Question to GP Maarten: Pain in my neck and can hardly use my arm
Maarten Vasbinder lives in Isaan. His profession is general practitioner, a profession that he mainly practiced in Spain. On Thailandblog he answers questions from readers who live in Thailand and writes about medical facts.
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Dear Martin,
Much respect for your human commitment in the medical field, I don't know if you can do anything with the following, just look. Wednesday morning around 7.30 am, lying on my stomach in the sun on a cushion, checking my e-mail on my mobile phone. Because my eyes are too close, I have to raise my head, with the result that after an hour and a half I straightened up and from that moment on my neck started to hurt.
Keeping warm and moving, but later nothing came of sleeping, too much pain. The next day my lady felt so sorry for me: “I help you, massage your arm?” Okay I let it happen, kneaded for at least 15-20 min, rubbed to the bone and probably touched more because believe it or not it cost me 3-5 nights of sleep. Except for a few hours in between, I can still barely use my arm, can't lift anything, can only hold things in my fingers.
Sleeping is now the problem again, I am a right side sleeper.
Now after a week I'm fed up and it makes me grumpy, painkillers don't help me and I'm really not economical with them. As; 2x500mg paracetamol, dicloFENAC 4x 25mg even morphine from the hospital noticeably does something.
I'm a bit distraught but we hold the head for her
I am 68, 177 cm tall and 70 kg, use QVAR extra fine aerosol 2x 2 puffs/day to keep asthma in check.
Regards,
M.
*****
Dear M.
If your lady only massaged your arm, it didn't do much harm, just a little extra pain. Therefore, cool your arm below the shoulder. If she did your neck too, it's a different matter. That can really hurt. Heavy-handed Thai massage is not without danger and I would never recommend it to anyone.
A good exercise is to contract all the muscles of the face and then move the neck in all directions. Your face will not become more beautiful during this exercise, but your beauty will return when you relax again. You will also hear some crackling and creaking.
If that doesn't help, you can consult a real physiotherapist. Traction often gives a good result in such a case.
I would also get a muscle relaxant. If necessary Valium (Diazepam) 5 mg. Do not use for too long, because of addiction.
If none of that works and/or if the complaints become more severe, then it is time for a visit to a neurologist or neurosurgeon. It will then order a scan. Then you can see further. Treatment is then given depending on your age. Maybe a collar. This is especially nice in the fridge.
Get a pillow that fills the space between your neck and shoulder so that your neck is straight when you sleep.
Most likely, you have exacerbated an existing hernia at level C5-C6-C7, causing a muscle spasm (cramping) which in turn compresses a nerve going to your arm as it propels the hernia out.
There are of course other diagnoses, but they are less likely in your case, because there is a clear "trigger moment".
As a painkiller I would take Paracetamol at most. 3×500
If you have more questions, let me know. Then I would also like to hear your age, employment history and any sports you have practiced and medical history. Do you smoke? The diagnosis is often hidden in such data.
Yours faithfully,
Dr. Maarten