Persistent Shoulder and Arm Pain: Which Specialist Should You See?

Q: Persistent Shoulder and Arm Pain: Which Specialist Should You See?

Hello： It is recommended that you undergo further examination by a neurosurgeon to confirm whether there is cervical nerve compression causing the numbness and tingling in your upper limbs. <br>Thank you.

I have been troubled by shoulder, neck, and arm pain and numbness for a long time, and I don't know which specialty to consult for help?

Since waking up around 6 AM on November 24th, I have experienced a loud "pop" in my left shoulder joint when I raised my arm.
Following that, my left arm down to my hand has felt very numb, and there is some pain in the shoulder joint.
I have already visited an orthopedic clinic, which confirmed that there are no issues with the bones, and I have undergone rehabilitation without improvement.
Now, it is already the end of December, and I still occasionally experience numbness and soreness from my left arm to my hand, along with intermittent shoulder pain.
Sometimes it seems to improve, but when I lie on my side with a pillow while using my phone, the pressure on my scapula causes the numbness to return.
This issue of shoulder, neck, and arm discomfort is not new for me, but this time it is more painful.
I have seen the orthopedic clinic several times and undergone rehabilitation multiple times without a permanent solution.
I am unsure if my lack of neck stretching is preventing recovery (I have malocclusion, which makes neck stretching uncomfortable, so I have only been receiving electrical therapy).
Doctor, aside from orthopedics, which other specialty should I consult for my symptoms?

Pipi, 30~39 year old female. Ask Date: 2020/12/30

Dr. Wu Zongying reply Family Medicine

Hello: It is recommended that you undergo further examination by a neurosurgeon to confirm whether there is cervical nerve compression causing the numbness and tingling in your upper limbs.
Thank you.

Reply Date: 2020/12/30

More Info

Based on your description of persistent shoulder and arm pain, it seems that you have already consulted an orthopedic specialist and undergone rehabilitation without significant improvement. Given the complexity of your symptoms, which include shoulder joint noise, numbness, and pain radiating down your arm, it may be beneficial to consider consulting additional specialists.

1. Physical Medicine and Rehabilitation (PM&R) Specialist: Also known as physiatrists, these doctors specialize in restoring function and improving quality of life for patients with musculoskeletal issues. They can provide a comprehensive evaluation of your condition and develop a tailored rehabilitation program that may include physical therapy, pain management techniques, and other non-surgical interventions.

2. Neurologist: Since you are experiencing numbness and tingling in your arm and hand, a neurologist can evaluate for potential nerve-related issues. Conditions such as cervical radiculopathy, thoracic outlet syndrome, or peripheral neuropathy could be contributing to your symptoms. A neurologist may recommend nerve conduction studies or electromyography (EMG) to assess nerve function.

3. Rheumatologist: If there is a suspicion of an underlying inflammatory or autoimmune condition contributing to your pain, a rheumatologist may be able to provide insight. They specialize in diagnosing and treating conditions like rheumatoid arthritis, lupus, or fibromyalgia, which can manifest as joint pain and discomfort.

4. Pain Management Specialist: If your pain is severe and persistent, consulting a pain management specialist could be beneficial. They can offer various treatment options, including medications, injections, and advanced pain management techniques to help alleviate your symptoms.

5. Chiropractor: If you are open to alternative treatments, a chiropractor may help with spinal alignment and musculoskeletal issues. However, it’s essential to ensure that the chiropractor is experienced in treating conditions similar to yours and to communicate your previous treatments and concerns.

6. Occupational Therapist: An occupational therapist can assist you in adapting your daily activities to minimize pain and improve function. They can also provide exercises and strategies to help manage your symptoms effectively.

In addition to consulting these specialists, it’s crucial to address any contributing factors to your condition. For example, if you have a misalignment in your jaw (malocclusion) that affects your neck and shoulder posture, seeking treatment from a dentist or orthodontist may also be beneficial. They can evaluate your bite and recommend appropriate interventions.

Regarding your concern about not performing neck stretches due to discomfort, it’s essential to communicate this with your healthcare providers. They can suggest alternative exercises that do not exacerbate your symptoms or refer you to a physical therapist who can guide you through safe stretching and strengthening routines tailored to your needs.

In summary, given the persistence and complexity of your symptoms, it would be wise to seek a multidisciplinary approach. Consulting a physical medicine and rehabilitation specialist, neurologist, or pain management specialist could provide you with a more comprehensive evaluation and treatment plan. Additionally, addressing any underlying issues, such as jaw alignment, may also contribute to your overall recovery. Remember to keep an open line of communication with your healthcare providers about your symptoms and any concerns you may have regarding your treatment plan.

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