Great video presentation full of great information. Last October 2023 I was at work (food industry), and I went to lift my arms to pick up a sample bucket for the lab and I had debilitating pain down my neck, shoulders, arms, hands and fingers like and electric shock. I could not move my arms for around 15 mins. I still get stiffness in my neck, shoulders and arm. Numbness/ stiffness in my hands and fingers. These symptoms have repeated every time I lift or push (shopping bags). I am getting motion X-ray, CT and MRI scans completed this week. Dr's have suggested pinched nerve and possibly Cervical Myelopathy as the cause, so hopefully I can get some answers soon. Cheers.
Thanks a lot, this gave me piece of mind. Been dealing with this for a while, into my pinky and ring finger. Mostly in upper and lower arm. Was scared of cardio, but this makes sense along with other nerve things I have elsewhere. I appreciate it.
I woke up a 3 m this morning with severe pain in my shoulders triceps /forearm and into my pinky, ring and middle fingers. I was crying it hurt so much. It gets worse every time I lay down. Also some pain in my back and neck between the shoulder blades.
Sorry to hear that. Here's a video about various causes of pain in the pinky and ring finger and some ideas that may help. ua-cam.com/video/QY_p34XU8FU/v-deo.html Good luck!
Thanks for caring, 100 excercises for a horrible rotation cup doesn't help until a massage therapist discovered a bicep tear, good news for me ! Not surgery, no bull , pain to heal and wisdom now so I can still lift!!!! PUMPING IRONMAN!
Most often if it's on both sides, it's a neck problem, but regardless of the cause, if you're having shoulder and finger pain on both sides, it's something you should see your doctor about.
Have had shoulder pain / wrist / elbow / finger pain for over a year. Have quit all physical activity. been to 9 physical therapists and none of them can figure it out. No trauma to the area. No idea how to tell where it's coming from.
Sorry to hear that. If you'd like, you can send more details about the problem to dave@m4lpt.com and we'll see if we can't either help you figure it out or help you find someone in your area who can.
I had a lot of pain and did Prolotherapy which helped. After a while it came back and I'm doing BPC 157 peptides and it's working amazingly. Peptides can only be purchased from a trustworthy lab.
Hello sir My mother facing hand pain from last 6 months I think it's more than that. Her age is around 45 to 49 And she is facing severely hand pain from shoulder to fingers I am not getting its muscle pain, joint pain, tendons or ligaments pain But we have done every test and every test is normal Now doctors have asked to do MRI test But i am not able to understand why my mother is facing such issue. Of course she have worked with that hand so much and now she has stopped doing it also medicine are there but still she is not feeling well What you think what is it and how should handle it ?
It's impossible to say for sure based on just that information, but radiating pain to the hand is usually from a nerve problem. Checking for pinched nerves in the neck and thoracic outlet syndrome would be a good place to start. If it's mostly hand, checking for carpal tunnel syndrome could be warranted but it may be more than that it it's in the shoulder too. Good luck!
Hi sir.....one year back doctor told me that i have muscle spasm in my left shoulder blade....but now i have left shoulder pain along with arm and finger pain.... sometimes i feel my hand is weak..need ur suggestion 🙏🏼
Here's a video about pinched nerves in the neck which can cause arm and finger pain and hand weakness. ua-cam.com/video/dGVpFKfJsNg/v-deo.html Make sure to get it checked out with your doctor as well though.
My right shoulder joint is in forward position and is pinching the nerves. I think I should release surratus anterior and retract scapula back and down. What do you think? Is it solvable? What about shoulder dislocation?
While I can't comment on your problem specifically without an examination, the shoulder joint being forward (i.e Dislocation or subluxation) is different is different from the shoulder blade being forward. The serratus anterior affects the shoulder blade, not the joint. Much more often though, it's the pectoral minor that rounds the shoulder blade forward.
sleep without pillow without mattress i mean no deep mattress .. try to use semi soft mattress beneath you and dont use pillow .. youw ill be ok in 5 to 10 days..
I'm sorry to hear that you're suffering. The best advice that I can give you specifically though is to go see a doctor or physio to get it checked out.
Mine is more like electrical shock going down my left arm &my thumb is numb but I have feeling in it&it's an off&on thing&doesn't last long I read something about stingers what can I do?
