system: You are a clinical documentation assistant. Generate only the requested clinical note section using only facts from the dialogue. Do not invent information. If the section is not supported by the dialogue, return N/A.

user: Section: GENHX

Dialogue:
Doctor: Welcome back.
Patient: Thank you.
Doctor: You are back for a follow up on your right arm pain, right?
Patient: Yes. It has been almost a year since the pain first started.
Doctor: How has your arm been feeling?
Patient: I still have this dull pain in my upper outer area of my arm.
Doctor: How long does the pain last?
Patient: It was coming and going, but now the pain is more persistent since I last saw you. It is still happening every day.
Doctor: Remind me again. You are right handed. Right?
Patient: Yeah. It makes is hard to do things with the persistent pain.
Doctor: I bet it does. Are you experiencing any numbness or tingling sensation in your arm or hand?
Patient: No, but I have had this achy sensation in my hand radiating down to my fingers.
Doctor: Do you have a history of any other neck or shoulder injuries?
Patient: It is not from a specific injury but I have had this neck pain for thirty years.
Doctor: Did you see anyone for the neck pain?
Patient: Yes. I saw someone for it in two thousand and six, and then I developed this ear pain. They could not figure out what was going on so eventually I was sent to have an M R I of my neck and upper spine, which showed some degenerative changes. Then I was referred to Doctor X who was treating me for neck pain. He gave me steroid injections.
Doctor: Are you still seeing Doctor X for the epidural injections?
Patient: Yes. I have been seeing him since two thousand and seven.
Doctor: How old are you?
Patient: I am fifty eight.
Doctor: Are you experiencing any symptoms from receiving the injections?
Patient: Those are for neck pain. My arm pain recent. I have been having the injections for a while now, without any trouble.
Doctor: What medications have you been taking for the pain?
Patient: There are a few of them that I take. I gave the list to the nurse.
Doctor: Okay.
Patient: I also have taken several Medrol packs. They make my blood sugars to increase so I try not to take it.
Doctor: Okay. Does the pain prevent you from doing your daily activities or decrease your quality of life?
Patient: No. I can do everything like normal, but constant nagging pain does get to me at times.

assistant: The patient is a 58-year-old right-handed gentleman who presents for further evaluation of right arm pain. He states that a little less than a year ago he developed pain in his right arm. It is intermittent, but has persisted since that time. He describes that he experiences a dull pain in his upper outer arm. It occurs on a daily basis. He also experiences an achy sensation in his right hand radiating to the fingers. There is no numbness or paresthesias in the hand or arm. He has had a 30-year history of neck pain. He sought medical attention for this problem in 2006, when he developed ear pain. This eventually led to him undergoing an MRI of the cervical spine, which showed some degenerative changes. He was then referred to Dr. X for treatment of neck pain. He has been receiving epidural injections under the care of Dr. X since 2007. When I asked him what symptom he is receiving the injections for, he states that it is for neck pain and now the more recent onset of arm pain. He also has taken several Medrol dose packs, which has caused his blood sugars to increase. He is taking multiple other pain medications. The pain does not interfere significantly with his quality of life, although he has a constant nagging pain.