Neck Arm pain

Shoulder

Keywords; neck arm pain, tingling in arms and hands, fresh spinach recipes.


I present here three letters received at the chiropractic help desk that will outline for the gravity and seriousness of an ache and tingling radiating down the upper extremity from the cervical spine. They may help you to understand that you are not all alone.


Here's the first letter.

Hello, I am a 26 year old male who has been experiencing pain and tingling in the area where my neck and shoulder meet, along with tingling in the arms and hands, wrist and fingers. This has been going on for over a year now.

I did data entry at my job for 5 years and that is where I first started experiencing discomfort in my hands, though most of my issues are on the right side. I have had 2 EMGs 8 months apart, 2 MRIs; one of the neck and one of the brain, an x ray of the neck, and cortisone injections in my wrists. The tests have all come back fine and I have seen many different doctors who can't seem to pinpoint an issue or come up with a diagnosis.

The symptoms used to be only lower arm pain; in my hands and wrists so they thought it was CTS, but over time my symptoms have changed and worsened. I have experienced tingling in all of my fingers. My arms feel easily fatigued. I feel it is difficult to sit up straight, I can't sleep on my side anymore because my arm; from my armpit all around, and neck feel pain and tingling sensation, where it feels like I need to move to relieve it but no matter what way I move the arm it doesn't feel right. I'm only able to sleep on my back, though sometimes when I do (and I am unsure if this is related) from the top of my rear down to my toes I feel an uncomfortable numbness, but it doesn't happen all the time.

I have been unable to work or enjoy my hobbies such as playing guitar, because any bit of work or activity I do seems to make them worse. Particularly the spot on my wrist and an area in my neck. Up until these problems I lead an active healthy lifestyle and exercised every other day by doing pull-ups, push-ups and lifting ten to thirty pound dumbbells, so I have always had good body strength. However, I have been unable to do this workout routine.


Here is the second letter.

Three months ago I fell down some steps at work and probably fell from a height of about one metre; I instinctively stuck my left arm out behind me. I came down fairly hard on the arm. This resulted in an intense burning sensation in the upper part of my arm lasting 10 minutes or there about.

The incident was reported and I was checked by site safety officer and after 30 minutes all seemed ok and I returned to work. Two months later I started getting pain in the left arm like a dull ache in the upper part; I went to my GP he said it was probably just soft tissue damage, to give it a few days and see how it goes. After a week it had progressed to numbness and pins and needles sensation down the forearm across the hand and thumb and first 2 fingers and the dull ache in the upper arm which was now fairly constant.

I also now have a constant twinge in my back in between my shoulder blades and the neck where it meets the shoulders.

I have had x-rays of the neck done but they were inconclusive.

What is it that I have most likely done to end up with these symptoms? I know the initial burning sensation I experienced was most probably related to stress on some nerve or nerves.


LOWER ARM PAIN

Letter 3

I have pins and needles starting in my finger tips and travelling up to my elbow. I cannot carry anything in my right hand without pins and needles beginning.


Neck Arm pain


I would say that the most challenging conditions at the Chiropractic Coalface concern neck shoulder arm pain. From the patient's point of view these conditions can be very disabling and to make matters worse they often seriously disturb sleep. Unlike a sciatica, you can't find a position to relieve the pain in the arm.


Obviously lower arm pain, for example, could be a local problem like arthritis in the fingers or if you fell an injury like a sprained wrist. Or the severe pain I'm suffering from after contact with a nasty rhus tree that gave me a very painful rash two months ago and the nerve pain is now waking me at night. I doubt an adjustment of the neck would help!

However, the stubborn carpal tunnel syndromes, the tennis elbows, the frozen shoulders and rotator cuff syndromes that haven't responded to medicine and physiotherapy's best efforts, I find almost always have one of two underlying causes:


The Upper limb tension test is the gold standard test for a pinched nerve in the neck.