I have the pain in my neck to fingers.. physiotherapy doctor told that is scapular problem it will be cure 1 week.. but i took physiotherapy in 4 days.. that time i feel better after 1 week i had pain.. I'm teacher when i was write on the board i have severe pain on my neck shoulder arms.. 😢😢 please give some solution.. nowadays i really upset i thought the pain is permanently with myself.. when I'm recovered to my old life 😢
Sorry to hear you're having a rough time. I'd suggest following up with your physio if it helped for awhile. I can't give you a solution without having evaluated your condition. However, if writing on the board bothers you one thing you could try is to avoid looking upward when writing on the board (write at your eye level or below). That decreases how much neck extension you're using as well as how high you have to elevate your arms.
It is overwhelming. I had a neck fusion back in 1993 at the C4-C5 level. For a month now I have pain in my left shoulder that runs down my arm and into my fingers. Also in my left shoulder blade. I'm wondering if it's coming from tight muscles in shoulder blade? I've tried different neck and shoulder exercises and massages but haven't gotten any relief. My question is can a Acupuncture Chiropractor help instead of going to physical therapy?
If you had a neck fusion at C4-C5 around 30 years ago, the most likely cause would be the segements below that C5-6 or C6-7 being hypermobile to make up for the fused segments. The C6 and C7 nerve roots do go into the hand. I'd recommend physical therapy, but I'm biased being that I am a physical therapist. If you do choose to go to a chiropractor, I would highly advise not allowing them to manipulate your neck.
Hi Dr Candy, I need your help please. I currently get pain that radiates down my left arm to my left hand, when this happens I also get a radiating pain down my left leg at the same time. The pain is always down my left leg and left arm. When the pain occurs it is always arm, hand, leg. When I get the pain I often get terribly painful spasming in my left foot and left arm. I have suffered from this for over 20 years. I have been for MRI and CT scans full body including brain 6 times over the 20+ years and nobody can find a problem. The pain happens for an hour then it completely goes away like it never happened for an hour. The duration of this pain varies every time. The pain comes and goes many times each day. I would love to hear your thoughts on this. Thank you in advance.
The nerves to your arm come out of your neck and nerves to your leg come out of your leg. So the only thing I could think of is a sensitization of the right spinothalamic tract. This is an image (not my image) - I just googled spinothalamic tract. teachmeanatomy.info/wp-content/uploads/The-Spinothalamic-Tracts-Ascending-Sensory-1.jpg As you can see, the nerves that carry pain cross the spinal cord and ascend to the brain on the opposite side of the spinal cord. If it was 20 years ago and all MRIs have been negative, there may not be a "lesion" per se that's visible on MRI but rather the pathway has become more efficient at sending signals to your thalamus and brain. There's more information about central sensitization / neuroplastic pain in my Chronic Pain book than I can possibly describe in a comment. m4lpt.com/book Again, I know nothing about your case other than what you've said, so don't take this as medical advice, but that's just my off-the-cuff thoughts. Make sure to follow up with your doctors as well.
That depends on whether it's a neck problem or a brachial plexus problem (watch the video at 0:42 to 2:48 to learn what that means). Either way, it would be a good idea to see a physical therapist in your area to get it further checked out.
Just based on that bit of information, there's not enough to tell what's causing it. So getting it checked out in person by a healthcare professional is the best thing to do.
I have pain on my back shoulder blade which radiates down my tricep and into my forearm. It is usually fine in the morning when I wake up but gets increasingly bad as the day progresses to the point where I'm in agony. If I bend my head back or look from side to side that causes pain, also if I do a chin tuck that is extremely painful. It's been going on for 5 straight weeks now 😔
Sorry to hear that. It sounds like it may be coming from your neck, but you'd have to get it evaluated by a healthcare professional in person to figure out the best way to treat it.
@@More4Life thank you for your reply. So even if there is no neck pain at all it could still come from my neck? My partner felt my shoulder blade where the pain is and can feel something there. Come to think of it the pain started when I had a muscle type of ache around my shoulder blade and she used a metal roller ball to massage the area and I told her to press very hard. I think then the next day or so I felt aching in my arm which then got gradually worse. The worst of the pain is in the forearm but as I said if I bend head back or look far to left/right or chin tuck the pain is shoulder blade. Doctors in the UK are very hard to see nowadays so trying to find out what it could be before potentially seeing a PT. Any advice would be very much appreciated!
