Since recently, a friend of mine is having trouble catching his breath. However, other medications may also be used to treat chronic nerve pain. He has 56% lung function currently. Hypothyroidism: Can it cause peripheral neuropathy? A phrenic nerve disorder on one side can especially cause breathing difficulty in people with obesity, heart disease, or lung disorders.. It is like injury happens over a year ago. The phrenic nerves are also the nerves responsible for a very common symptom related to contraction and spasm of the diaphragmhiccups. Elevation of the diaphragm on one side is often seen on a chest X-ray when one phrenic nerve is injured. 2017;125(4):1169-1183. doi:10.1213/ANE.0000000000002289, Shchukin D, Lesovoy V, Garagatiy I, Khareba G, Hsaine R. Surgical approaches to supradiaphragmatic segment of IVC and right atrium through abdominal cavity during intravenous tumor thrombus removal. For example, if someone has diabetes causing neuropathy, you need to focus on getting the diabetes under control and not worsening. When you visit the site, Dotdash Meredith and its partners may store or retrieve information on your browser, mostly in the form of cookies. When one or both phrenic nerves are damaged or severed, the diaphragm can no longer contract, resulting in paresis (partial paralysis) or paralysis. Mayo Clinic on Incontinence - Mayo Clinic Press, NEW The Essential Diabetes Book - Mayo Clinic Press, NEW Ending the Opioid Crisis - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education. I have heard about this Doctor Kaufman at UCLA but I have to have several tests before I can even be seen by Him. 2014;13(9):924-35. doi:10.1016/S1474-4422(14)70102-4, Gordin E, Lee TS, Ducic Y, Arnaoutakis D. Facial nerve trauma: evaluation and considerations in management. Brown AY. All rights reserved. The phrenic nerve is a mixed nerve arising from the anterior rami of C3-C5 spinal nerves, which are components of the cervical plexus.It arises in the neck and When the nerve is disrupted, it does not recover. Mayo Clinic. Mayo Clinic does not endorse companies or products. Central nervous system causes are possible as well. When the spasm is chronic, it might be due to exercise-induced bronchospasm, and you may also experience: A diaphragm flutter is a rare condition that can be misdiagnosed as a spasm. You can learn more about how we ensure our content is accurate and current by reading our. The phrenic nerves also have sensory and sympathetic functions. The pain is worse at night with lying down and associated with shortness of breath. By Erica Jacques Nicole G. Other symptoms associated with diaphragm flutter include: Anecdotal evidence suggests that practicing controlled breathing can stop diaphragm spasms. Thoracic back pain Last medically reviewed on December 12, 2017, Chronic hiccups are more serious than standard hiccups and usually require a doctor's attention. Upon first seeing his primary medical doctor, he had an x-ray and was diagnosed with bronchitis and treated as such, two times. WebDiaphragmatic weakness or paralysis is caused by damage or pressure on the phrenic nerve. WebWhen the phrenic nerve is injured, the electrical signals in it stop traveling from the brain to the diaphragm muscle. doi:10.1136/bcr-2012-008131, Naughton MT. You are so right, I have been doing research on my own because the Doctors have been telling me different diagnosis. Allodynia and hyperalgesia in neuropathic pain: clinical manifestations and mechanisms. You can find out more about our use, change your default settings, and withdraw your consent at any time with effect for the future by visiting Cookies Settings, which can also be found in the footer of the site. I have phrenic nerve damage from a heart ablasion. In: Goldman-Cecil Medicine. Recognizing Amyotrophic Lateral Sclerosis: What Are The Early And Advanced ALS Signs And Symptoms? Signals from the nerve (which can be voluntary or involuntary) cause the diaphragm to contract and flatten during inspiration, drawing air into the lungs. Sometimes, we dont know what causes neuropathy but what we can treat symptoms associated with it. The left phrenic nerve passes just anterior to the pericardium (the lining of the heart) near the left ventricle. Diaphragmatic pacing. 