Pain in shoulders and upper arms.

[jimn]

I had a hip replacement in the UK last August which went very well and I was soon back in the gym  My problem is that about 6 weeks after my op I started to get severe shoulder and arm pain,  which also radiates down to my left thumb. I also have a slight swelling in the neck above the left collar bone. I don't know if this is due to the use of crutches etc. Now 6 months later this is no better. I have been going to a Chriopractor for 5 sessions, he says I have pinched/trapped nerves. But after 5 weeks it is no better. Any ideas advice for diagnosis and treatment @SherylThanks. I am based in Pattaya.

[CharlieH]

C5 Nerve Root (C4-C5 Disc Level):

Can cause pain in the shoulder, lateral upper arm (deltoid region), and down to the elbow.

May also lead to weakness in the deltoid and biceps muscles.

Commonly affected by cervical disc herniation or foraminal stenosis.

C6 Nerve Root (C5-C6 Disc Level):

Pain can radiate from the neck to the shoulder, outer upper arm, down to the thumb and index finger.

Weakness may occur in the biceps and wrist extensor muscles.

Can be affected by degenerative disc disease, herniated discs, or cervical spondylosis.

 

Gentle Neck Stretches & Mobility Exercises (if pain allows)

Chin tucks: Tuck your chin in slightly while keeping your head level. Hold for 5 seconds, repeat 10 times.

Neck side bends: Slowly tilt your ear toward your shoulder, hold for 5 seconds, switch sides.

Shoulder blade retractions: Squeeze your shoulder blades together and hold for a few seconds.

 

Manual Therapy & Professional Help

Physiotherapy: A therapist can guide you with proper exercises and posture corrections.

Chiropractic Adjustments (if safe for you): May help realign the cervical spine.

Massage Therapy: Helps relieve muscle tightness around the nerve.

 

Check your pillow! How you sleep and correct nexk Support is always worth checking.

[jimn]

18 minutes ago, CharlieH said:

C5 Nerve Root (C4-C5 Disc Level):

Can cause pain in the shoulder, lateral upper arm (deltoid region), and down to the elbow.

May also lead to weakness in the deltoid and biceps muscles.

Commonly affected by cervical disc herniation or foraminal stenosis.

C6 Nerve Root (C5-C6 Disc Level):

Pain can radiate from the neck to the shoulder, outer upper arm, down to the thumb and index finger.

Weakness may occur in the biceps and wrist extensor muscles.

Can be affected by degenerative disc disease, herniated discs, or cervical spondylosis.

Thanks Charlie. It's both arms/shoulders that's the problem. I had no previous problems with my shoulders until as I said about 6 weeks after my right hip replacement. I am considering an xray as a first step but am unsure if it will show what is the problem. MRI would obviously be the ultimate test but for shoulder's and neck both sides it will be expensive.

 

[CharlieH]

3 minutes ago, jimn said:

Thanks Charlie. It's both arms that's the problem. I had no previous problems with my shoulders until as I said about 6 weeks after my right hip replacement. I am considering an xray as a first step but am unsure if it will show what is the problem. MRI would obviously be the ultimate test but for shoulder's and neck both sides it will be expensive.

 

 

Uneven weight distribution: Using crutches shifts weight to the upper body, especially the shoulders, neck, and arms.

Forward-leaning posture: Crutch use often causes a forward head posture, straining the cervical spine (C5/C6 area).

Overuse of upper body muscles: The deltoids, trapezius, and rotator cuff work harder, leading to muscle tightness and potential nerve comp

[potless]

Royal Physiotherapy Clinic Pattaya. www.physiotherapistpattaya.com .

Worth a visit. On 3rd road near to the old Tonys gym. They used to have another premises on soi khao noi. 

[Sheryl]

1 hour ago, jimn said:

Thanks Charlie. It's both arms/shoulders that's the problem. I had no previous problems with my shoulders until as I said about 6 weeks after my right hip replacement. I am considering an xray as a first step but am unsure if it will show what is the problem. MRI would obviously be the ultimate test but for shoulder's and neck both sides it will be expensive.

 

To be clear, when you say "both shoulders and arms" do you mean pain is on both the right and left sides? Or just that both the arm and shoulder of one side are affected? 

[jimn]

30 minutes ago, Sheryl said:

To be clear, when you say "both shoulders and arms" do you mean pain is on both the right and left sides? Or just that both the arm and shoulder of one side are affected? 

Thank you. Both shoulders and both arms are affected. The swelling in my neck is on my left side between the shoulder and neck just above the collar bone. The pain is sharp in upper arm when I use my arms to stand up applying pressure. I can raise my arms but in a circular movement I get pain in upper arm, this is both sides. Back of the neck around the highest point of my spine is sore. Some pain at the lower part of left thumb above the wrist. Thing is I can still go to the gym and do cardio treadmill and bike but no weights or lifting. I am 69 years old by the way 

[jimn]

1 hour ago, CharlieH said:

 

Uneven weight distribution: Using crutches shifts weight to the upper body, especially the shoulders, neck, and arms.

