Brief Answer:
It seems to be due to arm nerve involvement caused by the implant !!!

Detailed Answer:
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I have thoroughly reviewed health query you raised, and well realize all of those concerns. Being your physician, I will take care all of them today and will extend my expertise to solve the problems.

It seems more likely to be due to peripheral nerve involvement due to implant that has caused the nerve damage and irritation. It is a common problem but not every patient gets the issue with same procedure done surgically. Also, some get it earlier some later on.

If we go into the details of the issue you have, there is a disease named "Complex Regional Pain Syndrome=CRPS" that is actually pain and other symptoms in a limb as you have in your arm. Reason is the same :peripheral nerve involvement that may be damaged or is irritated due to implant. You have less sweating on affected arm and that is due to damage to the tiny blood vessels in the area of supply of affected nerve (microcirculation damage).

This also causes numbness and is natural course of the disease. Paresthesias is the term we use for it. Actually the injured nerve fibers release some chemicals that damage small blood vessels supplying the skin. Temperature regulation efficiency of skin is affected and it affects sweating, feeling of touch etc in the area.

For diagnosis we need to rule out Diabetes, some vein clot in affected arm that may also cause such symptoms in peripheral body areas.

Prognosis of the disease is good if dealt with earlier on.

Management includes: (Consult your Orthopedist for the medications discussed below that I usually prefer for my patients. He may also think of more advanced ones if you feel less improvements with below detailed medicines. Those include BOTULINUM INJECTION and some more. Discuss with your Doctor.)
1. Rehabilitation (Exercises):
Patients like you have got benefits in weeks to months and I have seen that consistency can give better results. You have to keep the arm moving so that small blood vessel circulation improves, muscles get more strength and energy.
2. Psychotherapy is also a good technique and I have seen remarkable improvements in my patients with Pain issues. Your Physician may help you counsel and how to deal with pain through Psychotherapy.
3.Medication: If I was your treating Physician I would have prescribed you with *NAPROXEN SODIUM for pain relief. Better to take with meals and to use for unbearable pain only.
*PREDNISOLONE for inflammation and injury reversal.
*PREGABALIN is good for nerve related pains.
*BENGAY ULTRA STRETCH OINTMENT (or VOLTAREN GEL) to apply topically and massage gently.
*Apply THERMACARE HEAT WRAPS on affected arm to soothe and raise blood circulation. It will improve symptoms.

Dizziness during sleep may or may not be related to this issue and most probably has some other reason like hypotension, imbalanced fluid and electrolyte balance or nutritional deficiency, hypothyroid disease of the thyroid gland etc. You need to consult your primary care physician for proper evaluation of cause of dizziness.

Hope I addressed all the concerns you have. Let me know if you have further questions. I will be more than happy to clear any doubts. Please give your 'rating' (if agreed, Five Stars) to help me assist patients in a better way; and, please don't forget to click on 'Close The Discussion'.
For any disease you have, a timely follow-up is necessary regarding the treatment efficacy and to see if there is a need to change treatment options. So keep a follow up to see how you doing (Always write down my name in start of your questions at this forum & I will be with you in no time).


Regards!
DR. HANIF
USA

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