3) Learn to live with it. When I brought this 4th option up to my husband's pulmonologist, he had never heard of it, but was willing to call Dr. Kauffman and discuss it with him. Some people may not experience any outward symptoms with phrenic nerve injury. This movement gives your lungs room to expand and take in air (inhalation). I can say that this is funny because it is very important part of your body, of our bodies and we all should know more about it. 2014;2014:924269. doi:10.1155/2014/924269, John S, Tavee J. Severe or chronic facial nerve pain can affect the sufferers daily life, relationships, and overall wellbeing. If you are a Mayo Clinic patient, this could A diaphragm spasm can occur for a number of reasons and in varying severities. I am in the process of having these tests set up to do. It also can happen during the heart surgery. 3) Set personal goals and celebrate your successes, even if theyre small. Rakel D, ed. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Accessed March 25, 2019. It is controlled by the phrenic nerve. The phrenic nerve is among the most important nerves in the body due to its role in respiration. Accessed March 26, 2019. Our website services, content, and products are for informational purposes only. Oral medications, including chlorpromazine. This contraction makes it flatter, creating negative pressure in the chest. It can cause a range of symptoms, often characterized by a combination of burning pain, tingling, numbness and a feeling of weakness in the hands and fingers. --the symptoms of nerve regeneration, as the nerve growth cones fight through and around other tissue and send out weird signals that the brain has trouble interpreting, can feel very much like the symptoms of increasing nerve damage, at There are several known causes that can lead to diaphragm paralysis: Birth It is the muscle responsible for helping you breathe. There is no function in the right diaphragm. Slowly breathe in through your nose. Damage to the nerves due to trauma, compression, some infections, and neuromuscular diseases can lead to partial or total paralysis of one or both sides of the diaphragm. Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health. This diaphragmatic paralysis is a serious disorder and can lead to respiratory infections and neurological problems. 13 People Explain What Its Really Like to Have a Migraine. Accessed March 25, 2019. over a year ago. Healthline Media does not provide medical advice, diagnosis, or treatment. As you inhale, your diaphragm contracts so your lungs can expand to let in oxygen; as you exhale, your diaphragm relaxes to let out carbon dioxide. Carpal tunnel syndrome is an example of mononeuropathy. Erica Jacques, OT, is a board-certified occupational therapist at a level one trauma center. Small hiatal hernias dont usually cause problems, whereas large hiatal hernias can cause pain and difficulty breathing. Because phrenic nerve damage is relatively rare, it is not going to be the first thing most doctors consider, know that! Damaged phrenic nerves can be treated with ventilation, diaphragm pacemakers, or surgery. Tumors or other structures that press on the phrenic nerve may lead to damage, including:. How successful is surgery for a Phrenic nerve damage/ injury? Your doctor may order an x-ray of the chest, which might show the paralyzed side of the diaphragm is stuck in a higher position. WebA nerve may be : Sensory : only carries sensations from the respective body part to the brain and spinal cord. McLeod Neurologist Olinda Spencer, MD, describes common causes, symptoms and treatments of neuropathy. It comes in any and all shapes and sizes and symptoms, Loeser says. WebWhat does phrenic nerve pain feel like? It grants freedom from the mechanical ventilator, enables speech, and improves quality of life. The Foundation for Peripheral Neuropathy. Similarly, some tumors near the top of the lungs, Pancoast tumors, may irritate the nerve as it travels nearby and cause pain that is sensed in the shoulder. If youre suffering from nerve pain, our Neuropathic Therapy Center may be able to help using a breakthrough physical therapy treatment Autoimmune and inflammatory diseases like, Complications from neck or chest surgeries, such as. Sci Rep. 2018;8(1):11697. doi:10.1038/s41598-018-30145-x, Kohse EK, Hollmann MW, Bardenheuer HJ, Kessler J. Thank you, {{form.email}}, for signing up. Carl Do you feel nerve pain sensations when touched or is your pain seemingly spontaneous? Separate groups of nerve fibres are I can do my own work since I am a touch for health practitioner. For example, irritation of the diaphragm (such as by carbon dioxide injected into the abdomen during laparoscopic surgery) may be felt as pain in the right shoulder. It passes motor information to the diaphragm and receives sensory information from it. The diaphragm is a dome-shaped muscle. If the nerve is damaged you can have trouble breathing. The phrenic nerve is supplied by C3, C4 and C5 nerve roots. Accessed March 25, 2019. People with neuropathy will have trouble with balance. How do you test it? WebBy: Resto. They provide both muscle movement and sensation to the diaphragm, the chief muscle in breathing. Phrenic nerve damage can be caused by spinal cord injury and depending on which vertebrae are damaged, nerve impulses can be disrupted. If your phrenic nerve becomes irritated or damaged, you may lose the ability to take automatic breaths. (2015). it is possible as a branch of the phrenic nerve does innervate the diaphragm. 