Tingling in arms and hands

Keywords: tingling in arms and hands

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Tingling is primarily a sign of nerve irritation or damage. That could be in the brain or spinal cord, but more usually it is in the neck, or trapped between the first rib and collar bone, or somewhere in the arm, for example at the funny bone, or in the forearm by the two bellies of the Pronator Teres muscle as occurs in the carpal tunnel syndrome.

Paresthesias

Take special note which fingers are tingling. The tongue? Around the lips? Do movement of the neck provoke the pain and or tingling? What about raising your arms in the air? Does it increase or relieve the tingling?

Tingling in arms and hands, as a general rule of thumb, sorry to be puny, is not something for which your doctor or chiropractor are likely to recommend you rush off and make a consultation. Having said that, an unknown symptom never experienced before needs to be taken more seriously.

Is it radiating down the left arm, are you sweating and nauseous? Get to the emergency room fast! A heart attack may be lurking.

However, neurological symptoms like tingling need to be attended to with greater concern. The neurological system is the most sensitive structure in the body, and early warnings are best heeded sooner rather than later. A young friend recently had a totally unexpected stroke, and is permanently blind in one eye. Why didn't you come sooner, complained the neurologist. For six weeks he had been getting warning tingling signs.


It's a hard decision; when must you rush off to the doctor or chiropractor, and when can you safely see if this too won't pass of itself? Inner wisdom is needed. When in doubt err on the side of too early than too late.

The situation needs also be assessed wisely. If you are healthy, and you wake up with tingling in your arm, I suggest you ignore it! But if you have a known heart condition, and the tingling is in your left arm, then obviously you shouldn't ignore it.

Likewise, if you have had a temporary ischemic attack before, or have high blood pressure or diabetes, then tingling should be considered in a most serious light.

For you, on a chiropractic website, more important is that, should you have had pain in your neck, or back, for that matter, for several days and now tingling in your arm or leg begins, then it is of the utmost importance that you immediately consult your chiropractor.

First, take note of what relieves and aggravates the tingling and pain. Does looking up hurt? Where does it hurt? In the neck only? Or, in the pinkie also? Does turning your head and then simutaneously looking up hurt? Again, where does it hurt? What does stretching out your arm do? And putting your hand on your head?

Do coughing and sneezing hurt?


C5 dermatome

Dermatomes are patches of skin belong to a specific nerve root.

A dermatomal pattern occurs when a nerve root is irritated in the neck, giving far more specific tingling, or pain, in the arm. For example,

In the c5 dermatome the tingling is felt on the side of the upper arm, and perhaps the side of the lower arm, the thumb side but not stretching as far as the thumb. The thumb belongs to the C6 nerve root.

Sometimes you may have tingling in arms and hands, bilaterally, but that is more typical of another condition.

If the irritation of the nerve root as it emerges from the intervertebral foramen affects the motor nerve, then you will be prone to tennis elbow, and weakened biceps and deltoid muscles.

The biceps reflex is used as a test of the integrity of the fifth cervical nerve root.



In the early stages of an irritated nerve in the neck, the skin becomes hyper sensitive, more sensitive. Should you rub your arm, or try pricking it with a pin it has an irritating feel, but later if you ignore the tingling, the feeling in your arm will lessen and then become numb.

New research has demonstrated that the cartilage in the small joints in the neck, in fact any joint cartilage in the body, is dependent on movement for its proper nutrition. Fixations within these joints starve the cartilage of oxygen and nutrients, and cause the build up of noxious waste products. These chemicals may themselves irritate the nerve, and causing tingling in the arm. However, it is often then of a more diffuse nature.

Arthritic changes within the foramen where the nerve emerges is another cause of tingling and pain in the arm. It occurs after a poorly managed whiplash, damaging the tiny joints of luschka. It could also be caused by a slipped disk in neck, and arthritic changes in the facet joints.

In fact the nerve root is vulnerable from all sides in the inter vertebral foramen.


C6 dermatome

Classically you may have pain in the lower arm and tingling in fingers one and two, the thumb and forefinger. In more serious cases the tingling is associated with a deep, numbing ache in arm, often worse at night.


Tip: Try sleeping with your hand under your head, or under the pillow.


C7 dermatome

The C7 and C8 nerves emerge from the lower neck, and will cause tingling in the middle finger, C7, and the ring and little finger, C8 dermatome.

The most common muscle affected in a neck condition is the triceps, an elbow extensor, usually when the nerve root is severely irritated. Doing press-ups will be difficult - that arm will tire very quickly. The Triceps is innervated primarily by C6-C7-C8 nerve roots.

Carpal Tunnel Syndrome never affects the pinkie, an important diagnostic point.

However, Cervical ribs and the First Rib syndrome (part of the so-called Thoracic Outlet Syndrome) will often cause tingling in the ring finger and pinkie, which is NOT from the spine per se. Adson's test makes the diagnosis.

The "thoracic outlet" is made up of a space behind the clavicle (collarbone) and above the first rib which is shown but not labelled above. Through this space three important structures pass on their way to the arm.

  • BP or brachial plexus of nerves
  • SA or subclavian artery
  • SV or subclavian vein

Two of these structures, the brachial plexus and the subclavian artery, but not the vein, first escape from the chest cavity via a narrow triangle known as the "inter scalene triangle".

This triangle is bounded by the

  • AS or anterior scalene muscle
  • MS or medial scalene muscle
  • the collarbone.


More about that subluxated first rib. Can you spy it with the brachial plexus and the subclavian artery and vein resting immediately on it?