I have a pain from shoulder to finger in left hand from some days ..and i can't tolerate this pain i have also done my echo ecg of my heart both of the reports are normal then what to do sir ?? I have neck pain also
sallam brother.. sleep without pillow for about 5 to 10 days on semi soft mattress..remember dont sleep in very soft deep mattress .. you will be ok .. i also did that and i am feeling well ..
I woke up one day and couldn’t move my neck much on its right side, the next day, I had a numbness and tingling spread through my right arm all the way to my thumb and palm. It’s been almost a week now and still feel the numbness anytime I add pressure on my right shoulder
brother sleep without pillow on flat semi soft nor deep mattress you will be ok in few days like 5 days .. i did it and i am feeling well. good wishes from Pakistan..
@@More4Life update: got it checked out and turns out I have a herniated disc on my c6 area in the spine. Doctor said it will go away with physiotherapy, been doing that for a little under a month now and it feels much better, no longer feeling a tingling or numbing feeling
also i got anti depression medicine from a psychiatrist .. basically a doctor told me that do your pain go with inflamatory , anti pain medicine ,, my answer was no .. do he transfer me to psychiatrist and it solved my issue.. coz the doctor told me that your pain is due to depression .. any how i use slim pillow and plain narrow metress .. not soft one but its a medical meteress.. i get relief withint a week..
In most cases yes, BUT only lift as heavy as you can without increasing your symptoms. You definitely shouldn't have increased arm symptoms when lifting weights.
I had a injury while performing front raise shoulder . I felt sometime stretched on upper back left side . After that i am having pain on upper back n it spread to my left hand . And while performing pushups my left hand is not able to take load and my shoulder are also unever (left is higher then right). Taken my physiotherapy session but not much improvement . Can you pls suggest how should i treat it 🙏
We can't give individual medical advice on this channel, but here are a few things to consider: 1) Such symptoms can be caused by either a neck problem (pinched nerve) or a local problem in the upper back such as the serratus anterior muscle (Google "serratus anterior trigger point" find a picture of the referral pattern.) Ultimately though, you'll need to have a doctor or a different physio check it out. 2) Here's a video about shoulder pain doing pushups that may help with that aspect. ua-cam.com/video/bMl4eJsaI0w/v-deo.html Good luck!
Very thorough explanation of each issue…Thankyou from Australia 👌
Glad it was helpful!
I have the same pain.
Leaned my head to the right and instant relief. Thank you!
You're welcome. Glad it helped!
Thank you so much Dr Candy
Great video presentation full of great information. Last October 2023 I was at work (food industry), and I went to lift my arms to pick up a sample bucket for the lab and I had debilitating pain down my neck, shoulders, arms, hands and fingers like and electric shock. I could not move my arms for around 15 mins. I still get stiffness in my neck, shoulders and arm. Numbness/ stiffness in my hands and fingers. These symptoms have repeated every time I lift or push (shopping bags). I am getting motion X-ray, CT and MRI scans completed this week. Dr's have suggested pinched nerve and possibly Cervical Myelopathy as the cause, so hopefully I can get some answers soon. Cheers.
Glad you enjoyed the video. Good luck!
Thanks a lot, this gave me piece of mind.
Been dealing with this for a while, into my pinky and ring finger.
Mostly in upper and lower arm.
Was scared of cardio, but this makes sense along with other nerve things I have elsewhere.
I appreciate it.
You're welcome!
Thank you for sharing, it help. God bless you
You're welcome
What about under the arm and armpit pain with a little pain stiffness or tenderness pinky side of arm( wrist )
ANGINA!
Lol!
This video kinda put me at ease a little bit.
I was very worried it could be a heart attack.
Thank you!
Glad it was helpful. Do make sure to follow up with your doctor though if you are concerned that it's a heart attack or angina.
How about grinding my shoulder blade with pain radiate to my fingers? Pls help me
I woke up a 3 m this morning with severe pain in my shoulders triceps /forearm and into my pinky, ring and middle fingers. I was crying it hurt so much. It gets worse every time I lay down.
Also some pain in my back and neck between the shoulder blades.
Sorry to hear that. Here's a video about various causes of pain in the pinky and ring finger and some ideas that may help. ua-cam.com/video/QY_p34XU8FU/v-deo.html Good luck!
