Tingling in the arms and hands

An interesting case

A very successful Dutch businessman was on holiday with his family on a Greek island last summer when in the middle night he developed intense pain on the left side of his chest. It radiated down his left arm so, assuming the worst, his family rushed him to hospital.

He played tennis that afternoon with his teenage son who was determined to show dad that he had come of age. It didn't seem significant at the time or, if so, only in relation to an impending heart attack. They hadn't played tennis since his previous summer holiday.

The cardinal signs of a heart attack are

  • Uncomfortable pressure, fullness, squeezing or central chest pain lasting more than a few minutes.

  • Pain spreading to the shoulders, neck or arms. The pain may be mild to intense. It may feel like pressure, tightness, burning, or heavy weight. It may be located in the chest, upper abdomen, neck, jaw, or inside arms or shoulders.

  • Chest pain or discomfort with lightheadedness, fainting, sweating, nausea or shortness of breath.

  • Anxiety, nervousness and/or cold, sweaty skin.

  • Paleness or pallor.

  • Increased or irregular heart rate.

  • Feeling of impending doom.

Certainly he had intense pain in the chest spreading from the left side of his chest into his neck, left shoulder and arm. He was also very anxious and reported a very real sense of impending doom. But there was no sweating, nausea or shortness of breath. His heart was pounding he recorded.

The long and the short of it was that the hospital could find nothing wrong. He was admitted for the night for observation, and discharged the next day. They decided to return to Holland immediately for further tests.

Further batteries of tests also revealed nothing wrong with his heart, and nobody considered a possible musculo-skeletal cause of the tingling and pain, predominantly in his neck and arm by that stage, sometimes extending into the chest. Twice more in the next year he was rushed to hospital with the same result.

Nine months after the first attack, his doctor first started to think of nerve rather than blood vessel. A visit to a physiotherapist brought a little relief, and a few visits to a manual therapist even more relief but the cardinal signs remained, and he was often wakened in the night with pain and tingling in his left arm.

He then did what the modern Dutchman does. He typed 'tingling in arms and hands' into Google.

Thoracic Outlet Syndrome

The artery and the bundle of nerves that supply the arm travel through a narrow triangle bounded by the first rib, the collarbone and two muscles called the Scaleni. Subluxation of the rib, injury to the collar bone or muscles spasm in the scalenii can cause two things:

  1. Clamping of the Subclavian artery that supplies the arm.

  2. Irritation of the Brachial Plexus, a large bundle of nerves that run from the neck through the Scalene triangle with the Subclavian artery.

The classic test is named after a Dr Adson, a very smart man. Turning the head to the left, then looking upwards followed by a deep breath completely blocked the pulse in his wrist. Returning his head to the normal position and breathing out, I could immediately feel the pulse returning.

Medicine likes to remove the offending rib through the arm pit. Chiropratic has a very simple solution. Adjust the subluxated the rib.

After just one treatment he reported a 70% less tingling and pain in his arm at night, and he slept through the night for the first time in months without wakening.

Now, after about ten treatments he has almost no problems, and is scheduled for a follow-up in two months.

What has been a little trying is that he also suffered from headaches since a car-accident about two years previously. (TOS is known to be associated with MVAs). Try as I may if I tried to treat his neck both for headaches and the outlet syndrome, it stirred up the other. So now he has either a treatment for his upper neck where the headaches come from, or the rib, but not both.





    Many people get sick on holiday. There's a simple solution. Take a quiet day at home before leaving on vacation, and make sure you come back a day early. Your holiday shouldn't be simply an extension of the mad rush of life.

    Be careful of sports that you play only once a year, or very occasionally. An annual skiing holiday is a disaster waiting to happen. Just look at the statistics on the internet. 50 000 and more broken limbs in Switzerland.

    Throwing up the tennis ball with his left arm, looking up and taking in a deep breath to serve is the classic cause of TOS. For much more about neck pain anatomy in general click here. NECK PAIN ANATOMY ...

    Nutritional corner

    Do you know just how much substance there is to the old saying "An apple a day keeps the doctor away"? You would be astonished at the enormous amount of research proving that our humble apple lowers cholesterol by 10%, cures constipation and gastric infections, lung function and much more.

    Read more about the apple. APPLE DIET ...

    Until next month then. Promise not fill your Inbox with information overload.

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    Yours in Better Health