Arm numbness and entire upper back tightness


Arm numbness and entire upper back tightness makes for a diagnostic conundrum.

At the beginning of the year I was driving and the right side of my body suddenly became numb. I thought I might be having a stroke. Went to the er and that was discounted as I had only sensory and not any motor involvement.

Since then I have experienced bouts of the same symptoms and a generalized tightness in my upper back, shoulders and underarm area (transient). I have had problems before with my right rhomboid muscle and it has been very sore so I assumed the problem was coming from there (irritated nerve?).

I have seen a chiropractor with little change. I would think this would have gotten better by now. It's scary at night when the numbness sets in.

I have had a stroke three yrs ago and that reminds me of that. I recovered fully as I am somewhat of a health nut, the last person anyone thought would have one. Also, I notice a stiffness and limited range of motion in my toes. Any insight into these issues would be most sincerely appreciated! Thank you!


Good day Dr Jim, and you have posed an interesting question.

The diagnosis obviously is paramount. Do you know if you have any increased reflexes, and whether there was any change in them in the last month. Some central involvement is more likely than a cervical spine issue which would not cause the whole of your right side of your body to become numb. The exception would be advanced cervical spine stenosis, when cord impingement is possible. Again, increased reflexes, especially in the lower limb.

If it was coming from your neck, then movements of your neck will usually provoke pain, and often radiating signs down the arm, or into the midback. If you turn your head to the right, and then look up, what happens?

The T1 dermatome covers the upper back and the under arm. Do you have any weakness in the fingers. If you sqeeze a piece of paper between your index and middle finger, and pull it away with the other hand, what happens? Is right and left equally strong?

With a pinched nerve in the neck, you would have a positive upper limb tension test. Find it using the search function at Chiropractic Help? You need a helper to do the test.

One other question concerns the position of your arm. If you raise it above your head, as in screwing in a light bulb, does it increase or lessen the numbness? If you carry a brief case in your right arm, does it increase the ache in your arm?

Upper back pain is always difficult. The skin is supplied to T1-3, but the underlying rhomboid muscles are pure C5. You make no mention of x-rays of your neck; is there anything significant?

Summing up, if movements of your head to not provoke the numbness, the ULTT is negative, there's no weakness or decreased reflexes in the arm, then I think a neurologist is the right way to go. I hope this contributes.


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Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I've left alone. After seven treatments his pain and stiffness is 50 percent better, and he's happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He's doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost painfree. 

Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he's well pleased; sixty five percent better after three treatments.

5. Mr T is a wise man; he's taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily walk has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. Xrays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65 year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88 year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done.  

10. Mr X is a 71 year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a year ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

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. Mr D is a 38 old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he couldn't sleep on that shoulder.

13. Mr D, a 71 year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

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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