2021;48(1):1-4. doi:10.1186/s43166-020-00051-0, Goff RP, Spencer JH, Iaizzo PA. MRI reconstructions of human phrenic nerve anatomy and computational modeling of cryoballoon ablative therapy. Vagus nerve and phrenic nerve irritation are known causes of chronic hiccups. While the Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Tighten the muscles in your stomach, having your abdomen fall inward, and exhale through your mouth, with pursed lips. WebFast heart rate, chest pain and tightness or trouble breathing (especially when lying down). Peripheral neuropathy is a disease characterized by pain or loss of function in the You can even continue exercising while holding the stretch. hiccups, cough, dyspnea, pleural effusion and thoracic pain. Some very common medicines are Gabapentin or Lyrica. High-frequency diaphragmatic flutter: symptoms and treatment by carbamazepine. There are 8 carpal bones, 5 metacarpal bones, and 14 phalanges in your hand and wrist. Most people with peripheral neuropathy have polyneuropathy. Paralysis of the diaphragm is caused by damage to both phrenic nerves. Now, the two of us searched a bit on the internet and we found out that he might have damaged his phrenic nerves. In addition, they are often responsible for the referred pain to the shoulder that can accompany abdominal disorders. Nerves such as the phrenic nerves are made up of axon fibers, which convey information to and from the brain. He is currently the only doctor in the world who does this surgery, and has a fairly high success rate, though that is improved if done within the first 8-12 months of symptomatology first presenting. Conditions associated with phrenic nerve function or dysfunction can range from benign hiccups to paralysis of both sides of the diaphragm and severe respiratory distress. Review/update the Diaphragm and diaphragmatic pleura (thin tissue covering the upper part of your diaphragm). "Cleveland Clinic: "Phrenic Nerve. Because nerve pain is unique, it has some medical buzzwords associated with it. If these aren't successful, you may need mechanical ventilation for the rest of your life. Chronic hiccups: an underestimated problem. numbness and tingling in right hand, stabbing neck pain, and shortness of breath after ACDF, shortness of breath and upper chest tightness after total thyroidectomy, 6 Things You Should Know About Breathing Problems If You Have Multiple Sclerosis, Sciatica Exercises to Relieve Pain of the Sciatic Nerve. Lifestyle and home remedies include eating smaller meals, avoiding foods that can cause heartburn, avoiding alcohol, losing weight, and elevating the head of your bed. You should: SOURCES:Christopher and Dana Reeve Foundation: "The Important Phrenic Nerve. The left phrenic nerve innervates the left Last reviewed by a Cleveland Clinic medical professional on 01/09/2022. The phrenic nerve is among the most important nerves in the body due to its role in respiration. The phrenic nerve lies deep in the chest and is rarely injured. If you want to get notified by every reply to your post, please register. Your peripheral nervous system sends information from your brain and spinal cord (central nervous system) to the rest of your body. AskMayoExpert. Nerve pain is complex and can be caused by nerve damage, irritation, or destruction. Peripheral neuropathy is nerve damage caused by a number of different conditions. Peripheral neuropathy, a result of damage to the nerves located outside of the brain and spinal cord (peripheral nerves), often causes weakness, numbness and pain, usually in the hands and feet. Other symptoms of a hiatal hernia include: The phrenic nerve controls the muscle of the diaphragm. Originating in the cervical spine (C3 to C5), the phrenic nerves are vulnerable to injury as they travel down the neck and through the chest into the diaphragm. When the diaphragm relaxes, air is expelled. Learning how to describe your nerve pain can help your healthcare provider more quickly diagnose and effectively treat your pain. What Is Thyroidectomy And Why Is It Performed? The right phrenic nerve descends along the inner aspect of the lung and passes just lateral to the right atrium and