3 months of a tingling finger


Hi, thank you for your site. I had what everyone thought was a pinched nerve at my C6 but only had an xray so we don't know for certain. Most of the pain has since dissipated. But the tingling index finger remains. I have been in physical therapy and to my neurologist. They decided I have double crush of TOS and narrowing near my C6. I also have slight scapular winging. Or had. Through PT that has improved. But not the tingling finger. Also, as a ballet dancer for 20 years, I always had excellent posture so I don't know how this happened! My physical therapist is suggesting I see a coworker for a second opinion.


So, my question is, how long does it take for the tingling to go away usually?
Thank you!

Hello,
Firstly it does indeed sound like you have had a C6 nerve root lesion, which would normally have affected the thumb and index finger.

Sometimes with an associated triceps weakness. If you do press ups does that arm tire more quickly?

When it was very painful, did turning your head to that side, and simultaneously give you pain or tingling in the arm?

It could have been a slipped disc, or UncoVertebral degeneration. Look these terms up using the Search this site …

Generally, I find that if the pain goes away the numbness and tingling usually also subside.

Frankly, I don't too much about Physical Therapists, so I'm not sure of what treatment you have had. If you are satisfied with the progress, continue with them.

If not... Find a good chiropractor may be your next step.

But to be honest, this is a difficult condition for all of, surgeons too. It sounds to me like you are doing okay. Don't carry heavy parcels, shopping in that arm, and avoid looking up, especially with rotation.

I hope this has contributed.

Dr B

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Dec 17, 2013
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starstarstarstarstar 		Multi level Spondylosis in cervical spine
by: Anonymous

Ha ha! I swear I never had whiplash and I fairly certain I would remember hitting my head in the swimming pool or rock (grew up near lakes), falling off a horse, etc. Unless I have brain damage! Great, thanks, another thing to worry about. I do seem to have the c-spine of a 90-year old arthritic woman though. I reviewed the initial MRI and noticed it mentioned not only reverse lordosis, narrowing at the C6, but also multi-level spondylosis. And my x-ray showed my affected shoulder being a few mm higher, which is new (I remember being told I have 3 degrees of scoliosis when I was 5, but that was pretty minor). So I all of these structural problems have contributed. I don't know what we can to rejuvenate my spine (or at least make it the same age as the rest of me) but hopefully some of the curve can be put back, if necessary. Who knows! In the meantime, I look forward to having feeling in my fingers again and the shaking to end.

Hello, that reversed lordosis definitely, in my book anyway, points to previous trauma. Some authorties claim it's merely caused by muscle spasm of no consequence. In my experience, reversed lordosis is traumatic and always associated with pain, disc degeneration and ultimately the likelihood of symptoms in the arm.

The fact that there is advanced degenerations points to something that happened a long time ago. No point worrying about it, won't change anything. But something lurks back in your history.

Take omega 3 every day. Fatty fish, walnuts and freshly ground flaxseed.

Exercise, and perhaps a home traction unit, though the research is weak.

Dr B
Dec 16, 2013
Rating
starstarstarstarstar 		I finally have an answer
by: Anonymous

And you were right! The brachial MRI showed that my C6/C7 is very inflamed and the root nerve is infected. Hope mega dose of steroids will help and chiro in new year to give neck its curve again and maybe put it back in place. Still don't know how this happened in first place. Oh well. Thank you again!

Hello again, almost certainly an old bang on the head or neck. A whiplash your've forgotten, crash against the side of a swimming pool, fall off a horse. One of the mysteries, is that even minor trauma to the neck that causes no pain, but a spinal fixation, disturbs the nutrition of the joint causing what is known as immobilisation arthritis.

One of the most painful conditions treated at the chiropractic coalface so don't feel guilty feeling a bit sorry for yourself. It hurts.

For what it's worth, a few chiropractic treatments I find can help a lot, but too much treatment may worsen it too. Don't sign up for 500 treatments!

Dr B
Nov 27, 2013
Rating
starstarstarstarstar 		Negative for Adson's test
by: Anonymous

Come on, that would be far too easy! Results from Doppler was that I don't have arterial TOS (not significant enough change?). Maybe just pinched nerve in brachial area? Neuro wants MRI. I am going to try massage deep tissue too. Maybe relax some of the muscles in area. Also, got under desk keyboard thing since desk too high causing me to raise shoulders. Not the cure, but can't hurt. And I eat an apple a day.
[I too thinking against TOS with relief from raising your arms. But remember only a small percentage of confirmed TOS patients have a vascular component. Adsons is certainly a difficult and subjective test, Doppler would be more objective, but I have no experience of it.

Computer posture. Add support for the elbow, small desk or somesuch thing.

Good luck, confusing when you get ten different opinions. Means nobody knows! DX: GOK. Know what that means? But for me, this is a neck issue.

