Arm, hand, neck and shoulder pain RSI?

[rhall0981]

29 year old male, 155 lbs. Sept. 2010: deep ache in wrists after weekend of heavy typing (working on PhD dissertation  A LOT of computer work and sitting down the majority of the time). Saw NP at internists office referred me to occupational therapy& went for 4 weeks with no change. Oct: forearms aching all the time beginning early October. Typing makes it worse, but they hurt to drive, twist things, etc. Pain in neck and shoulder also severe in Oct. Started seeing massage therapist for deep tissue massage which helped but only gave temporary relief, and never complete relief. Other bothersome symptoms: burning/stinging sensation on the back of both hands when writing, holding a book or using computer mouse, searing tricep pain and shooting stinging pain from hands into forearms and shoulders (not exactly a straight traveling pain but more diffuse through arm when using fingers for typing, texting or holding things. All symptoms bilateral. Nov: saw internist who suspected cervical disk/nerve issue. MRI of neck showed only minor hypertrophy. referred to physiatrist, did blood work and EMG testing. All tests were normal. Dec: arms a bit better with rest bUt ALWAYS have some pain even resting. Now doing trigger point massage for myofascial pain related to repetitive stress injury at computer for years. It's helpful but still temporary, no full relief. Had neurology consult this week: diagnosed with 'muscle tightness'. I want some relief more than anything. spent hundreds of $ on massage because its the only thing giving any relief. Main probs now: neck/shoulder blade pain/tenderness, burning/stinging on back of hands up forearm and awful tricep pain, all made worse by sitting, reaching and computer work/texting - both of which I have drastically cut down. Except the neurologist, all of my MDs dismiss RSI/myofascial pain yet have no idea what it 'could be.' I don't even remember what it feels like for my arms/neck not to hurt. :(

[Eveningsun]

A related discussion, hands and fingers was started.

[Jyoti Kalra, MBBS]

Hi Friend,
Ho are you doing now?What appears to me is the fact that you have moved towards CRPS (Complex regional pain syndrome). The cause of this disease is linked with short circuiting of the pain pathway, resulting into abnormal reaction to the pain stimulus or discomfort.
What you must take care, is to break this barrier or nerve short-circuiting. Hence just continue on all the routine activities and increase the pain thresh-hold. If you start reacting to pain, then it wont help. Also there is a need to consult a good pain and palliative doctor, who will be able to help you out, in controlling the pain and breaking through the pain thresh-hold.
Please discuss

[NCPAStudent]

Sorry to hear about your medical conditions. I will keep you in my prayers and wish you nothing but the best. I am currently in PA school and have studied the disorders you're suffering from. A section of your post caught my attention. I recently injured my right wrist. Fracture and tendon damage to my right thumb. My physician ordered the same therapy as yours. Splint for 6 months to avoid surgery . I saw where your thumb fused, I am now very concerned this may happen to me as well. Any advice from your experience would be greatly appreciated. By the way, you are correct. RSD/CRPS are debilitating medical conditions and more physicians should be versed in the diagnosis and treatment of these conditions. Typically a good physicatrist can and will treat you with the most up to date medicinal and therapeutic programs available. Dont give up, there is always someone out there who can make a difference. Again, best of luck and I'll be looking forward to your reply.  

[rockygurl2]

Have ypu seen a Pain Management Physician?  Many of your symptoms are those of patients who suffer from RSD (Reflex Sympathetic Dystrophy), now called CRPS (Complex Regional Pain Syndrome), especially the burning, the shooting and stinging pain, or what many of us who have RSD, call stabbing pain.  We also have aching pain. I fractured my shoulder four years ago, and when I went to use the computer after finally having surgery on the shoulder, I never realized just how related our hand typing was related to the shoulder.  First time I used my computer, I about fell out of my chair the pain was so severe in my hand.  But I have severe contractures in the right hand and bilateral fusing of both wrists.  I can't bend either one down, and now both thumbs are fused.  The left thumb became fused after I broke my tendon that holds the thumb and my hand surgeon thought by splinting it for six weeks we could avoid surgery. Wrong!!  And then earlier this year, I saw a nice 4 X 4 drive by, and even though I am a woman, I wanted to give the guy a thumb's up, only the thumb didn't move, and I never felt a tendon break on the right thumb because when it snaps, you scream like the dickens.

It is a rare Physician, be it your PCP or ED Physician who knows what RSD/CRPS is.  I have two friends who are going to help me with my nine year quest to finally start a new non profit organization to educate ED Physicians about RSD/CRPS since they don't have a clue as to what it is.

But with your burning, stinging and the way you describe your pain, it couldn't hurt to see a Pain Specialist to rule out RSD/CRPS because the sooner treatment is started, the better your hopes for remission or at least good pain control.  I went 22 months between my minor foot surgery that triggered my RSD until I could start Pain Management..  There is no cure, only remission in only a rarre few.  It's such a debilitating disease that in 70% of the patients who develop it, it will spread to other parts of the body.

Best of luck.
Rockygurl2