Thank you seem like a good doctor
Thanks!
Thank you Doctor for the vedio exactly what I am feeling
Now.
You're welcome
Thanks for the info very useful.
You're welcome. Glad it helped.
Thanks doc for your video it help
Glad it helped
I muscle scrapped my bicep muscle today with that metal tool and now my arm works again 😮
Glad you're feeling better.
Thanks for caring, 100 excercises for a horrible rotation cup doesn't help until a massage therapist discovered a bicep tear, good news for me ! Not surgery, no bull , pain to heal and wisdom now so I can still lift!!!! PUMPING IRONMAN!
I have shoulder finger pain both side
Most often if it's on both sides, it's a neck problem, but regardless of the cause, if you're having shoulder and finger pain on both sides, it's something you should see your doctor about.
Good evening sir one year nundi shoulder thump and second finger and back head pain
Physiotherapy 10 days no use
I have pain in left arm from shoulder till wrist come and goes why its happening
Have had shoulder pain / wrist / elbow / finger pain for over a year. Have quit all physical activity. been to 9 physical therapists and none of them can figure it out. No trauma to the area. No idea how to tell where it's coming from.
Sorry to hear that. If you'd like, you can send more details about the problem to dave@m4lpt.com and we'll see if we can't either help you figure it out or help you find someone in your area who can.
How to figure my shoulder pain out
I had a lot of pain and did Prolotherapy which helped. After a while it came back and I'm doing BPC 157 peptides and it's working amazingly. Peptides can only be purchased from a trustworthy lab.
Hello sir My mother facing hand pain from last 6 months I think it's more than that. Her age is around 45 to 49
And she is facing severely hand pain from shoulder to fingers I am not getting its muscle pain, joint pain, tendons or ligaments pain
But we have done every test and every test is normal
Now doctors have asked to do MRI test
But i am not able to understand why my mother is facing such issue. Of course she have worked with that hand so much and now she has stopped doing it also medicine are there but still she is not feeling well
What you think what is it and how should handle it ?
It's impossible to say for sure based on just that information, but radiating pain to the hand is usually from a nerve problem. Checking for pinched nerves in the neck and thoracic outlet syndrome would be a good place to start. If it's mostly hand, checking for carpal tunnel syndrome could be warranted but it may be more than that it it's in the shoulder too. Good luck!
Shoulder blade pain come down to elbow and go up to wrist.
I have pain in my thumb and all the way it has reached to my shoulder and it pains a lot
Hi sir.....one year back doctor told me that i have muscle spasm in my left shoulder blade....but now i have left shoulder pain along with arm and finger pain.... sometimes i feel my hand is weak..need ur suggestion 🙏🏼
Here's a video about pinched nerves in the neck which can cause arm and finger pain and hand weakness. ua-cam.com/video/dGVpFKfJsNg/v-deo.html Make sure to get it checked out with your doctor as well though.
@@More4Life thanku sir
@@tejashwiniks273 you're welcome
My right shoulder joint is in forward position and is pinching the nerves. I think I should release surratus anterior and retract scapula back and down. What do you think?
Is it solvable? What about shoulder dislocation?
While I can't comment on your problem specifically without an examination, the shoulder joint being forward (i.e
Dislocation or subluxation) is different is different from the shoulder blade being forward.
The serratus anterior affects the shoulder blade, not the joint. Much more often though, it's the pectoral minor that rounds the shoulder blade forward.
@@More4Life
Thank you!
@@baderqassim3248 you're welcome
sleep without pillow without mattress i mean no deep mattress .. try to use semi soft mattress beneath you and dont use pillow .. youw ill be ok in 5 to 10 days..
What should l do the pain came and go it the worst pain that l have ever suffered 💔
I'm sorry to hear that you're suffering. The best advice that I can give you specifically though is to go see a doctor or physio to get it checked out.
I have neck to thumb finger pain why sir left side
That often corresponds to the C6 nerve root, but it's a good idea to get it checked out in person.
I am 22 years old and exacyly I have shoulder pain radiating to thumb and this couses more to my hand I sow psychotherapist but still paining
Mine is more like electrical shock going down my left arm &my thumb is numb but I have feeling in it&it's an off&on thing&doesn't last long I read something about stingers what can I do?
