1. Avoid lifting heavy objects.
2. Avoid using soft and high pillows.
3. Avoid prolonged forward neck bending.
Patient's Query
Hi doctor,
I have attached the reports of my NCV test. I was told that it was normal. I am taking the tablets prescribed and do not feel the pins and needle sensation. But the left-hand feels slightly weaker. What could be the reason? If it could be due to mild compression between C5 and C6, will surgery be a permanent solution? I will consult a physiotherapist soon.
Kindly help me.
Hello,
Welcome back to icliniq.com.
I saw your nerve conduction velocity (NCV) test report; it appears normal (attachments removed to protect the patient's identity). Your symptoms can be due to existing nerve compression at the neck. Your symptoms are getting better with medical management. The decision on the need for surgical treatment can be taken by physical examination and looking at the MRI films directly and not by the report only.
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