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What Causes Numbness In The Left Shoulder?

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Posted on Fri, 6 Oct 2017
Question: I was given my first round of Botox injections in XXXXXXX My left shoulder to touch it has no sensation, but burns really bad under the skin and at times itches. It's bigger then the right shoulder. I have tried heat, ice, XXXXXXX XXXXXXX my jet stream to beat on it, but nothing is helping. My Orthopedic and the pain clinic thinks a nerve or a muscle got damaged. I just want to know why it's burning and make it go away. What is causing it to burn so much that I am in tears after just a few minutes of sitting?
doctor
Answered by Dr. Dr. Muhammad Sareer Khalil (3 hours later)
Brief Answer:
injection neuropathy with associated paresthesia

Detailed Answer:
Hello and Welcome

I appreciate your concern

Based on your description, injection neuropathy with associated paresthesia can be the cause of the pain and burning sensation. Adhesive capsulitis (Frozen shoulder) is another possibility. However, the paresthesia are not as pronounced as pain in that case. Treatment in both cases is similar.

If NSAIDs, heat, ice etc aren't working then its time step up the treatment to corticosteroids. A short course of steroids such as prednisolone can help. NSAIDs can be replaced by prednisolone. A PPI can also be added to the regimen. Pregabalin or gabapentin can help with the neuropathic component of the pain as well as the paresthesia. Muscle relaxants like tizanidine should also be advised. If this combination doesn't yield improvement in overall symptoms then intra articular subacromial or glenohumeral injection can be advised in consult with your doctor.

Wishing you best of health

Thanks

Let me know if you have any query

Please consult your doctor before deciding on any further course of action.

For future follow up / correspondence you may ask me directly at the link given below

http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=68107

Dr. M.S. Khalil
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Muhammad Sareer Khalil (2 days later)
Thank you first for getting back to me. However, I can't have any NSAIDS, they found Cortisteroids don't work on me plus I can't be given anything with a steroid in the medication. Whether by pill or shots. I have a bad kidney and I swell up to much with fluids. I have been on Gabapentin and never had any relief. I've had bursitis before, but never anything like this. I remember when getting the Botox injections, of jerking like he hit some nerves. I see him again next week for the second round. I just had an MRI on my Thorax part of the spine up to the skull, nothing showed as far as any herniated disk. I do have a frozen right shoulder, but it only hurts if cool air hits it, so I wear a sweater on my right arm and shoulder. But this is almost as bad as passing kidney stones and those who've had those knows that is the worst pain you can have. I put a heating pad on it the other night, for 10 minutes no pain, then it started back up while still on the heating pad. I turned it off, and padded it with warm towels while in bed. Still no relief. I am on the muscle relaxer you suggested, my Neurologist has me taking one at bedtime. But while laying down, I have no pain, only when I'm on my feet or sitting. I'm so tired of not being able to get anything done in my home as the burning pain is so horrible. Even right now, it hurts just to breathe, the pain is radiating down into my shoulder blade. Would a TENS unit make it go away?I am also on Oxycontin 10mg, and it doesn't phase the pain what-so-ever. It does help with the Migraines I suffer, but not this intense burning pain. It's affecting my neck, down thru the shoulder blade, and at times hurts to even breathe. I'm at my wits end.
doctor
Answered by Dr. Dr. Muhammad Sareer Khalil (19 hours later)
Brief Answer:
Explained

Detailed Answer:
Hello again

If there is kidney disease then NSAIDs and corticosteroids should be avoided as it can lead to renal failure, acutely. The gabapentin dose can be gradually increase to 2400 mg per day in divided doses in severe cases. A suboptimal dose may also be the cause of failure to have any relief. Tizanidine can be taken up to 4 times a day. You can discuss increasing the dose of these medications.

Transcutaneous electrical nerve stimulation (TENS) is a viable option and is recommended in severe atypical pain. Its worth giving it a try. One can never be a 100 percent sure with a certain approach.

Wishing you best of health

Thanks

Let me know if you have any query
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Muhammad Sareer Khalil (7 hours later)
I was on 4800 mg of Gabapentin a few years ago. It was for censor nerve damage in left knee. They called it Reflex Sympathic Distrovy Symdrom (RSDS), it's a twin sister to Fibrology. It affects the censor nerves. That was in 1998. They took me off after about 6 months as it was having no affect on the censor nerves.
Three years ago I was put on Lyrica to help control my migraines. I had a seizure when I took the medication.
doctor
Answered by Dr. Dr. Muhammad Sareer Khalil (11 hours later)
Brief Answer:
Explained

Detailed Answer:
Hello again

Both pregabalin and gabapentin are basically anticonvulsant meds with pain relieving properties.
They should not be stopped abruptly without tapering the dose at which you were taking else the risk of seizures increases significantly.

You can go for TENS or the intra articular shot in consultation with your doctor, instead.

Wishing you best of health

Thanks
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Dr. Muhammad Sareer Khalil

General & Family Physician

Practicing since :2012

Answered : 2906 Questions

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What Causes Numbness In The Left Shoulder?

Brief Answer: injection neuropathy with associated paresthesia Detailed Answer: Hello and Welcome I appreciate your concern Based on your description, injection neuropathy with associated paresthesia can be the cause of the pain and burning sensation. Adhesive capsulitis (Frozen shoulder) is another possibility. However, the paresthesia are not as pronounced as pain in that case. Treatment in both cases is similar. If NSAIDs, heat, ice etc aren't working then its time step up the treatment to corticosteroids. A short course of steroids such as prednisolone can help. NSAIDs can be replaced by prednisolone. A PPI can also be added to the regimen. Pregabalin or gabapentin can help with the neuropathic component of the pain as well as the paresthesia. Muscle relaxants like tizanidine should also be advised. If this combination doesn't yield improvement in overall symptoms then intra articular subacromial or glenohumeral injection can be advised in consult with your doctor. Wishing you best of health Thanks Let me know if you have any query Please consult your doctor before deciding on any further course of action. For future follow up / correspondence you may ask me directly at the link given below http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=68107 Dr. M.S. Khalil