Doctor I have severe in the right shoulder and neck, right upto the forearm since 4 days.
Gently lift the arm, at the shoulder, above the head. If this is very painful, it is shoulder periarthritis or Frozen shoulder. If this is painless, it is cervical spondylitis to the patient, it is painless. Dou you get tingling numbness in the fingers? No. Does the pain radiate to the fingers? Yes. Do you get giddiness on looking upwards?
This looks like cervical spondylitis.
Palpate cervical spine, and paravertebral muscles, upto trapezius for tenderness. Test all the neck movements, flexion, extension, lateral flexion and rotation. (Pain on extension and lateral confirms the diagnosis spondylitis).
Compare both palms and look for wasting in Thenar and hypothenar eminence. If patient is young. Test for cervical rib or thoracic outlet syndrome.
If pain was radiating to the left arm, ask- Does it increase on walking or activity? Angina must be ruled out.
Ask for history of Epigastric burning or sour eructations in the past (Peptic ulcer). Before prescribing and NSAID. Ask History asthma. Check the BP.
Action:
Local liniments, Injectible or oral NSAID’s, Regular neck muscle exercises. If pain is severe. Ask for X-ray of cervical spine AP and Lateral. Cervical traction 5-7 kg, for 20 minutes, 2 times a day, for 5 days. Cervical collar for constant use.