It's a not uncommon cause of pain and tingling in arms and hands. The condition is called a Thoracic Outlet Syndrome (TOS) in which the artery and or nerve bundle may be pinched either in the inter scalene triangle or in the space below and behind the collarbone.

The tingling is usually of a diffuse nature, rather than to one particular part of the arm, known as a dermatomal pattern. Working with your hands above your shoulders  as in hanging washing is immediately very fatiguing as both blood and nerve supply are limited. In other words, not just in one single dermatome, like your thumb and forefinger, the C6 dermatome, for example.


Adson's test confirms the the tingling comes from an irritation within the Inter Scalene Triangle rather than a nerve root impingement. See the video at Adsons test but this is not a test to be done at home. It requires a great deal of experience to interpret the results.


T1 dermatome

Lesions of the T1 dermatome often cause pain in the upper midback - around the shoulder blade, sometimes to the front of the chest, and down the inner upper arm. Deep upper back pain.

Tingling in arms and hands is not the only sensation that may be caused. You may also have numbness, weakness and arm pain. The pain is of a deep aching nature, and can be very severe, and is often worst at night.

Placing your arm on your head, the so called Shoulder Abduction Relief sign, or making a windmill motion with your arm may relieve the tingling in arms and hands.

For more information about neck pain anatomy or the affect of neck pain and tingling in the arm on society, click on these links. If you are eager to know about chiropractic treatment of tingling in arms and hands, click here: neck pain treatment.

You will notice there are variations in various dermatomal atlases. Some for example place the index finger in the C7 dermatome. More usually the index finger belongs to C6.

Upper limb tension test

The definitive test for a pinched nerve in the neck is the upper limb tension test which places increasing stretch on the nerve roots. You can do this test at home to see if think you may have a pinched nerve, follow the link to YouTube. 

After a test called Spurlings (which I don't recommend you do at home as it can increase the pain and tingling in arms and hands) the ULTT is probably the most commonly used test in my clinic, and you can test yourself.

Anxiety

Tingling and pain in the arms and hands raises a great deal of anxiety and concern. You can submit questions via Chiropractic Help Questions forum lower down.

Tingling in the finger tips and toes, and around the lips, coupled with anxiety and fatigue, and muscle cramps are signs of a fairly rare condition called Hypoparathryoidism. It's also a serious cause of osteoporosis.

Joint fixations in the neck

Stiff joints in the neck are probably the most common cause of tingling in the arms and hands. These are the result of an injury (for example Whiplash Chiropractic ...) or an improper movement or position. We are often consulted my people with neck pain after sleeping in the upright position for example, or having a child sitting astride the neck. For more about joint fixations, or subluxations as we chiropractors call them, Click here: Chiropractic subluxation ...


Carpal Tunnel Syndrome

Carpal tunnel syndrome is another fairly common cause of tingling in the arms and hands. It usually starts in the thumb, index and middle finger, sometimes the ring finger but NEVER into the pinkie. It may extend into the arm, and then the other arm. It's always wise to simply start with these Carpal Tunnel exercises if there's merely tingling in the lower arm and hand.


Tingling in feet and legs

Of course the general principles of the arms apply also to the legs. Irritated nerves in the lumbar spine by a

  • Slipped disk, characterised by pain in the leg when bending forwards, more commonly in the younger and middle-aged person, or a
  • Lumbar Facet Syndrome, characterised by pain or tingling in the feet and legs on backward and sideways bending can be nearly as painful. Sometimes the
  • Sacroiliac Joint syndrome could have a similar effect, with tingling and pain, and possibly weakness in the legs and feet.

The most common sciatica refers to the outside of the foot and the small toe. If there is weakness you will have difficulty standing on one foot and raising your heel or great toe from the ground. For more about tingling in feet and legs follow this link.

Multiple Sclerosis, better known as MS

Researchers at the university of canberra, australia, reported in the medical journal neurology, february 8, 2011, have found two things, tested independently, to help prevent multiple sclerosis.

  1. More exposure to sunlight
  2. More vitamin D

It's a serious neurological disease in which the nerves are stripped of their fatty covering, known as the myelin sheath. Then the nerves won't conduct and so sensory and motor disturbances are experienced, often starting in the eyes.

Eating the right fats, and just important the right ratio of omega 6 to omega 3, is vital in the body. In short, more fruit oils from the olive and avocado and less seed oils; and more fatty fish like salmon.

People living in the south of australia were thirty two percent more vulnerable that those living in the north. This isn't new information; people living in the far northern european and american states are also more vulnerable to multiple sclerosis. Whilst medicine would advise taking vitamin D pills, in chiropractic we advise a regular walk in the sun, with a hat, and more shellfish; especially if you live far from the equator.



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We say this because walking and vitamin D are vital for the body for a host of reasons, not just to prevent multiple sclerosis. There are many neurological conditions other than multiple sclerosis that cause tingling in arms and hands and feet and face. And seafood contains the vital omega 3 fatty acids too, so essential for reducing inflammation in all the body and not just the nerves.

  • For another interesting and informative page about tingling in arms and hands at another site, see below; it's about the serious repercussions of a too low fat diet disease. Fat, that is, the right fats, is absolutely vital for sparkling good health.
  • You can read more about vitamin D in this mussel facts page.

  • IMPORTANT CONSIDERATIONS



    Did you find this page useful? Then perhaps forward it to a suffering friend. Better still, Tweet or Face Book it.


    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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