  • A First Rib (aka Thoracic Outlet syndrome ) affecting both the brachial plexus of nerves and often the artery supplying the arm too. A double wammy of nerve irritation and insufficient blood to the arm. The key sign is a very weak, tired arm when it is raised and used above the shoulders - as in hanging the washing. THORACIC OUTLET SYNDROME ...


The "inter scalene triangle" is bounded by three structures:

  • Anterior scalene muscle
  • Medial scalene muscle
  • First rib

NECK ARM PAIN CASE HISTORIES

ARM PAIN Case Histories

I present here two challenging cases. Two cases, one with pain in her upper arm of some two years duration. Surgery did not help, and eventually the nerve bundles to her shoulder became so badly irritated she got a frozen shoulder from her neck arm pain. In a case of left arm shoulder pain of acute onset, an impending heart attack should of course also be considered. Nausea? Sweating? Extreme anxiety?In the second case, a 6 month pain in arm, was a very stubborn case of tennis elbow. And standing behind it, a twenty year history of neck pain. Both cases have been a challenge, both are doing very nicely, but... get that neck sorted out before it starts giving you a nasty neck arm pain. That nerve pain in the arm is far worse than the pain in the neck. CARPAL TUNNEL Case File ...

HOME TRACTION UNIT @ Neck Arm pain

When all else fails in the management of neck arm pain, think exercises, think omega-3 oil and think traction. There is no scientific evidence that traction ON ITS OWN has any benefit with pain upper arm or lower arm pain ... but combined with chiropractic care I can offer you anecdotal evidence that it does contribute. Perhaps you'd like to make a home traction unit like this innovative patient did. We couldn't find a decent traction unit in Holland. It made a big difference to a stubborn two-year upper arm muscle pain. In fact in the end, he found that the traction helped more than my treatment! or that of various doctors over the previous two years. HOME TRACTION UNIT ...


Carpal Tunnel EXERCISES

One of the frustrations of neck arm pain is that the patient feels helpless. There appears to be nothing they can do to help themselves. Well there is. Provided the pain and tingling in arms and hands excludes the pinkie these Carpal Tunnel exercises MIGHT help, and certainly won't make it worse. Do them lying down if you have shoulder pain.

Arm pit pain


"The radiographer angled the screen towards me so that I could see the corolla of dark tumours spiralling through my breast."

My cancer heartbreak


If you have pain in the arm pit that you can't provoke by turning your neck, or raising your arm, then I'd see your medical doctor first. Just to be sure because it might NOT be the Neck Arm pain we have been discussing. The Subscapularis, Teres Major and Latissimus dorsi muscles are the usual causes of arm pit pain, but nasty swollen lymph nodes lurk there very occasionally. Every woman, in particular, should be looking to replace some of the animal protein - eggs, cheese, meat - in her diet with vegetable protein such as tofu and hummus, green beans and lentils.

Research in the Netherlands, where one in eight women will get breast cancer, the highest in the world, is that too much animal protein is the chief cause, along with post-menopausal hormone replacement therapy.


Ribs pertain normally to the thoracic spine, in the midback, but occasionally a very large cervical rib, in the lower neck may interfere with the artery and nerves supplying the arm, causing a mystifying array of neck arm pain signs and symptoms for the clinician. The cervical rib casefile below may help you grasp the significance of a large cervical rib. 

Small ribs are not uncommon and probably have little significance.

If you have no interest in the problems and questions that others have regarding neck arm pain, then just scroll quickly down past several letters. 


RIGHT DECISIONS

It's the responsibility of all who are treating the patient with neck arm pain to help the patient make the right choices and decisions ... it's not the time for partisan politicking.

If the patient is not responding well to Chiropractic help, then it's time for a second (medical) opinion, or even the opinion of another chiropractor.


If the patient suffering from pain and tingling in the arms and hands is not responding well to anti inflammatory drugs  then it's time for the medical doctor to consider whether a course of chiropractic adjustments may not be in the patient's interests.

