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severe pain after having blood drawn

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was just at the local small town clinic getting blood drawn for a test, I have had this done before and have no trouble with needles or blood, I have arms were the muscle is very dense and super low bodyfat, (Blacksmith) so the veins pop right out, so this should have been no problem, this time however the nurse, or assistant apparently ran the needle through the back side of the vein, since the vile stopped filling at less than half full, and I got a super sharp stabbing pain that ran all the way down to the tips of my fingers, all I could do to not fly out of my seat, she removed the vile asked another nurse if that was full enough??, seriously, was told no, stuck the vile back on the needle, and with the added pressure caused my enough pain that my left arm reactions were purely involuntary convulsions, I was literally holding it down with my right hand, fortunatly I pulled away from the needle just enough it filled the vile in an instant. Both nurses were completly oblivious to me, apparently assuming I couldnt stand the little needle prick, Now one day later I have had 8 or 10 serious twinges of pain running down that forearm into my hand and fingers.
What happened, and what should I do about it? I thought they actually struck a nerve since only pinched nerves can generate that type of pain in my experience, but Im not sure that is possible on the inside of the elbow? Is it possibe this could get worse or is something else entirely?
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First Helper DaBusyBee
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replied December 7th, 2011
Especially eHealthy
Haybudden,

Yes, it is possible to hit a nerve from the front of the elbow. The median nerve runs down the through the anticubital fossa (the front crook of the elbow). The median nerve runs all the way down to the fingers, supplying the ones on the thumb side of the hand.

Usually the median nerve is fairly deep in there. But, everyone's anatomy is just a little different, so you may have a very superficial nerve.

There is not much you can do about it now. The nerve will usually get better on its own.

But, it the future, when you have blood draws, inform the phlebotomist that your median nerve is very close to the surface, so please, do not plunge.

Good luck.
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replied December 13th, 2011
thanks for the info, further searching online with the right words has revealed a surprising number of people who have suffered the same thing, its a shame the medical personnel were so unaware of the problem, its still causing a good deal of pain after a week and a half, but I would expect a nerve to take a bit longer to heal
Thanks
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replied December 13th, 2011
Especially eHealthy
Haybudden,

Unfortunately, nerves are very finicky. The mildest from of nerve injury is called neuropraxia. In this condition the nerve may go all the way to sleep or just tingle and be painful. But, in neuropraxia, the nerve is not permanently injured. Unfortunately, it may take a nerve in neuropraxia up to six months to completely recover.

If the problems last longer than six months, then by definition, the injury is more severe and is then called axonotmesis. But, that's for neurologists.


Yes, it is too bad that the people performing phelbotomy (taking blood) are not required to do a little more thorough gross and micro anatomy. The should really know where the major nerves usually course, so that they can try to avoid them.

One problem I hear about a lot, is patients having pain on the distal wrist, thumb side, after having an IV started there. There is a big vein there, called the intern's vein, because it is good sized and almost invariably present. BUT, a branch of the superficial radial nerve runs right along with it. And this nerve is very prone to injury. In fact, some patients can have problems with it from just wearing their wrist watch too tightly. Problems with compression or injury of this nerve is also called hand-cuff palsy, because prisoners who have cuffs put on too tightly or for too long, can have problems with this nerve. (Sorry for the side note.)

I've seen so many patients just blown off by the nurse of tech, as being whimps. But, I have seen patients, where the health care provider actually tried to cannulate the tendons or nerve, instead of the vein. They are very, very close together there.


In fact, it is normal for the nerves to run with blood vessels, in a neurovascular bundle.

So, I'm surprised that nerve injuries do not occur more often. If you Google "Median nerve anatomy" you can get pictures of how the nerve runs through the elbow region.

The median nerve and the brachial artery run together through the elbow. They are under the fascia, and the veins are mostly above the fascia, in the subcutaneous layer. But, in patients who do not have a lot of adipose (fat) tissue for the veins to run in, they basically just lay on the fascia. So, it is skin, vein, fascia, neurovascular bundle. So, in patients like you, it is not hard to see how a supposedly "deep" nerve can be right up against the surface.


Hope your nerve gets better soon. If the nerve pain really bugs you, you might want to see if your physician can prescribe one of the medicines used for nerve pain modulation, such as gabapentin (Neurontin) or pregabalin (Lyrica). These don't cure the nerve damage, but they often help with the pain.

Good luck.
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replied October 2nd, 2012
Hi Haybudden,

I just had my blood drawn today and the same thing happened to me. I felt a sharp shooting pain going down my arm when the vile was almost full. I told the phlebotomist about it and she said that a little bit of alcohol may have sipped through but I don't think it was that at all. I think that she knew that she had done something wrong because she avoided making eye contact with me. So I rushed home and did some research on the internet and came across this article from the New York Times (see link below). I'll definitely watch my arm and will call my Doctor if it still hurts by tomorrow. Hope you're feeling better now. Would love to get an update from you.

http://www.nytimes.com/2006/05/30/health/3 0case.html?_r=0
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replied May 10th, 2014
The same thing happened to me yesterday. It felt like a lightening bolt shot down my arm . Most of the pain was in my wrist and thumb. I recently had thumb arthroplasty and a carpal tunnel revision on my left hand. I am left handed. I am still getting the same pain, although not quite as bad as when the blood was drawn.
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