Forward-leaning posture: Crutch use often causes a forward head posture, straining the cervical spine (C5/C6 area).

Overuse of upper body muscles: The deltoids, trapezius, and rotator cuff work harder, leading to muscle tightness and potential nerve comp

Thank you that's my theory on why this started. My worry is, what is the treatment. It's been a while now with no improvement.

[No Forwarding Address]

2 hours ago, jimn said:

Thanks Charlie. It's both arms/shoulders that's the problem. I had no previous problems with my shoulders until as I said about 6 weeks after my right hip replacement. I am considering an xray as a first step but am unsure if it will show what is the problem. MRI would obviously be the ultimate test but for shoulder's and neck both sides it will be expensive.

 

I have had good luck seeing a Chinese acupuncturist……….took half a year with weekly treatments but pain is gone, I couldn’t even wash under my arms, shoulders and upper arms were in such pain.  plenty of them in Bangkok.

[Celsius]

8 minutes ago, No Forwarding Address said:

I have had good luck seeing a Chinese acupuncturist……….took half a year with weekly treatments but pain is gone, I couldn’t even wash under my arms, shoulders and upper arms were in such pain.  plenty of them in Bangkok.

 

I would never do this. Acupuncture may relieve symptoms but not the cause of pain.

 

 

[No Forwarding Address]

Just now, Celsius said:

 

I would never do this. Acupuncture may relieve symptoms but not the cause of pain.

 

 

Hmmmm. I have been almost pain free for the past year……….guess it is a miracle huh??

[Celsius]

3 minutes ago, No Forwarding Address said:

Hmmmm. I have been almost pain free for the past year……….guess it is a miracle huh??

 

I have no idea what you suffered from. Reading the op, acupuncture is the last thing I would do 

[Sheryl]

6 months is a long time, longer than would be expected if the problem were just muscle related. 

 

The likely differential is between cervical spine issue compressing the nerves and a bilateral shoulder injury. I would start by ruling out the first. You will need to come to Bangkok to see a spine specialist. Get an MRI of cervical spine first and bring with you on DVD.  Xray of cervical spine will also be needed. Xray is not expensive but the best price you can get on MRI is 9k at an imaging center:

 

https://mrithailand.com/

 

Ask for MRI of cervical spine without contrast. There is a branch in Bang Na which is convenient when coming from Pattaya. Do not worry about waiting for report, spine specialist will disregard anyway and read the scan themself. Just bring it on DVD which you can get right after the scan.

 

In  terms of doctors, I suggest one of these 2:

 

https://www.bnhhospital.com/search-doctor/entry/4093/

 

 

https://www.bch.in.th/find-doctor/52

 

Consultation plus Xrays will be around 4-5 k. 

 

Get recommendations in writing in case you want to go elsewhere for actual treatment. 

[Lacessit]

6 minutes ago, Celsius said:

 

I have no idea what you suffered from. Reading the op, acupuncture is the last thing I would do 

There is a scientific basis for acupuncture. It works for some muscle injuries, not for others.

I have not heard of it causing harm when done by a qualified practitioner, although infection and organ puncture are possible with unskilled people.

[CharlieH]

1 hour ago, jimn said:

Thank you that's my theory on why this started. My worry is, what is the treatment. It's been a while now with no improvement.

Unfortunately there is unlikely to be any "quick fix" if this is nerve or soft tissue related, correct exercise/stretch  routine, and decent massage (not the soft happy ending type) should see improvement. The work is mostly on your part, with posture, flexibility exercise and strengthening supporting muscles.

 

Why not go along to the suggested physiotherapy centre and get an assessment and go from there .

 

I would try this before incurring possibly unnecessary expense of MRI etc, not saying rule it out, but if you are paying and not insurance I would explore other options before digging into the bank balance for specialist or imaging etc. 

[No Forwarding Address]

30 minutes ago, Celsius said:

 

I have no idea what you suffered from. Reading the op, acupuncture is the last thing I would do 

In all fairness, I forgot to mention along with the acupuncture, I went thru Gua Sha and Cupping sessions, all seemed to work - there’s something to say about traditional Chinese medicine.    Peace

[jimn]

31 minutes ago, CharlieH said:

Unfortunately there is unlikely to be any "quick fix" if this is nerve or soft tissue related, correct exercise/stretch  routine, and decent massage (not the soft happy ending type) should see improvement. The work is mostly on your part, with posture, flexibility exercise and strengthening supporting muscles.

 

Why not go along to the suggested physiotherapy centre and get an assessment and go from there .

 

I would try this before incurring possibly unnecessary expense of MRI etc, not saying rule it out, but if you are paying and not insurance I would explore other options before digging into the bank balance for specialist or imaging etc. 

