Rhomboid knot, numbness tip of index finger

by Melvin
(Bridgeport, CT USA)

The yellow portion belongs to the C5 dermatome.

The yellow portion belongs to the C5 dermatome.

The yellow portion belongs to the C5 dermatome.
Sharp pain in the midback is often caused by a subluxated rib head.

Rhomboid knot, numbness tip of index finger may be two separate conditions.

I had a large knot on the left side of my upper back between the shoulder blade and spine. Felt like a knife was sticking me and a pretty large knot was present.

Is rhomboid muscle knot/pain normally accompanied by some index finger numbness? The knot went down after some self massage and naproxen but the area is still sore. What type of exercises can I do? My wife noticed right before my knot happened that I was walking slouched over but my pecs don't seem to be tight. I'm still in pain, not as bad as it was when the knot was present but the pain is still sharp and persistent. I purchased a Wahl electric massager that also has an option for heat. How long do these things/pain normally last?

Hello Melvin,
No, a rhomboid knot is not normally directly accompanied by numbness in the index finger; however there are some ifs and maybes.
An active trigger point in a muscle may refer well away from the area, and even down to the hand, but it won't actually cause any numbness; more likely some other condition is causing the rhomboid knot and the numbness in your hand.
Here lies the dilemma; the rhomboid muscle is supplied by the dorsal scapular nerve which is pure C5; it also goes to the side of the upper arm, but not down to the hand.

And then sharp pain in the midback is usually caused by a subluxated rib head, and not secondary to a nerve root entrapment, particularly if it's associated with deep breathing.

Numbness in just a finger tip is a little mysterious; I'd be checking the first rib as a condition called the thoraco outlet syndrome can affect anyone of the dermatomes, or all of them; and also the entrapment areas of the median nerve in the shoulder and arm. But then you'd expect it to affect more than one finger tip.

In short, neurology is complex and mysterious and doesn't always follow the expected rules. I'd start with an examination of the rib head, and the lower cervical spine and first rib. No amount of anti inflammatory pills or massage will fix these.

I hope this contributes; let me know.

Dr B

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Aug 28, 2016
Weights over my head
by: Melvin

Weights over my head can lead to neck pain.

Barrie, thank you for your thoughts and expertise. It is now Sunday the 28th 2016 and I have an appointment on the 30th with a physiologist for other issues I have. I didn't mention that I exercise 3-5 times a week and some of that involves strength training on nautilus style machines. Anyway I am also an avid runner that injured an ankle some 30 days ago. I've been doing elliptical which requires me to pull and push the handles, I've also been doing rowing type exercises on the nautilus as well as exercises that strengthen the shoulders, i.e. sitting and pushing weights over my head.

I'm hoping that whatever it is (and I'll get an idea on Tuesday the 30th) that it's just over use and not serious. I'm going to print your reply and give it to my therapist. Thanks again for taking the time to respond to my post and for having such an informative site.

It's a pleasure, Melvin, and I hope it takes you a step forwards. For what it's worth, some of the very severe neck patients we encounter in the practice have been doing pull downs, and in general weights above the head.

One little thought; in my humble opinion exercises should be done to improve one's health and well being; when that's not happening, is it not worth stepping back and asking a few questions?

Dr B

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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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