Should I Visit the Emergency Department?
A 42-year-old woman, standing 5 feet 11 inches tall and weighing 298 pounds, generally enjoys good health. She has a medical background marked by vasculitis stemming from an inflammatory autoimmune condition and has been effectively managing her symptoms with plaquenil for the last decade. Recently, she experienced significant discomfort in her shoulder, suspecting a pinched nerve. Three days ago, she awoke with soreness in both her shoulder and arm, and the situation has since deteriorated, with pain extending down her entire arm into her hand. Seeking relief, she consulted a registered massage therapist yesterday, but instead of improvement, her condition seems to have intensified. The pain has been severe enough to bring her to tears throughout the day. Despite her attempts to alleviate the discomfort with Advil, Tylenol, a heating pad, and topical anti-inflammatory treatments, nothing has proven effective, leaving her incapacitated. With a public holiday approaching tomorrow, she faces uncertainty regarding whether she can secure an appointment with her general practitioner before Tuesday. The thought of enduring the pain until then raises her concern about whether a trip to the emergency department (ED) might be warranted, given her rapidly escalating symptoms and lack of relief.
Answers (1)
2/15/2026, 9:40:31 PM
OpenHealth AI
It sounds like you're experiencing significant and worsening pain, which is understandably concerning. Given the details you've provided, it's essential to take your symptoms seriously since they have intensified despite trying multiple at-home treatments.
Key Points:
- You have escalating shoulder and arm pain that is significantly affecting your daily activities.
- Your current pain management strategies have not been effective.
- You have a history of autoimmune issues, which can complicate pain presentations.
Explanation:
The pain you're describing, especially with it radiating down your arm and accompanying severe discomfort, could suggest several possibilities, including a pinched nerve or musculoskeletal issues. Considering your history of vasculitis, it’s crucial to rule out any potential complications affecting your condition or new issues that might be related, such as inflammation or nerve involvement.
Next Steps:
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Visit the Emergency Department (ED): Given the severity of your pain and the fact that it is incapacitating, a trip to the ED is warranted. This is especially important if you experience symptoms like weakness, numbness, or changes in bowel or bladder function, which may indicate nerve involvement.
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Pain Management: When you go to the ED, let them know all the treatments you've attempted and how they haven't worked. They can assess your situation better and provide you with stronger pain relief options.
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Monitor Symptoms: While you head to the ED, keep track of any changes in your symptoms. Note if you experience any new symptoms or if your current symptoms worsen, as this information will be helpful for the healthcare providers.
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Plan for Follow-Up: Once your immediate concerns are addressed at the ED, ensure you discuss with the healthcare team about follow-up care with your general practitioner after the holiday, as they are familiar with your medical history.
Taking these steps should help you find relief and ensure that any serious underlying issues are addressed promptly. Please take care of yourself and seek help as soon as you can.
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