Left Shoulder Pain and Numbness: Which Specialist to See?

Left shoulder pain and numbness in the left hand?

I have been experiencing pain in my left shoulder for a while, which is usually relieved by applying a medicated patch.
However, recently the pain has intensified to the point where my left arm feels numb and weak.
Which department should I visit at the hospital?

Miss Lin, 20~29 year old female. Ask Date: 2022/10/04

Dr. Jiang Junyi reply Neurology

Hello Ms.
Lin,
You mentioned experiencing symptoms of "pain radiating to the left arm with numbness," which may indicate compression of the nerve roots from the sixth cervical vertebra to the thoracic spine.
This could be due to a herniated disc or structural issues with the vertebrae.
Symptoms of peripheral nerve compression include:
1.
Pain characterized by a burning sensation and tingling.
2.
Symptoms that have a specific dermatomal distribution, which can be triggered by touch or pressure.
3.
Accompanied by muscle weakness and fatigue.
Examinations for peripheral nerve issues typically involve electrophysiological studies to assist in diagnosis.
Nerve conduction studies assess the conduction velocity and waveform of large fiber nerves.
Electromyography (EMG) evaluates the muscle response in the affected nerve distribution areas.

I recommend that you consult with a neurologist or a rehabilitation specialist for further evaluation and follow-up.
Thank you for your inquiry, and feel free to discuss any related questions!
Wishing you good health and peace,
Dr.
Jiang Junyi, Taoyuan Medical Center

Reply Date: 2022/10/04

More Info

When dealing with left shoulder pain and associated numbness in the arm, it is essential to understand the potential underlying causes and the appropriate specialists to consult. Given your symptoms, which include persistent shoulder pain and numbness radiating down to your hand, it is advisable to seek evaluation from a specialist who can accurately diagnose and treat your condition.

Recommended Specialists
1. Orthopedic Surgeon: An orthopedic surgeon specializes in the musculoskeletal system, which includes bones, joints, ligaments, tendons, and muscles. If your shoulder pain is due to a structural issue, such as a rotator cuff tear, impingement syndrome, or other injuries, an orthopedic surgeon would be the right choice. They can perform physical examinations, order imaging studies (like X-rays or MRIs), and recommend treatments ranging from physical therapy to surgical interventions if necessary.

2. Neurologist: Since you are experiencing numbness in your arm, it may indicate nerve involvement. A neurologist specializes in conditions affecting the nervous system, including nerve compression syndromes such as thoracic outlet syndrome or cervical radiculopathy. They can conduct nerve conduction studies or electromyography (EMG) to assess nerve function and determine if there is a neurological component to your symptoms.

3. Physical Medicine and Rehabilitation (PM&R) Specialist: Also known as physiatrists, these specialists focus on restoring function and improving quality of life for patients with musculoskeletal and neurological conditions. They can provide a comprehensive rehabilitation plan, including physical therapy, pain management, and non-surgical interventions.

4. Rheumatologist: If there is a suspicion of inflammatory or autoimmune conditions contributing to your shoulder pain, a rheumatologist may be appropriate. They specialize in diagnosing and treating conditions like rheumatoid arthritis or other inflammatory disorders that can affect the joints and surrounding tissues.

Initial Steps to Take
- Consult Your Primary Care Physician: Before seeing a specialist, it may be beneficial to consult your primary care physician. They can perform an initial evaluation, provide referrals, and help coordinate your care.

- Imaging Studies: Depending on your symptoms, your doctor may recommend imaging studies such as X-rays, MRIs, or CT scans to assess the condition of your shoulder joint and surrounding structures.

- Physical Therapy: Regardless of the specialist you choose, physical therapy can be an effective treatment for shoulder pain. A physical therapist can design a rehabilitation program tailored to your needs, focusing on strengthening the shoulder muscles, improving range of motion, and reducing pain.

Conclusion
In summary, given your left shoulder pain and numbness in your arm, starting with an orthopedic surgeon or a neurologist would be advisable. They can help determine the underlying cause of your symptoms and develop an appropriate treatment plan. Early intervention is crucial to prevent potential complications and improve your quality of life. Don't hesitate to seek help, as timely diagnosis and treatment can lead to better outcomes.

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