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pain in left arm, sore shoulder and now pins and needles in hand

i have had pain in my upper arm going down to my lower arm for over 2 months consistantly, now im getting pins and needles in my hand, sometimes it even feels like my shoulder is dislocated.. All are on my left side...i was diagnosed with arthiritis some time ago. i am a 49 year old black female, obese, abt 230lbs 5'4 and have no other health problems other than sinuses...Could this be a blood clot or is is just an advanced stage of the arthiritis?

Can you give an educated guess.. i eat healthy, no blood pressure or diabetes, but i am a smoker (that's the reason for the question on blood clots, and have family history of hardening of arteries and blood clots)...Also can you describe what blood clot pains feel like?

Thank you, and educated input is welcome.
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replied October 10th, 2011
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Deep vein thromboses are not very common in the upper extremities. That is not to say that they don't occur, but they are kind of rare. With a DVT, the usual presenting symptom is swelling in the limb, below where the thrombosis (blood clot) is located. It is a diffuse edema. The patients will often complain of a deep aching pain in the muscles of the area. If the vein in close to the surface, the clot may be palpable as a "cord" (sort of like a gummy worm in the vein). If the clot happens to break loose, it becomes an embolus, which can travel to the heart and/or lungs. This is why DVT's can be dangerous.

However, from the symptoms you describe, you may have a disorder called thoracic outlet syndrome (TOS). This disorder affects the neurovascular bundle in the subclavian region. In other words, the nerves and blood vessels in the shoulder/chest area, under the collar bone.

TOS is more common in women, especially those who are a little overweight and not necessarily in the best physical condition. However, it can also affect athletes, but it usually due to a different cause.

TOS can be caused by: a congenital problem called a cervical rib, where there is an extra rib, in the lower neck region; by overdeveloped neck muscles in athletes; bands of fascia (scar like tissue) in the lower neck and shoulder region, pressure from bra straps or other straps like on backpacks; tumors in the upper lung (very, very rare); and sometimes a cause cannot be found at all.

Patients will often complain of pain in the shoulder and upper arm regions. The pain can radiate down into the hand. Due to pressure on the nerves in the subclavian region (brachial plexus) there can be numbness/tingling or weakness in the upper extremity. Due to the involvement of the subclavian artery the pulse can be affected, altering the circulation to the limb. Ischemia (lack of oxygen) in the muscles that are not getting the blood supply they need can cause a cramping, aching feeling.

However, this is just a thought based on the symptoms you listed. There are actually many things that can cause the symptoms you have, from spinal disorders, arthritic conditions, neurovascular problems, inflammatory spondyloarthropathies, metabolic processes, etc, etc, etc.

The only way to determine what is causing your symptoms is to have an examination. So, if the symptoms do not go away or they get worse, with other symptoms developing, you might want to see an orthopedic surgeon or a physician who can examine the spine and upper extremity, including the bones, joints, muscles, and neurovascular structures.

Good luck.
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