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Question
Posted by: Ruby | 2008/06/03

Tremor

Hello Dr Bets,
I have developed a tremor that is getting a bit worse. It is worse in my right arm/hand. It is very bad when I use the hand (like trying to open something). It kindoff started out of the blue... I am a bit concerned. When I did the arm excersizes at biokinetics 6 weeks ago, I started to get shaking in my whole arm, but I thought that it is just weakness... Now my hands are shaking when I just try to hold them still or do something with them... I had a bad health day on Sunday concerning pain and weakness... Weakness as in my muscles inside my body hurts when I breathe, sing or talk ). The pain did not go away with painkillers on Sunday.... This cant possibly be normal??? Or is it, like my doctor said last time I told him that I battle with weakness, because I dont gym enough??? Is the shaking related to the weakness? Doctor, I am really concerned about my health and dont know what to do. The neurologist I saw said that it is not nerve pain, but muscle pain, that I have a tremor and that all the pins and needles etc that I experience in my arms and hands must be because of my shoulder surgery. She offered me a drug for nerve pain. Thanks Dr Bets, I appreciate your help :-) Ruby

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Our expert says:
Expert ImageCyberDoc

Hi Ruby
You may have Complex Regional Pain Syndrome (CRPS) or also called Reflex sympathetic dystrophy syndrome.
Symptoms are usually:
Continuing pain, which is disproportionate to any inciting event
Must report at least one symptom in each of the four following categories:
Sensory: Reports of hyperesthesia and/or allodynia ( pain with non painful stimulus)
Vasomotor: Reports of temperature asymmetry and/or skin color changes and/or skin color asymmetry
Sudomotor/Edema: Reports of edema and/or sweating changes and/or sweating asymmetry
Motor/Trophic: Reports of decreased range of motion and/or motor dysfunction (weakness, tremor, dystonia) and/or trophic changes (hair, nail, skin).
Must display at least one sign* at time of evaluation in two or more of the following categories:
Sensory: Evidence of hyperalgesia (to pinprick) and/or allodynia (to light touch and/or deep somatic pressure and/or joint movement).
Vasomotor: Evidence of temperature asymmetry and/or skin color changes and/or asymmetry.
Sudomotor/Edema: Evidence of edema and/or sweating changes and/or sweating asymmetry.
Motor/Trophic: Evidence of decreased range of motion and/or motor dysfunction (weakness, tremor, dystonia) and/or trophic changes (hair, nail, skin).
There is no other diagnosis that better explains the signs and symptoms.
Management/Treatment
Interdisciplinary management including occupational therapy, physical therapy, recreational therapy, vocational rehabilitation, and other therapeutic interventions (hyperbaric oxygen therapy, acupuncture, and chiropractic manipulation)
Pharmacotherapy :Anti-inflammatory drugs/immunomodulators ,Anticonvulsants/neuromodulators,
Antidepressants/anxiolytics, Opioids, N-methyl-D-aspartate (NMDA) receptor antagonists
Anti-hypertensives and alpha-adrenergic antagonists, Calcitonin,Bisphosphonates
Psychological interventions
Patient and family education
Psychological evaluation and Psychological pain management intervention
Sympathetic nerve blocks /Intravenous (IV) regional anesthetic bocks (IVRA) /Intravenous infusions /Other (brachial plexus/spinal blocks-infusions) blocks /Neurolytic sympathetic blocks (radiofrequency/alcohol-phenol)
Neurostimulation

As you can see this is difficult to diagnose and treat and maybe you should ask your neurologist if he/she knows of someone in your area with a special interest in this kind of disease.
Dr Bets

The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical exmanication, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.

2
Our users say:
Posted by: Sands | 2009/02/15

Hi, I have been suffering with Anosmia for the past year. Could acupuncture work or could you give me some other options as this driving me insane.

Tnx

Reply to Sands
Posted by: Ruby | 2008/06/03

The neurologist also said that my legs and neck is very weak (she only tested my neck and legs for strength). The biokinetest said that my arms are very weak (they only tested my arms). I asked her why I have this weakness and she said that it is probably because I have so much pain (the pain is causing the weakness). But why then do I have weakness in my neck (I dont get pain in my neck).... I am really concerned since my condition is definately getting worse.... Thanks Dr Bets :-)

Reply to Ruby

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