Bad tingling in the tip of my right index finger

by Kevin
(Haverhill, MA)

Back in June 2013, I tore the tendon connected to my elbow from golfers elbow. I had to go to a Physical Therapist for 3 months for re-hab and didn’t play golf again to the middle of September. In 2014, my elbow was fine playing golf this past year wearing the brace and then I lost it. played 2 rounds w/o it and tweaked it a little but then it was fine again until just recently.

Something real strange is going on.. in early Dec 2014, I got some weird pain in the upper back of my right shoulder --near my back (figured slept wrong it) and it hurt a lot for 2 weeks (real hard to sleep) and then it went away but when it did go away… I got real bad "numbness" (tingling) in my right index finger (especially toward the tip of my finger) so figured it may be related to the shoulder issue. It still is bothering me a lot, for example when I try to write I can't feel my finger correctly. I called my reg. doc 2 weeks ago and we discussed a Nerve Conduction study exam but he suggested to wait it out (especially w needles and pain of the exam). He figured it probably related to my old golfers elbow problem.

Well what I finally noticed this week is if I bend my finger a certain way or touch it lightly towards the tip- I can (sometimes) feel a strong tingle down through my hand to my arm to the outside of my elbow...hmmm?

Also I did play golf with it in late Dec (2 warm days) and had a problem feeling the grip in my right hand and hit some slices which I never do :-(. It doesn’t really bother me playing hockey unless it’s real cold outside.

I did get input from my physical therapist who re-hab’d my elbow and he thinks that is a problem with my T1 root nerve which is near my upper back from what I saw on the web and that was the original problem back in early Dec.

I am not sure if the shoulder or elbow caused this nerve problem. Suggestions – wait it out, orthopedic, or Chiropractor? What is the treatment for this type of injury?

Hello Kevin,
Firstly, by golfer's elbow, I presume you mean the inner elbow which is the attachment for the flexor tendons of the wrist. It's very close to the ulnar nerve which is why your therapist was thinking T1. But there's a problem: it's goes no where near the index finger which it C6, and should typically affect the thumb too.

It's unlikely to be a carpal tunnel problem affecting the thumb, index, middle and often ring finger.

My guess this is completely unrelated to your golfer's elbow.

Of concern is that slice. There's possibly neurological weakness developing in the arm or shoulder; a thorough neurological exam will quickly find it. Which of the shoulder, elbow, wrist or finger movements is weak, and is there wasting of the muscle. The reflexes will confirm the test.

With a pin, comparing right and left, see if it's only the index finger, or is it affecting the thumb and or middle finger.

Three little tests:
1. When the tingling is bad, place your hand on your head. Does it relieve or increase the tingling. The so called Shoulder Abduction Relief sign.

2. Turn your head to the right and look up. What happens?

3. Find the search function in the navigation bar at Chiropractic Help and type in Upper Limb Tension Test. Follow the link to Youtube and do the test at home. What happens?

4. If placing your hand on your head increases the tingling, then you have to find someone to do Adson's test. It's not invasive but difficult to interpret unless your chiropractor, doctor... has done it many times. It's for a condition called Thoracic Outlet Syndrome. An xray would rule out a cervical rib. You can follow these terms using that search function.

Time for an xray of your lower neck and upper thoracic spine. Make sure they include obliques of the cervical spine. An MRI would be great but expensive.

The Dorsal Scapular nerve comes from the lower neck and supplies the area between the shoulder blades often causing a deep ache in the upper back. The same area of the spine supplies the arm too, but more classically the outside of the upper arm, not the hand.

All in all it's quite complex. An experienced and thorough chiropractor? Do your homework, talk to friends and family and your medical doctor.

Let me know the results of the tests above, and a copy of the radiologist's report. Start hunting for that skilled chiropractor in Haverhill; he's waiting for you!

Good luck.

Dr B

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