Thanks for the advice Charlie

[jimn]

40 minutes ago, Sheryl said:

6 months is a long time, longer than would be expected if the problem were just muscle related. 

 

The likely differential is between cervical spine issue compressing the nerves and a bilateral shoulder injury. I would start by ruling out the first. You will need to come to Bangkok to see a spine specialist. Get an MRI of cervical spine first and bring with you on DVD.  Xray of cervical spine will also be needed. Xray is not expensive but the best price you can get on MRI is 9k at an imaging center:

 

https://mrithailand.com/

 

Ask for MRI of cervical spine without contrast. There is a branch in Bang Na which is convenient when coming from Pattaya. Do not worry about waiting for report, spine specialist will disregard anyway and read the scan themself. Just bring it on DVD which you can get right after the scan.

 

In  terms of doctors, I suggest one of these 2:

 

https://www.bnhhospital.com/search-doctor/entry/4093/

 

 

https://www.bch.in.th/find-doctor/52

 

Consultation plus Xrays will be around 4-5 k. 

 

Get recommendations in writing in case you want to go elsewhere for actual treatment. 

Thanks for the advice Sheryl 

[ExpatOilWorker]

Calcific tendinitis, maybe?

 

[Oliver Holzerfilled]

4 hours ago, Sheryl said:

6 months is a long time, longer than would be expected if the problem were just muscle related. 

 

The likely differential is between cervical spine issue compressing the nerves and a bilateral shoulder injury. I would start by ruling out the first. You will need to come to Bangkok to see a spine specialist. Get an MRI of cervical spine first and bring with you on DVD.  Xray of cervical spine will also be needed. Xray is not expensive but the best price you can get on MRI is 9k at an imaging center:

 

https://mrithailand.com/

 

Ask for MRI of cervical spine without contrast. There is a branch in Bang Na which is convenient when coming from Pattaya. Do not worry about waiting for report, spine specialist will disregard anyway and read the scan themself. Just bring it on DVD which you can get right after the scan.

 

In  terms of doctors, I suggest one of these 2:

 

https://www.bnhhospital.com/search-doctor/entry/4093/

 

 

https://www.bch.in.th/find-doctor/52

 

Consultation plus Xrays will be around 4-5 k. 

 

Get recommendations in writing in case you want to go elsewhere for actual treatment. 

OP also noted "I also have a slight swelling in the neck above the left collar bone."

Maybe an unrelated issue?

[Presnock]

On 3/2/2025 at 11:03 AM, CharlieH said:

C5 Nerve Root (C4-C5 Disc Level):

Can cause pain in the shoulder, lateral upper arm (deltoid region), and down to the elbow.

May also lead to weakness in the deltoid and biceps muscles.

Commonly affected by cervical disc herniation or foraminal stenosis.

C6 Nerve Root (C5-C6 Disc Level):

Pain can radiate from the neck to the shoulder, outer upper arm, down to the thumb and index finger.

Weakness may occur in the biceps and wrist extensor muscles.

Can be affected by degenerative disc disease, herniated discs, or cervical spondylosis.

 

Gentle Neck Stretches & Mobility Exercises (if pain allows)

Chin tucks: Tuck your chin in slightly while keeping your head level. Hold for 5 seconds, repeat 10 times.

Neck side bends: Slowly tilt your ear toward your shoulder, hold for 5 seconds, switch sides.

Shoulder blade retractions: Squeeze your shoulder blades together and hold for a few seconds.

 

Manual Therapy & Professional Help

Physiotherapy: A therapist can guide you with proper exercises and posture corrections.

Chiropractic Adjustments (if safe for you): May help realign the cervical spine.

Massage Therapy: Helps relieve muscle tightness around the nerve.

 

Check your pillow! How you sleep and correct nexk Support is always worth checking.

great reply! as usual with varied suggestions.  Pillow can be a big problem, especially if your sleep position doesn't match the pillow and mattress.  Best of luck.

[JJ-Thailand]

How about visiting a large private Thai hospital, they'll find out what's wrong.

[PFMills]

You could try a physio …I travel from Bangkok to Si Racha to Supak Physio Clinic…I think that she is very good, bit painful sometimes but my spine  is straighter.

[Snackbar]

Josh Brolin on JRE

 

worked out till it fixed itself 

[jimn]

2 hours ago, Presnock said:

great reply! as usual with varied suggestions.  Pillow can be a big problem, especially if your sleep position doesn't match the pillow and mattress.  Best of luck.

Thank you. I find it painful in my neck to sleep on my left side and yes my pillow is soft and probably too low. I will look for an alternative.

[Crazy Noobie]

I had the same issue and found out it was a pinched nerve. With therapy for 3 month the pain all went away. Except the numbness in my fingers never did and it's been over 10 years now.