SLIPPED DISC ARM PAIN

(Keywords: SLIPPED DISC ARM PAIN, arm pain, slipped disc in neck, tingling in arms and hands )

Pain radiating from the neck into the arm is common at the Chiropractic Coalface, but the true slipped disc in neck producing pain and tingling in arms and hands is fortunately relatively uncommon.

It's an extremely painful condition, and a deep ache in the arm is one of the noteworthy features, and it's often worse at night.


ANATOMY OF A DISC

The Intervertebral Disc (= between the vertebrae) is made of two parts.

  1. ANNULUS FIBROSIS ... a very thick tough ligament-like ring of fibres which contains the
  2. NUCLEUS PULPOSIS ... a gel-like material that keeps the vertebrae apart, whilst giving them mobility.


The gel is essentially a liquid, and liquids are incompressible. When the neck is moved the bubble of gel bulges into the surrounding ring-like annulus which distorts to accommodate the nucleus. That's all quite normal anatomy.

The annulus fibrosis consists of about six layers, criss-crossed to make a very tough ring to support the nucleus pulposis.

However, in the slipped disc in neck the gel ruptures through one or more layers of the annulus fibrosis. Initially there is just pain in the neck, but the disc will swell and then may cause arm pain.



SHOULDER ABDUCTION RELIEF SIGN

If the slipped disc arm pain is significant then you will often get relief by placing your arm on or above your head, or sleeping with your hand under your head. Raising the arm takes the stretch off the nerve, bringing relief.

If raising the arm INCREASES the pain and tingling in the arm then we are probably talking about a THORACIC OUTLET SYNDROME most likely, rather than a slipped disc in the neck.



KEMP'S TEST

Another sign of slipped disc arm pain is that rotating your head to the side of the painful arm, and then looking up, immediately produces pain and tingling not just in the neck, but in the arm too.

When this happens you must take it seriously. It's a very serious condition and if you neglect it, the chances of spinal surgery are relatively high.

The seriousness is that the arm becomes numb, and may become weak. The triceps is the most commonly affected muscle. Press ups will be difficult... the arm becomes lame.


UPPER LIMB TENSION TEST (ULTT)

Your chiropractor will stretch out first your good arm, and then the naughty arm. In the true slipped disc arm pain, the naughty arm will feel very tight and painful in the lower arm. This is a test you could do at home... but be careful, when it's strongly positive it can be very painful and, injudiciously done, could aggravate the condition:



Cervical compression tests

There are various test, placing axial compression on the head and neck in different positions, looking to provoke the pain in the arm. Cervical compression test ...

A variation is Spurling's test. Does turning to the side of pain, and then looking up produce lower neck pain, and more significantly, pain or tingling in the arm?


NEUROLOGICAL EXAM


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Your chiropractor will test the reflexes, look for sensory changes and test for weakness in the arm. This is a serious condition and needs to be taken seriously, both by you, and by those treating you.

Controversial, this may make me a few enemies, if your chiropractor doesn't do a proper examination, and just wants to click your neck or, for that matter, your medical doctor just wants to give you anti inflammatory drugs without examining you, then I recommend you decline treatment, and go elsewhere. This is not a condition to be treated by those who are out of their depth, or want to take short cuts.

The most common muscle affected by slipped disc arm pain is the triceps which straightens the elbow. Try doing some pressups. Does the affected arm tire much more quickly?


TRACTION

Research does not confirm that traction ON ITS OWN will relieve a slipped disc in neck, or help reduce the pain and tingling in arms and hands, but my experience is that as an adjunct to chiropractic care it is very helpful. But that is just an opinion, based on my experience, and not confirmed by research. HOME TRACTION UNIT


PAIN AND TINGLING IN ARMS AND HANDS

One of the first nasty signs of slipped disc in neck is various nerve-like symptoms that radiate down your arm. Not that this necessarily implies a slipped disc neck pain.

