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Why am I unable to sleep on my left side?

Q: I am a 51 years old male who underwent coronary artery bypass graft (CBAG) seven years back. For the last one and a half year, I am unable to sleep on my left side. The moment I sleep on my left side, my left shoulder and scapula region starts panning and the pain also spreads to the arm, hand and the fingers. The pain doesn't increase/decrease with my morning walk and stretching exercises. The onset, duration and location have no set pattern except that it starts if I sleep on my left side.

A:From your history it is apparent that you are a patient of high blood pressure, dyslipidemia and coronary artery disease. You are young to have had a CABG at the age of 43 years. You have not mentioned anything about any history of diabetes I presume you are not. Your symptoms are a little unusual in that the pain is brought on only by lying on the side. You have not mentioned any stiffness in your shoulder along with the pain. I presume you do not have it. Worsening of pain with tilting of the head to one side as can happen when you lying on your side is often indicative of nerve root irritation in the neck due to either a cervical disc or a prominent cervical osteophyte (this is bone formation secondary to normal ageing commonly called as spondylosis). Your combination of symptoms does not fit in anything else. Sideline might be irritating the nerves which supply the shoulder and the fingers causing you the typical symptoms. However, it is difficult to predict this without examining you and looking for physical signs suggestive of nerve root irritation. You will need to be examined by an orthopaedic surgeon regarding:

  1. Neck movements and its effect on provocation of pain.
  2. Test for checking if there is any indication of narrowing of the root of neck. Occasionally you may have an additional rib that can contribute to this (called cervical rib).
  3. Examination of your shoulder for any restriction of movements or weakness in the power of muscles around the shoulder.
  4. Neurological evaluation of your upper limb.

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