Chronic pain in Neck, shoulder and arm

What does she do for a living?
I was a lab tech...lots of manual pipetting (in 70s-90s) on equipment designed for male hands/anatomy, plus computer data entry, with several issues around carpal tunnel, ulnar nerve entrapment(around elbow), and eventually issues could not be resolved with PT or NSAIDs, so in the late 80s I progressed to pain management. I actually had injections through the front of the R side of my neck of lidocaine or xyzlocain and perhaps steroids, into the C3 area, IIIRC. It was Ling ago. Relief lasted for roughly ten or 12 years but as I transitioned jobs and more computer work I has recurring issues that needed PT and all.the work station accommodations the PT could recommend. Lotsa NSAIDs would stave it off but not always. Never bad enough for surgery. Each of us has different levels of pain tolerance too, so she may be genetically predisposed to sense pain more acutely. Now retired I have some minor damage at rotator cuff, and my ball and socket at shoulder are misaligned....probably from birth but tolerated til it wasn't.
If all the structural issues have been investigated (and it sounds like they have) then that leaves something metabolically, perhaps. So family history might matter?

Hi, I had a workplace injury in December 2021, drs initially treated me for shoulder bursitis, pain was in shoulder and down my right arm into my thumb and pointer finger, I was given 2 cortisone injections that didn’t help, I then had an MRI to check the brachial plexus and all came back clear. Dr did MRI of cervical spine and found c5/6 and c6/7 were herniated, I underwent 6 months of physio 3x week, still no relief so I was given an epidural injections in both c6 and c7 nerve roots, all this done was cause the pain to worsen and move to my neck, 3 months later I ended up having C6/7 adcf, waking up from surgery I had a strange burning buzzing sensation down my entire right side, drs assured me everything was normal, the arm and neck pain were worse than ever!!!
3 months post surgery, new MRI showed surgery was successful regardless of ongoing pain, I was sent for EMG which was within normal limits, after this appointment I was diagnosed with right upper quadrant CRPS.
6months pass and the pain burning pressure and pain now runs down my entire right side, I have since been diagnosed with ipsilateral CRPS.
I have had a 8 day ketamine infusion, 4 sympathetic lumbar blocks, 4 stellate ganglion blocks and a trial of 2 different spinal cord stimulators.. nothing helps with the pain

Chronic regional pain syndrome might be something to look into, does your wife suffer from colour or temperature changes in her arm or hand?

@jack993
Has your wife had an updated MRI of her cervical spine after her ACDF surgery and more recently? Did you read through the detail of the MRI report? Did her MRI show spinal cord compression or nerve root/nerve/radiculopathy? I had ACDF surgery c5-c6 due to spinal cord flattening/compression injury affecting neck/shoulders/arms/hands. I was never sent for PT. Why did your wife have 40 sessions in 3 months?

Has your wife had X-rays/ultrasound/MRI/CT scan of shoulder/arm/hand?

Has your wife had a vein specialist look at her veins/blood vessels from neck to fingers? Microvascular issues should be ruled out, too.

Has your wife had a MRI of her brain? Has she had a spinal tap to check for elevated proteins for chronic inflammatory demyelinating neuropathy?

Has your wife had testing of viruses that impact central/peripheral nervous systems (like Epstein Barr/mononucleosis, herpes simplex/chickenpox, etc.)? Did your wife get COVID vaccines in that arm?

Has your wife had an ultrasound of her neck/thyroid to see if there is a nodule compressing nerves/blood vessels to right shoulder to fingers?

Has your wife had a myelogram mapping of nerves to check nerve health? Did she have an upper EMG done by a neurologist?

Thats for replying dear Terry and i wish you will get better soon.

She was working back office in a bank and currently she quitted due to this issue.

Fortunately no historical issues were reported that might be related to those symptoms.

Thank you DLY for replying.

Thankfully, cervical spine MRIs are clear with no complications or disc compression.

Before the operation, there was a mild compression on the nerve root, and now that compression was resolved.
The most common thing doctors keep on saying that her cervical spine is straight with no C curve shape due to muscles spasms.

XRays, MRIs and ultrasound reports showed that she has an inflammations on the shoulder even after the capsular release surgery.

Regarding veins and blood vessels, all showed clear.

Protein ratio is very high and to be more accurate, it’s currently double the normal amount.

Both COVID shots were taken on both shoulder on 2021.

As for the myelogram mapping m, i contacted our doctor and asked for that test in order to check this one as well.

Thank you Misty for your reply.

Could you please tell me, what are the tests that you've done and were diagnosed as CRPS? Because in Jordan (where we live) doctors diagnose any patient that his/her symptoms are not direct, they could diagnose CRPS or fibromyalgia,… etc. with no solid evidence.

Hope you will get well soon dear.

I’m in Australia.. 42yr old female
Crps here is diagnosed by the Budapest criteria, there are no definitive tests.

I had a 3D bone scan and ct spect scan all results were normal.
I had an EMG 3 months post adcf which was normal, but I did have signs and symptoms of crps such as sensitivity to touch, constant burning/tingling pressure pain, swelling, stiffness and both colour and temperature changes.
12months after this I spent a week in hospital having a continuous ketamine infusion, I had another EMG this time it showed damage/denervation at the C7 nerve root.
I also had a brain scan mri which showed I had lesions on both frontal lobes but neurologist assured me they were nothing to cause concern, probably just because I suffer from chronic migraines, no other lesions were found anywhere in the spine.
I also had a lumbar punch in order to check for an autoimmune component but thankfully they were all clear.

Due to the nerve damage (which took 12months to show on EMG) I have been diagnosed with CRPS type 2 in right upper quadrant and crps type 1 in my right lower limb.

I just had an IME with the work cover dr, he made the assumption that my lower limb symptoms could be due to osteoarthritis but I have just had X-ray of hip, knee and foot and results are all clear, they confirm that there is no other reasonable explanation for my lower limb symptoms other than CRPS.

It’s been a long road, I’m almost 3 years in now, keep advocating for your wife I’m sure she appreciates your support
I wouldnt wish CRPS upon anyone, it’s horrible, I truely hope you both get to to the bottom of what’s going on

Cheers Leigh

sounds horrible (as I sit here in the same kind of pain!) Try botox in the muscles which are impinging on the nerves causing pain, try MRF (that is SUPER helpful for pain relief - kiss a lot of frogs to find the prince!) and try low dose opioids (I like percocet) if she doesn't have an addiction issue. Acupuncture. I am in P.T. now and it only seems to exacerbate my pain and muscle spasms. WET HEAT and stretching. Try sleeping on a rolled towel. I did that for maybe 6 months straight and it TOTALLY helped! I am going to start doing it again tonight. I had two cervical surgeries - on both sides. So sad it didn't resolve my problem. Oh - and wear a soft $10 whiplash cushy brace when she gets tired (when the muscles get tired) that is GREAT. I was good for about 30 years and then I wasn't. Seems my auto accidents and whiplash added up. It can take a couple of years to heal. My last whip lash was 6 weeks ago. Good luck.

Has she had any physiotherapy?

Has anyone checked her for brachial neuritis? I have a suspicion. This might be what it is. The clinical name is Parsonage Turner syndrome. I currently have this , mine started on May 10. I always put on steroid packs and pain medication. I still have partial paralysis of my arm and am in PT. if you suspect this could be it the neurologist needs to do a brachial plexus MRI as well as a nerve conduction study.. good luck I hope possibly this might help.