A Cervical Facet syndrome for example, can easily mimic a slipped disc in neck. So too can worn joints of Luschka in the neck, usually caused by an injury to the neck, such as an old whiplash that wasn't properly attended too. CHIROPRACTIC HELP Whiplash and the joints of Luschka ...


CERVICAL RIBS
So too a large cervical rib can cause pain and tingling in arms and hands, mimicing a slipped disc arm pain condition. See in the graphic below how the cervical rib passes through the interscalene triangle, along with the brachial plexus and the Subclavian artery?



CHIROPRACTIC MANAGEMENT OF Slipped Disc Arm pain

Your chiropractor will have to work out what works best for your slipped disc in neck. Usually a gentle cervical adjustment is in my book the treatment of choice, but it has to be done very skillfully and carefully.

And sometimes manipulation just doesn't seem to help, and may even increase the pain. Then your chiropractor will have to try this and that. Axial traction often helps, working on the scalene muscles, ice, acupuncture, electrical modalities... this is a difficult condition and you may well have to be patient. It will take at least six weeks to heal.


SLIPPED DISC ARM PAIN CaseFile

Mr G is a 42 year old weight lifter. He had an old lifting injury to his shoulder and neck. Suddenly, two months previously, whilst doing a pull down, he developed severe neck and arm pain... a separate page will be built with this case history. SLIPPED DISC IN NECK ...


USEFUL LINKS


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Interesting challenges of the day

1. Mr B  came initially for a painful and stiff neck and then asked whether chiropractic could help the cold numb feeling running down the side of his thigh for six months. Meralgia paresthetica is a double crush syndrome with the nerve affected in the back and groin. He's 80% improved after five treatments.

2. Mrs C has a long history of severe, disabling migraine headaches since having her wisdom teeth removed. She clenches her teeth at night. After six treatments she has no migraines but some jaw joint discomfort remains; a bite plate is in the offing.

3. Mrs U has the trophy for the worst back this year. After major surgery with plates and screws two years later she still had paresis in the lower leg and severe disabling back pain. She's doing far better than expected, in no little part due to a lift in her shoe for a very short leg.

4. Mr V is 86 years old and hurt his back helping his wife into the car. Just one treatment of the sacroiliac joint and he's eighty percent better. It's not always like that.

5. Mr W lay on his back knocking down a pillar. Turning his head causes severe vertigo. He needs the Epley exercises, not pills, research shows. Update, he's fine.

6. Mrs X, a young mother has severe lower back pain, with numbness down the posterior thigh, calf and side of her foot. It started after a long drive in the car. After six treatments she is 60 percent better, but it's slow and is going to take the full 6 weeks to heal.

And now a setback, after lifting her child she now has leg pain. It's going to the be difficult.

7. This lady is a 70 year old woman, is on maintenance care for a nasty lumbar stenosis despite having to do everything at home. Her husband has a hospital acquired infection after a total shoulder replacement. After four operations he is incapacitated.

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. This man is a 73 year old engineer, still working, is doing fine after a long episode of lower back pain. Some pain on the side of the hip remains after five treatments. I reassured him it's not hip arthritis.

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. Mr 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. Both Mrs E and I can't believe how much better her lower back and leg pain are. Surgery for a scoliosis and spondylolysthesis three years ago helped greatly for one year. But then her leg went lame and weak. He was responded extremely well despite all expectations.

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



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Brachial plexus


Arm pain

1. Shoulder

Frozen Shoulder

Rotator cuff

"My thumb, forefinger and middle finger went weak after cuff surgery."

"Hello John, I take it you've been back to the surgeon.

It's probably temporary inflammation of the median nerve, but of course could be worse... I'm afraid I don't think chiropractic has anything to offer at this stage.

Once everything has healed up, if you don't get the strength back, or your fingers remain numb and tingly, then I'd consult a local chiro to see if there is also a problem in your neck or the first rib.

Dr B"

Letter from reader looking for advice.

2. Elbow

Elbow pain

3. Wrist

How bad is your arm shoulder hand pain?