I have pain in the left and right shoulder can't raise my hand a lot of pain
I’m having pain pain down to my elbow.
Sorry to hear that. I hope some of these tips help you get pointed in the right direction.
I have the pain in my neck to fingers.. physiotherapy doctor told that is scapular problem it will be cure 1 week.. but i took physiotherapy in 4 days.. that time i feel better after 1 week i had pain.. I'm teacher when i was write on the board i have severe pain on my neck shoulder arms.. 😢😢 please give some solution.. nowadays i really upset i thought the pain is permanently with myself.. when I'm recovered to my old life 😢
Sorry to hear you're having a rough time. I'd suggest following up with your physio if it helped for awhile. I can't give you a solution without having evaluated your condition. However, if writing on the board bothers you one thing you could try is to avoid looking upward when writing on the board (write at your eye level or below). That decreases how much neck extension you're using as well as how high you have to elevate your arms.
It is overwhelming. I had a neck fusion back in 1993 at the C4-C5 level. For a month now I have pain in my left shoulder that runs down my arm and into my fingers. Also in my left shoulder blade. I'm wondering if it's coming from tight muscles in shoulder blade? I've tried different neck and shoulder exercises and massages but haven't gotten any relief. My question is can a Acupuncture Chiropractor help instead of going to physical therapy?
If you had a neck fusion at C4-C5 around 30 years ago, the most likely cause would be the segements below that C5-6 or C6-7 being hypermobile to make up for the fused segments. The C6 and C7 nerve roots do go into the hand. I'd recommend physical therapy, but I'm biased being that I am a physical therapist. If you do choose to go to a chiropractor, I would highly advise not allowing them to manipulate your neck.
Hi Dr Candy, I need your help please. I currently get pain that radiates down my left arm to my left hand, when this happens I also get a radiating pain down my left leg at the same time. The pain is always down my left leg and left arm. When the pain occurs it is always arm, hand, leg. When I get the pain I often get terribly painful spasming in my left foot and left arm. I have suffered from this for over 20 years. I have been for MRI and CT scans full body including brain 6 times over the 20+ years and nobody can find a problem. The pain happens for an hour then it completely goes away like it never happened for an hour. The duration of this pain varies every time. The pain comes and goes many times each day. I would love to hear your thoughts on this. Thank you in advance.
The nerves to your arm come out of your neck and nerves to your leg come out of your leg. So the only thing I could think of is a sensitization of the right spinothalamic tract. This is an image (not my image) - I just googled spinothalamic tract. teachmeanatomy.info/wp-content/uploads/The-Spinothalamic-Tracts-Ascending-Sensory-1.jpg As you can see, the nerves that carry pain cross the spinal cord and ascend to the brain on the opposite side of the spinal cord. If it was 20 years ago and all MRIs have been negative, there may not be a "lesion" per se that's visible on MRI but rather the pathway has become more efficient at sending signals to your thalamus and brain. There's more information about central sensitization / neuroplastic pain in my Chronic Pain book than I can possibly describe in a comment. m4lpt.com/book
Again, I know nothing about your case other than what you've said, so don't take this as medical advice, but that's just my off-the-cuff thoughts. Make sure to follow up with your doctors as well.
@edwintheron989 Check out this video ua-cam.com/video/bsQ2rnrHppM/v-deo.htmlsi=bUEKRAEOhW7aZSZi
I got pain in my back down my arm
If it's the upper back by the shoulder blade, you neck can sometimes refer pain in to the upper back as well.
@@More4Life its from my back triggers down my arm
Pain on my left arm it's come and go if I pick up something to heavy
Any improvement? I face the same issue
I have shoulder pain,arm and wrist pain and especially little finger and ring finger and below shoulder pain.what is the treatment...
That depends on whether it's a neck problem or a brachial plexus problem (watch the video at 0:42 to 2:48 to learn what that means). Either way, it would be a good idea to see a physical therapist in your area to get it further checked out.
Me same pain
When i move my ring finger it was pain and it was radiating through wrist and arm and shoulder aa well what i need to do?
Just based on that bit of information, there's not enough to tell what's causing it. So getting it checked out in person by a healthcare professional is the best thing to do.