right ventricle of the heart. https://www.uptodate.com/contents/search. WebAs peripheral neuropathy can be a very painful and troublesome problem that may only partly be relieved by standard treatments, you may be tempted to try other therapies. This multi-modal treatment approach can keep nerve pain symptoms under better control. Neuropathic Pain. Some kinds of infectious and neuromuscular diseases can also affect the phrenic nerves. The chief function of the phrenic nerve is to stimulate breathing, so its disorders may cause symptoms related to breathing. The accessory muscles of inspiration, such as the intercostal and abdominal muscles, provide some help. How Can You Help Median Nerve Damage Heal? 2015;3(5):370-372. doi:10.1016/j.jchf.2015.01.006, Verlinden TJM, Van dijk P, Herrler A, De gier-de vries C, Lamers WH, Khler SE. You may opt-out of email communications at any time by clicking on 2005 - 2023 WebMD LLC. (2017). Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2018. He is an avid ping pong player and does not have pain or shortness of breath with playing ping pong. If your usual cures dont work, try these all-natural remedies.Hiccups can strike your toddler at any, A hiccup is a reflex. All rights reserved. The diaphragm muscle turns off and the patient may have As Health n Joy wrote, since the symptoms of phrenic nerve damage aren't some regular symptoms which could be noticed by doing tests or so, the doctor is just going to talk to you and ask you question about your daily activities and how you react to them in order to conclude whether or not do you have a phrenic nerve damage. 2023 McLeod Health. I realize the posts here are nearly a year old, but I felt compelled to contribute for anyone who happens to stumble upon it in the future. You actually wrote all the symptoms of phrenic nerve damage in your question, Stradivarius. With phrenic nerve irritation, you might also experience: hiccupping shortness of breath when lying down diaphragm paralysis Temporary paralysis Your diaphragm can Accessed April 3, 2019. The Foundation for Peripheral Neuropathy. https://www.foundationforpn.org/what-is-peripheral-neuropathy/causes/. Colloca L, Ludman T, Bouhassira D, et al. Ulnar nerve entrapment occurs when the nerve is compressed in the elbow or the hand and wrist. The diagnosis is often made by visualizing the abnormal motion of the diaphragm on ultrasound or fluoroscopically. Every nerve in your peripheral system has a specific function, so symptoms depend on the type of nerves affected. Treatment of diabetic neuropathy. Ulnar nerve entrapment occurs when the nerve is compressed in the elbow or the hand and wrist. In other cases, an underlying condition may need to be addressed, and once the condition is treated, the spasm is treated as well. Neurologist. FEBS J. We have worked with 3 different pulmonologists who all have told us much the same; there are 3 options. WebThe parietal peritoneum is the outer layer of the peritoneum that adheres to the abdominal wall and underside of the diaphragm. If you have a hiatal hernia, part of your stomach comes up through your diaphragm in the hiatal opening. Peripheral neuropathy risk factors include: Complications of peripheral neuropathy can include: The best way to prevent peripheral neuropathy is to manage medical conditions that put you at risk, such as diabetes, alcoholism or rheumatoid arthritis. Read our, Neuropathic, Autoimmune, and Infectious Processes, Endotracheal Tube: Purpose, What to Expect, and Risks, The Anatomy of the Superior Laryngeal Nerve, Causes of Collarbone Pain and Treatment Options, A Powerful Straw-Like Device Could Cure Your Hiccups, Cervical spondylosis as a possible hidden reason beyond delayed phrenic nerve distal motor latency, MRI reconstructions of human phrenic nerve anatomy and computational modeling of cryoballoon ablative therapy, Development of the diaphragm a skeletal muscle essential for mammalian respiration, Pancoast's tumour presenting as shoulder pain in an orthopaedic clinic, Phrenic nerve stimulation for central sleep apnea: wiping out apnea or whipping the muscles, The human phrenic nerve serves as a morphological conduit for autonomic nerves and innervates the caval body of the diaphragm, Chronic hiccups: an underestimated problem, Surgical approaches to supradiaphragmatic segment of IVC and right atrium through abdominal cavity during intravenous tumor thrombus removal, Bilateral diaphragmatic paralysis due to cervical chiropractic manipulation, Comparison of phrenic nerve injury during atrial fibrillation ablation between different modalities, pathophysiology and management. WebNeuropathic pain happens