After fall, slight tingling in hands, pain in extensors of forearm, weakness in tricep.

by Samuel
(Japan (US military))

Which fingers are affected?

Which fingers are affected?

I recently fell on the beach after scrambling backwards to avoid a wave, falling onto my back, at which point I felt what seemed similar to a muscle pull in the upper left of my back. I felt fine after at the time, but for the rest of the day felt like I had pulled something in the left side of my back.

Two weeks later, and I am still experiencing tightness in the left side of my neck, like a knot (only present on left side), as well as tightness in the left trapezius and levator scapulae, especially upon awakening. I am a lifetime weightlifter, over 20 years, and have never injured my spine. Heavy loads for deadlift or squat are unaffected with no pain. The only strength affected seems to be the left tricep, with about a 25 percent reduction in strength. Bicep strength is unaffected.

No X rays yet or MRI, doctor has prescribed muscle relaxers and naproxen. Symptoms are worst in the morning, but get better as I loosen up, and sometimes disappear completely after stretching, massage, or exercise, though the left arm is still weak. Some of the tightness in the morning seems to be getting better. I'm really concerned about the strength loss and the best course of treatment. Please assist if possible.

Hello Samuel,
Firstly thank you for taking the time to write clearly and succinctly.

The triceps is the most commonly affected muscle after a pinched nerve in the neck, so you are right to be concerned.

Could you do you some tests for me please.

1. If you turn your head to the left, and then look up, what happens? this is called Spurling's test, or sign, if you want to look it up.

2. Following the arm pain page at Chiropractic Help, locate the 'upper limb tension test.' With the help of a friend do the test, and let me have the result.

3. Ask someone to test the triceps reflex.

4. Prick the skin with a pin; is there a difference in the right and left arms?

If any of these are strongly positive, get an x-ray taken, including 'obliques.'

Don't do any weight lifting at present.

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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