I have pain on my back shoulder blade which radiates down my tricep and into my forearm. It is usually fine in the morning when I wake up but gets increasingly bad as the day progresses to the point where I'm in agony. If I bend my head back or look from side to side that causes pain, also if I do a chin tuck that is extremely painful. It's been going on for 5 straight weeks now 😔
Sorry to hear that. It sounds like it may be coming from your neck, but you'd have to get it evaluated by a healthcare professional in person to figure out the best way to treat it.
@@More4Life thank you for your reply. So even if there is no neck pain at all it could still come from my neck? My partner felt my shoulder blade where the pain is and can feel something there.
Come to think of it the pain started when I had a muscle type of ache around my shoulder blade and she used a metal roller ball to massage the area and I told her to press very hard. I think then the next day or so I felt aching in my arm which then got gradually worse.
The worst of the pain is in the forearm but as I said if I bend head back or look far to left/right or chin tuck the pain is shoulder blade.
Doctors in the UK are very hard to see nowadays so trying to find out what it could be before potentially seeing a PT. Any advice would be very much appreciated!
Mine exactly
@@gregoryeidukas8354 hey are you OK?
I have a pain from shoulder to finger in left hand from some days ..and i can't tolerate this pain i have also done my echo ecg of my heart both of the reports are normal then what to do sir ?? I have neck pain also
Hey how are you doing
I have neck pain, shoulder pain and left arm pain liter 2 finger also what is the treatment for that and which deportment doctor is good for check up.
In most cases, that's either from the lower neck and/or brachial plexus. Physical therapy would be a good place to start as far as treatment.
@@More4Life Thanks sir
@@MohammadShahid-xs5ul you're welcome.
sallam brother.. sleep without pillow for about 5 to 10 days on semi soft mattress..remember dont sleep in very soft deep mattress .. you will be ok .. i also did that and i am feeling well ..
I have pain in neck shoulder back arm front chest all are in right side and numbness in thump and next finger 🤞
That sounds like a C6 nerve root referral pattern. I suggest checking with your doctor and/or physical therapist.
Thank you very much for your kind advice
@@krishnajo8603 you're welcome.
You may check your heart and do one angiography first for any blockage to opt it out ... because these are also the same symptoms of blockage 😢😢
I have same issue , left arm down to the hand
I woke up one day and couldn’t move my neck much on its right side, the next day, I had a numbness and tingling spread through my right arm all the way to my thumb and palm. It’s been almost a week now and still feel the numbness anytime I add pressure on my right shoulder
Sorry to hear that. Probably a good idea to get it checked out sooner rather than later.
brother sleep without pillow on flat semi soft nor deep mattress you will be ok in few days like 5 days .. i did it and i am feeling well. good wishes from Pakistan..
@@More4Life update: got it checked out and turns out I have a herniated disc on my c6 area in the spine. Doctor said it will go away with physiotherapy, been doing that for a little under a month now and it feels much better, no longer feeling a tingling or numbing feeling
@@SalehAlderazi thanks for the update. Glad you got it checked out and that you're feeling better.
also i got anti depression medicine from a psychiatrist .. basically a doctor told me that do your pain go with inflamatory , anti pain medicine ,, my answer was no .. do he transfer me to psychiatrist and it solved my issue.. coz the doctor told me that your pain is due to depression .. any how i use slim pillow and plain narrow metress .. not soft one but its a medical meteress.. i get relief withint a week..
Can I do weight training with neck pain
In most cases yes, BUT only lift as heavy as you can without increasing your symptoms. You definitely shouldn't have increased arm symptoms when lifting weights.
@@More4Life thank you very much
My rotator cuff caused that
So basically go to see some one
Get to the point
I had a injury while performing front raise shoulder . I felt sometime stretched on upper back left side . After that i am having pain on upper back n it spread to my left hand . And while performing pushups my left hand is not able to take load and my shoulder are also unever (left is higher then right). Taken my physiotherapy session but not much improvement . Can you pls suggest how should i treat it 🙏
We can't give individual medical advice on this channel, but here are a few things to consider: 1) Such symptoms can be caused by either a neck problem (pinched nerve) or a local problem in the upper back such as the serratus anterior muscle (Google "serratus anterior trigger point" find a picture of the referral pattern.) Ultimately though, you'll need to have a doctor or a different physio check it out. 2) Here's a video about shoulder pain doing pushups that may help with that aspect. ua-cam.com/video/bMl4eJsaI0w/v-deo.html Good luck!