Dr B]
Nov 23, 2013
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starstarstarstarstar 		3 months of a tingling finger
by: Anonymous

This wouldn't be the first time my body didn't follow the script! And, frankly, if it continued as a by-the-book C6 root lesion I probably would have not contacted you ;) My reflexes tested normal. No mention of whiplash and I don't crack my neck (only thing on me that doesn't crack). Chin tucks increased tingling at first, now don't. Oddly, up and away doesn't but down and away does. Brachial area on affected side like cement--one big knot, but super sensitive. Doppler showed difference when elbows back and in 90 degrees, though that is not official doctor findings, just me looking at monitor. This goes against TOS, but at least its something and not more of nothing. Hopefully the full results are meaningful. I cannot see another chiro until Jan (insurance). Thanks again for your help!

[Mmm, arms extended would pull the pec minor tendon tight - that can also affect the nerves and artery to the arm.

Ask if you have a positive Adson's test.

Dr B
Nov 20, 2013
Rating
starstarstarstarstar 		Shoulder abduction relief sign
by: Anonymous

Shoulder abduction relief sign


I think it's actually improving

Sorry, here is the full scoop: horrible pain and x-ray did show pinched nerve but minor reverse lordosis of c-spine and minor degradation of vertebrae. Theory was muscle spasms from minor cervical misalignment. Pain in arm lessened when raised above head. Massage didn't help.

After 6 weeks of PT, pain subsided but still finger tingling, went to neurologist. She assumed pinched C6. Performed EMG (normal), brain MRI (unremarkable--a little judgemental), cervical MRI (minor degredation & reverse lordosis, narrow nerve at C6).

Same theory about spasms from beginning of reverse lordosis. I never knew spasms were so powerful. So I went to chiropractor who said I had very minor straightening and its not the cause, to continue PT and I don't need a chiropractor. Neuro diagnosed TOS. Last week had xray for extra rib (no). I think steroids worked and its starting to tingle less. I hope. Dopplar next.

[Sorry, but I'm not happy with all this.

Firstly, relief by raising your arm is an ominous sign of a severely pinched nerve. It's called the Shoulder Abduction Relief sign ... when it's really bad, patients walk into the clinic with their hand on their head. Diagnosis already made.

Coupled with the severe pain you have been having down the C6 dermatome, the strongly positive Upper Limb Tension tests and weakness in the triceps ... it all points to severe nerve root impingement.

The classical medical opinion is that loss of the lordosis (reversal of the curve) is caused by muscle spasm. However, in my experience it is always associated with severe pain, and is actually caused by an old tear of the interspinous ligament in a whiplash type injury. The function of the ligament is to maintain the lordosis: ruptured > reversal of the lordosis and change of the whole biomechanics of the neck, and ultimately where you are.

Personally I think a thoracic outlet syndrome unlikely. Wish it was TOS! Much easier to correct in most cases. In TOS raising the arm above the head INCREASES the symptoms. Adson's test?

Would you know if the triceps reflex has been affected?

That "narrow nerve at C6" is very significant. Any mention of the uncovertebral joints? Aka paravertebral joints and Joints of Luschka.

So you are getting lots of contradictory advice. And in general you should weight the opinion of some person who has never examined you, from the web, me, less than those on the ground. Perhaps much less.

So where does that leave you? Not sure. If you are happy you are actually getting better, then continue with what you are doing. If not...

Good luck, let me know how you get on. It's difficult, I treat what you have very frequently and it's one of the most painful conditions in the practice.]
Nov 18, 2013
Rating
starstarstarstarstar 		just cut off all my fingers!
by: Anonymous

Ooh, the Upper Limb Tension Test is definitely positive. Neurologist is concerned nerve is still upset too. Sometimes I think my middle finger tingles too, not always.

[Hello again,
Afraid, I can't make recommendations. Obviously there is still a problem, and something should be done, otherwise your arm is likely to waste and become numb and painful again.

If you are satisfied with the PT, continue with them. If not, either return to your original chiro (how many times did you see him/her? Any relief?) or perhaps someone new.

I don't recommend after all this time that you simply do nothing. Sounds to me like it's time for an MR scan. Lots of stuff not seen on a routine X-ray.

Dr B
Nov 16, 2013
Rating
starstarstarstarstar 		still tingling...
by: Anonymous

Thank you for your response. I should have mentioned that I went to a chiropractor, though perhaps not a good one since he said to keep up with the physical therapy adjusting my neck and back. The neurologist put me on steroids which helped a little and is sending me for imaging for in the brachial area and along my arm. My tricep didn't tire before but now its starting to and occasionally you can press on spots and increases tinging in my finger and thumb. Thank you again!

[Pleasure.
Suggesting you continue with PT doesn't make your chiropractor less good. Sometimes a combination of treatment is better still, though not if both are doing manipulation.

Do this Upper Limb Tension Test ... I'd be concerned if the test is still positive after all this time. It means the nerve is still strongly irritated.

Another frequent site of entrapment is in the forearm where the median nerve passes between the two bellies of the Pronator teres muscle. See our Carpal Tunnel syndrome page. But then I would have expected tingling in the middle finger too.

Dr B]

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