Often there's an arthritic component. Are there degenerative, inflammatory changes within the joints of Luschka? Would a course of fish oil and some of the findings from flax seed nutrition information to be considered. Omega-3 is a powerful anti-inflammatory.

Hard choices have to be sometimes made.


Contact me directly right here.

I receive many questions at Chiropractic Help. It might be help for a spinal condition, but it could also be about a failed Carpal Tunnel operation, or some such thing.

I will do that by answering your questions personally, but it will be converted to a Web Page so others can benefit from your questions. Omit your name if you like...

However, do understand that, in the main, I'm going to be directing you (should it be pertinent) to a Chiropractor in your neck of the woods. I'll respond to all reasonable inquiries, but please be specific, and give some details: which fingers, what increases the pain, and relieves it, injuries, do xrays show anything, does placing your arm on your head relieve or increase tingling in the arm... without these sort of details, I'm unable to give a sensible answer.

Please also don't write from your blackberry or iphone. Many many people will be reading what you write, and I don't want gobbledygook at chiropractic help. It lowers the tone of the whole site, and Google is now downgrading sites with poor grammar and spelling. I just won't answer.

There is no charge for this service, however if you find my answer useful, you might like to consider purchasing my latest book, Stones in my Clog. Gems, both funny and healthful, from the life and work of a Chiropractor. It's only $2.99. Stones in my Clog ...

Pose Me A Question! Pretty please, in decent grammar and spelling.

I will never give or sell your e-mail address to anyone.

PS. If you find my answer instructive, would you please ask a friend to rate the page. Many thanks.

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"If you have only one smile in you, give it to the people you love. Don't be surly at home, then go out in the street and start grinning 'Good morning' at total strangers."

Maya Angelou's mother.



From the garden

Healthy fats come mainly from three sources: avocado, olive and fatty fish. Of course, nuts and seeds, especially omega-3 rich flax seed.And omega-3 is vital if you suffer from joint pain, in general, more specifically from neck arm pain.

An miniature avocado tree will be such a blessing if you have the space. Not only is avocado fat rich in momo-unsaturated fatty acids, the good stuff, zero cholesterol, but an avocado-a-day contains all the beta-sitosterol (a phytosterol) a man needs to prevent nasty benign prostate enlargement.

Nerves are coated in fat (called a myelin sheath), vital for conduction of nervous impulses. Diseases such a Multiple Sclerosis attack this fatty sheath, and a very low fat diet, or eating the bad fats, is strongly implicated in these very serious autoimmune diseases. Tingling in arms and hands in the absence of neck pain? What are phytosterols ... ?


Tofu

Tofu is the main source of protein in the East. It's an (unexciting) but extremely valuable source of vegetable protein, derived from the soya bean. But unlike soya bean burgers that I personally find detestable, tofu is perfectly palatable if you dickey it up with chillies, ginger and garlic. It's also a very cheap source of protein, try and eat Tofu nutrition at least once a week.


Hummus

Hummus is a traditional Mediterranean dish made from chickpeas. Also known as Garbanzo Beans, chickpeas are the world's favourite legume. Hummus is quite expensive to buy, and often laden with chemicals such as preservatives, flavour enhancers... instead, I make a large tub twice a week in our own kitchen. It takes me less than five minutes from start to finish. Chickpeas are very cheap.

We have one to three large tablespoons almost every day with a salad, or on bread. AUTHENTIC HUMMUS RECIPE ...


Planning. Now is the time to decide just how much space you have in your garden for vegetables and fruit, remembering that FIVE colours in your diet every day is mandatory if you don't want to get cancer. The Black and White diet went out with B&W TV! If your space is limited, could I punt for growing green beansJust three or four pole bean seeds, planted every week or two will keep you in green beans right through the summer. They'll grow like weeds up any trellis work in a sunny spot in the garden, on a fence, up a stake... easy!

And, once you have considered this green bean and lentil soup you WILL find a sunny corner for a few pole bean plants!