from short circuiting of the nerves that carry signals from the brain to the body because of damage from MS. A nerve graft may be needed to avoid stretching. That led me to a Dr. Kauffman from New Jersey who also practices at UCLA with another doctor, and is performing phrenic nerve surgery on patients with phrenic nerve damage. Learn what causes hiccups, from diet to medications. Neurological examinations. Policy. Lynne Eldrige, MD, is a lung cancer physician, patient advocate, and award-winning author of "Avoiding Cancer One Day at a Time.". His cough improved after 2-3 months, but the other symptoms did not improve, rather, they gradually worsened. After doing so, he was actually very excited about this cutting edge treatment option, and equally excited that there is a 4th option to offer his future patients potentially. Brandon Callahan, MD is a board-certified orthopedic physician with a decade of experience in providing comprehensive orthopedic care to patients with musculoskeletal injuries and disorders. Facial pain encompasses every type of pain in the It sends signals that cause your diaphragm to expand and contract. Peripheral neuropathy can result from traumatic injuries, infections, metabolic problems, inherited causes and exposure to toxins. Sometimes the spasms are due to normal overexertion and can be relieved easily. Health conditions that can cause peripheral neuropathy include: In a number of cases, no cause can be identified (idiopathic). I need to tell you that I never have heard of the phrenic nerve until my friend told me about it. The human phrenic nerve serves as a morphological conduit for autonomic nerves and innervates the caval body of the diaphragm. It causes your diaphragm to contract and expand, giving your lungs ability to inhale and exhale air. They play a critical role in breathing and are responsible for the hiccup reflex. my.clevelandclinic.org/health/articles/diaphragmatic-breathing, mayoclinic.org/diseases-conditions/hiatal-hernia/basics/definition/con-20030640, Everything You Need to Know About Hiccups, Why You Get Hiccups When Drinking (And How to Stop Them), Everything You Need to Know About Pheromones, Understanding the Bones of the Hand and Wrist, New App-Based 3-D Anatomy Model May Be a Game Changer for Womens Health, Why Chewing Gum Isnt Proven to Improve the Appearance of Your Jaw, a feeling of pulses in the abdominal wall. over a year ago. With some injuries causing only partial paralysis, function may return in time. information and will only use or disclose that information as set forth in our notice of Procedures like intercostal nerve transfer or phrenic nerve stimulation may then be required to restore diaphragmatic movement. Damage to a phrenic nerve can lead to a paralyzed diaphragm. Peripheral neuropathy fact sheet. I have another chest x Ray next week. People who have severe damage to their phrenic nerve may need a mechanical ventilator to breathe. 2013;280(17):4026-4035, Kokatnur L, Rudrappa M. Diaphragmatic palsy. WebWhat does phrenic nerve pain feel like? They enter the muscle and innervate it from the lower surface. In order to be sure, I want you guys to tell me about the symptoms of phrenic nerve damage so I could compare them to the symptoms whichmy friend has. http://www.ninds.nih.gov/disorders/peripheralneuropathy/detail_peripheralneuropathy.htm. People with peripheral neuropathy generally describe the pain as stabbing, burning or tingling. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. The Foundation for Peripheral Neuropathy. Causes of Rib Cage Pain, Allodynia and hyperalgesia in neuropathic pain: clinical manifestations and mechanisms, Facial nerve trauma: evaluation and considerations in management, Repetitive nerve block for neuropathic pain management: a case report. The internal mammary artery in the chest is sometimes removed for use in coronary bypass surgery, and this procedure sometimes injures the phrenic nerve, which is close by. Last but not least, muscle spasms can also lead to intense pain in the right shoulder blade. For example, you can feel the pain in the tip of the shoulder. What is peripheral neuropathy. Does chewing gum work? The following week, while working out of state, (my husband is a 48 year old heavy equipment mechanic for a bridge construction company, who was in excellent health prior to this), ended up in an ER due to feeling as though he had had the wind knocked out him for no reason. Connects to the C4 and C5 vertebral levels in your neck, below the C3 vertebra. Feel your stomach moving against your hand. What Causes Phrenic Nerve Damage And How To Treat It? The importance of chronic