The conditions that can cause this type of pain are:. In addition to pain, you may also experience some of the following symptoms in or around your right shoulder and arm:. You may think that heart attack pain may only radiate to your left shoulder and arm. However, according to the American Heart Association , heart attack pain can be felt in the shoulders and one or both arms. If you or someone else is experiencing right shoulder and arm pain that occurs with any of the symptoms below, call If your right shoulder and arm pain is mild to moderate, you can try the following things at home before making an appointment with your doctor.
If you talk with your doctor about right shoulder and arm pain, they may recommend the following, depending on the severity of your condition. Exercise can help reduce pain and improve your flexibility. In fact, a review of 16 studies found that exercise therapy can be just as effective at easing persistent shoulder pain as corticosteroid injections or decompression surgery.
Below are three exercises that you can try out to help ease or prevent pain in your right shoulder or arm. You can do these stretches either standing up or sitting down.
When doing any exercise or stretch, remember to always use good posture and never push yourself further than you can go. When you do this exercise, you can feel the stretch in your chest, shoulders, and upper arm biceps. Many conditions can lead to pain in your right shoulder and arm. This pain can affect different locations and may sometimes happen with numbness. The most common cause of right shoulder and arm pain is an issue with your rotator cuff, such as tendinitis or bursitis.
Other potential causes include fractures, arthritis, and cervical radiculopathy. If you have mild to moderate pain, you can try using home remedies such as R. When something goes wrong with your shoulder, it hampers your ability to move freely and can cause a great deal of pain and discomfort.
In many cases…. Arm pain is defined as discomfort or pain experienced anywhere throughout your arm. It can include pain in your wrist, elbow, and rotator cuff. But pain in one part of the body can sometimes originate elsewhere. A pain in your left arm could…. Learn how to do 10 simple shoulder exercises to relieve pain and tightness, increase your range of motion, and bring greater comfort and ease to all….
The rotator cuff is a common spot for injuries. The most common are tears, strains, tendinitis, and bursitis. Learn more. Learn what can cause bone spurs in your shoulders, see images of bone spurs, how to recognize common symptoms, and how to seek treatment.
Dead arm syndrome occurs when repeated overhead motions, such as throwing a ball, injures the muscles or tendons in the shoulder. Learn about symptoms,. Rotator cuff tears are common injuries caused by damage to the muscles or tendons that stabilize your shoulder joint. They can be diagnosed by using a…. Coronavirus always appears to be two steps ahead of efforts to contain it. It wields its unpredictability in the area of symptoms. As the virus has ravaged communities, it has become all too apparent that it is not comparable to the flu.
This curveball has come at a hefty cost - intensive care units have had to contend with blood clot formations in seemingly healthy individuals, for example. A New York cyclist who developed severe leg pain in May was initially diagnosed via telemedicine with a bulging disc.
She sought a second telemedicine opinion with Dr. Jordan Metzl, a sports medicine specialist at the Hospital for Special Surgery in New York, who asked her to move, twist and put pressure on her legs as he watched her on video. An ultrasound showed she had no pulse in her legs and severe clotting in both legs, putting her at risk of amputation. Metzl said it was fortunate that he had just had a conference call with colleagues about blood clots and COVID. Rhabdomyolysis is rarely seen and was only reported in 0.
A magnetic resonance imaging MRI showed hyperintense T2-weighted signal of supra- and infraspinatus muscles, indicating intramuscular edema, with normal cervical spine and both brachial plexuses, further confirming the diagnosis Fig. Magnetic resonance imaging MRI of cervical spine and both brachial plexuses in a year-old male. An extensive blood workup showed normal complete blood count; renal and liver functions; serum electrolytes; creatine kinase; inflammatory markers erythrocyte sedimentation rate, C-reactive protein ; serum vitamins B1, B6, B12, and folate; protein electrophoresis; immunoglobulin essay; thyroid function; and antithyroid autoantibodies.
A panel for vasculitis and autoimmune antibodies yielded negative results. Cerebrospinal fluid CSF analysis showed normal protein and glucose levels, with no WBCS, negative culture and sensitivity, and gram stain for bacterial infection. Polymerase chain reaction screening for neurotropic viruses was negative in serum and CSF. The patient was commenced on intravenous methylprednisolone mg per day for 5 days, but it was stopped due to dermatological side effects.
There was partial relief of pain with no improvement in muscle power. His motor and sensory examinations remained the same after 8 weeks of symptoms onset. In an early study from China [ 8 ], it was estimated to affect 8. This involvement may result from direct neuro-invasion or from an autoimmune, post-infectious mechanism [ 8 ]. Understanding the sequence and mechanism of events leading to neural damage in patients with COVID might help in early diagnosis and treatment and highlights the need for prospective research on patterns of peripheral and central nervous system involvement in patients with COVID [ 9 ].
Neuralgic amyotrophy is a rare form of peripheral neuropathy that has been rarely reported in association with COVID, to our knowledge. The report of Cacciavillani et al. The report of Siepmann et al. A third report by Mitry et al. These different presentations of post-COVID neuralgic amyotrophy highlight the possible variability of symptoms in patients with peripheral nervous system involvement with SARS-CoV-2 infection, and the importance of detailed assessment of patients with COVID for neurological deficits [ 9 ].
Neuralgic amyotrophy is a distinct disorder that is more common in males, predominantly affecting the roots of the brachial plexus, and characterized by excruciating neuropathic pain followed by multifocal paresis and sensory loss in C5, C6, and less frequently in C7 distribution. Diagnosis is confirmed by electrophysiological studies and sometimes with evidence of strain in the supra and infraspinatus muscles on MRI [ 10 , 11 ]. Some features in our report are different from the other published cases.
First, the bilaterality of pain and weakness, which is an uncommon feature of neuralgic amyotrophy in itself. Second, the very early onset of symptoms during the initial presentation of COVID, suggesting a probable direct viral neuroinvasion, rather than an autoimmune post-infectious response against SARS-CoV-2 [ 13 ]. Moreover, our report showed hyperintense T2-weighted signal of supra and infraspinatus muscles in MRI. This is explained by denervation of skeletal muscles in the distribution of the brachial plexus nerves, due to intramuscular edema [ 14 ].
MRI helpsin ruling out other etiologies of painful shoulder weakness. Treatment of neuralgic amyotrophy has not been validated, in the absence of randomized controlled trials RCTs.
Intravenous immunoglobulin IVIg has also been proposed as a treatment [ 16 ], in case of contraindication to steroids or the emergence of side effects, similar to our case. Our case adds to the growing body of evidence of peripheralnervous system involvement in COVID patients.
Despite being a rare disease, neuralgic amyotrophy should be suspected and ruled out in COVID patients, presenting with severe pain and weakness of the shoulder and arm muscles. This study highlights the importance of detailed assessment of patients with COVID with neurological deficits, to avoid delay in diagnosis and allow for early management.
All authors critically appraised and revised it. All authors read and approved the final manuscript. Written informed consent for publication of this case report was obtained from the patient.
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