In short, healthy eating is vital for sparkling good health, and especially a healthy nervous system. Don't expect to be healthy if you eat crap!


USEFUL LINKS @ Neck arm pain



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Interesting challenges of the day

1. Mrs D, a 78 year old woman has very severe sacroiliac joint pain, and even more severe cramps in her right leg. There are two problems; she is on two diuretics but no slow K. Taking her temporarily off one diuretic and adjusting the SIJ brought 50 percent relief within four days. 

2. Mr S, a 48 year old man, has right low back pain, groin pain and a numb feeling in his lower leg when he sports. For six months he's been off football. He too has two problems; a very treatable lumbar facet syndrome and a very serious blocked artery in the groin; it's called intermittent claudication. Smokers beware.  

3. Mr S looks like the leaning tower of Pisa; he has a slipped disc at L5 making him lean towards the opposite side. It's called the postero lateral disc hernia; we'll fix it, but he has to stop for a week or two. Antalgias are serious so take them seriously. 

4. Mrs V too has  two conditions; a chronic low grade sciatica giving her an ache in the right leg, and a threatening Morton's neuroma. She's glad I'm back in Holland; chiropractic fixed it before, and we'll fix it again. 

5. Mrs W is one of the lucky ones, says her doctor. I agree. He says only 40% of patients with lumbar stenosis have a successful operation. We fixed a nasty slipped disc three years ago, but it came back two years later; the surgeon did a fine job but she has a weak ankle now giving her subtalar joint pain; it's routine stuff. 

6. I myself had an acute exacerbation of a femoral nerve lesion last year. One immediate treatment of the new strain by my colleague has fixed the pain in the lower back, but there's some residual numbness in the lower leg; no soaring tomorrow alas.

7. This lady is a 86 year old woman with a 63 scoliosis. Chronic lower back has been her lot in life but she's well pleased with chiropractic and comes for chiropractic help once a month; some conditions you can never cure.

8. She is an 78 year old woman, is doing remarkably well with a bad sciatica. But over 200 pounds she is not losing weight; in fact, gaining despite my suggestions. She's high risk for a stroke. I have referred her to a dietician to crack the whip.

9. A 61 year old man with upper cervical pain yesterday; it's not severe but also not getting better of its own accord. He's afraid it may turn very acute as when I treated him three years ago. Since then it's been fine. 

10. A 64 year old woman has had scheuermanns disease; it's left her with a spinal kyphosis and chronic middorsal pain. She responds well to chiropractic treatment provides she come every six weeks or so for maintenance treatment.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

12. Mrs D, a middle aged woman with hip pain of one year duration, despite other treatment. Xrays reveal an impingement syndrome and early hip arthritis. There's much to be done.

13. Mrs B has had one of the nastiest of conditions; vertigo caused by a disturbance in the inner ear. Falling repeatedly and vomiting she consulted her doctor but medication didn't help. After two sessions of the Epley manoeuvres she was 50 percent better. After two weeks 75 percent improved. No longer vomiting all falling. She's not enjoying the Brandt Daroff home exercises.

And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.



Have a problem that's not getting better? Looking for a different slant on your pain? Want to pose a question?


Interesting questions from visitors

CLS writes:

Greetings, Dr B.
You helped me quite some time back with a soothing and professional response which turned out to be exactly correct. I now consult a local chiropractor. You write a superb newsletter, too.

Your own unresolved problem. Pose a question

Knowing that up to 70% of the time the correct diagnosis is made with no examination, no special tests, no xrays, but just from the history, there's a fair chance I can add some insight to your unresolved problem. But at least 30% of the time, I may be quite wrong! Give plenty of detail if you want a sensible reply.


You visited this chiropractic help site no doubt because you have a problem that is not resolving and want to know more about what chiropractors do.

The quickest and most interesting way is to read one of my ebooks of anecdotes. Described by a reader as gems, both funny and healthful, from the life and work of a chiropractor, you'll love them. Priced right at $2.99, though Kindle fiddles the price without telling me.