hiccups, medically known as "persistent singuitis," has gained renewed attention both for the severe quality of life issues they create and the importance of a thorough workup for potential causes. Except for abdominal bloating he denies any other symptoms. They similarly connect to the pericardium, the covering of the heart. For others, the pain may be severe and nearly unbearable. Left shoulder pain can be caused by a variety of issues, including injury, inflammation, and nerve issues. In some cases, surgery is necessary. Let's take a closer look. If you overexert your diaphragm during exercise, it may start to spasm. Advertising on our site helps support our mission. Travels through your neck and chest (thorax) and past your heart and lungs to reach your diaphragm. Chronic hiccups could also be potentially related to pressure on the phrenic nerve anywhere in its course from the neck to the diaphragm, such as a tumor in the mediastinum pressing on the nerve. You may notice breathlessness during physical activity, though, or when you are lying down (orthopnea). DOI: Mayo Clinic Staff. When only one nerve is damaged in an adult, there may be no symptoms, or there may be BMJ Case Rep. 2013;2013:bcr2012008131. A spinal cord injury between C3 and C5 can cause. When both sides are involved or if one phrenic nerve is involved but a person is symptomatic, options include:. I fell down an elevator shaft several years ago and fractured my C4 in my neck. Diaphragm paralysis is uncommon. According to the symptoms, your doctor can be able to determine the proper treatment for phrenic nerve damage. 2015;8(1):1-13. doi:10.1055/s-0034-1372522, Naja Z, Naja AS, Rajab O, Mugharbil A, Shatila AR, Al hassan J. Diseases. This stimulates the phrenic nerve periodically, causing diaphragmatic activity and breathing. For some, it can feel like mildly bothersome pins and needles. The left phrenic nerve sends signals to the left part of your diaphragm, while the right phrenic nerve controls your right side. Ranging in intensity from barely perceptible to full-blown unbearable, The nerves that control the movement of the diaphragm away from and towards the lungs as we breathe are known as the phrenic nerves. 2023 Dotdash Media, Inc. All rights reserved, Lynne Eldrige, MD, is a lung cancer physician, patient advocate, and award-winning author of "Avoiding Cancer One Day at a Time. Even if my husband never regains 100% lung function, we would consider 75-80% a huge improvement over the current 56% he has now. Regardless of the cause, nerve pain can feel like any of the following: Burning 1 Tingling 1 Shooting Sharp 1 Stabbing Prickling Like other types of pain, nerve Hey guys. Understanding Nerve Damage In Diabetes: What Is Diabetic Neuropathy? Each performs the same function. Treatment of idiopathic diaphragm flutter. https://www.foundationforpn.org/what-is-peripheral-neuropathy/. The diagnosis of phrenic nerve injury requires high suspicion due to nonspecific signs and symptoms including unexplained shortness of breath, recurrent pneumonia, anxiety, insomnia, morning headache, excessive daytime somnolence, orthopnea, fatigue, and difficulty weaning from mechanical ventilation. Verywell Health's content is for informational and educational purposes only. It is FREE! The phrenic nerve provides the primary motor supply to the diaphragm, the major respiratory muscle. But for people who deal with The information on this site is intended to increase your awareness and understanding of specific health issues and services at McLeod Health. (1992). Starts at the C3 vertebral level, the part that aligns with your jaw and helps you bend and rotate your neck. In the chest, it passes through the mediastinum, a space between the lungs that also contains the heart, blood vessels, esophagus (food pipe), and other nerves. This content does not have an Arabic version. Other symptoms may include chest wall pain, cough, fatigue, anxiety, and morning headache. The phrenic nerves pass through the diaphragm upon reaching it. WebThe phrenic nerve controls the diaphragm, which is the major muscle for breathing. WebWhen the phrenic nerve is injured, the electrical signals in it stop traveling from the brain to the diaphragm muscle. Aurora-Borealis349353 National Institute of Neurological Disorders and Stroke. 2018;6(1):16. doi:10.3390/diseases6010016, Ronan L, D'Souza S. Pancoast's tumour presenting as shoulder pain in an orthopaedic clinic. Sometimes you may be unable to feel your feet while walking. You may feel short of breath and have problems sleeping. The phrenic nerve(s) may be injured with spinal cord injuries, but this depends on the level of injury.