I need Dr. House of Sports Medicine?

Question

Is there a doctor in the house?

My right arm is suddenly so lame that I cannot adjust the rear view mirror with my right hand and I can barely get the key in the ignition with my right hand without the help of my left hand.

In the last five months I have gone from my regular MD, to a family orthopedic surgeon, now a professional-sports surgeon and most recently a brain surgeon. I have had two MRI's, two X-rays a nerve test (EMG) and four cortisone shots.

It would seem that I am in good hands, but there are two things that do not make sense to me. First is that I have two separate issues. One is a pinched nerve causing the loss of strength in my right arm and second is the garbage (bones spurs & such) and clicking/popping in my right shoulder joint that needs to cleaned up and ultimately have the joint replaced. Is this a strange coincidence maybe?

But the other thing that does not make sense to me, is that both the brain surgeon and the sports medicine guy agree that

that I have a pinched nerve according to my MRI but I do not have any of the other symptoms other that the loss of strength in my right shoulder which means to me that there is a piece missing in the puzzle and it is stopping me from surgery?

This maybe irrelevant, but my hands are somewhat swollen, both my thumbs suddenly seem arthritic, and at 62 year old my PSA level jumped from 3.9 to 7.1 in a year, but my prostate biopsy test was negative. And I am due to take another test next month (six months after the 7.1)

This all seems to be too much of a coincidence?

Answer 1

Hi Hebb. I have a couple of thoughts for you. First, have your doctors ruled out a condition called "Thoracic Outlet Syndrome" (TOS)? This is a fairly common condition (that many medical doctors are not well trained in) that causes strange/bizarre patterns of upper extremity pain, weakness, paresthesias, swelling, etc.

TOS is often the long-term sequelae (consequence) of a whiplash type of injury to the neck. Car accidents, sports injuries, falls, etc. can cause this condition. TOS involves injury to the nerves, blood vessels and lymphatic vessels (called the neurovascular bundle) as they pass through the muscles of the neck, cross through the shoulder and into the arm. These are complex issues that may require an expert in this condition to properly evaluate and treat it. A good Chiropractor can provide effective treatment in most cases of TOS. Medical doctors or physical therapists with expertise in Myofascial Pain Syndromes can also provide effective therapy.

Second, did you have any major dental work prior to the onset of your upper extremity symptoms. New research is showing that chronic infections in teeth, jaw bones (maxilla or mandible) or gums that follow root canals and/or tooth extractions can cause difficult to explain symptoms like you describe. Often the teeth themselves are assymptomatic. However, any root canal with residual pain is virtually guaranteed to be infected with associated cavitations (necrotic infections) in the bone. Again, this is a condition (sometimes called cavitational osteonecrosis) that many docs and dentists know little about. If this sounds like a possibility, you will need to see a dentist/surgeon that specializes in cavitations.

Best wishes and good luck.

Answer 2

I would trust the doctors who have looked at you. They are the ones who have run all of the tests and know more about your situation than anyone. Your symptoms do sound like a pinched nerve, and you will probably need to get that fixed before being able to determine what else is wrong. If you are having concerns I would certainly recommend expressing them with your doctor, because they will be able to give you the best answers. Good luck, and I hope everything turns out well.

Once again I feel that it is very important that bring your questions and concerns to the doctors you are seeing. Even if I thought I could give you a diagnoses over the internet, it would not be appropriate nor wise. If you have any kind of doubts about the people currently treating you then I urge you to try and find a second opinion. But as I have said before, these doctors have studied your history and your test results and they are the ones who will have the most answers for you. Also, symptoms are always going to vary from person to person. Some may have more for the same problem, while others may have less.

Answer 3

He is the head of Diagnostic Medicine Department, specializing in Infectious Disease and Nephrology. And a frickin' bad a ss. ;)