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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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 have left alone. After seven treatments his pain and stiffness is 50 percent better, and he is 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 is 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 pain-free. 

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 is well pleased; sixty-five percent better after three treatments.

5. Mr T is a wise man; he has 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 stroll 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; he has a short leg.

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. X-rays 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 few months 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 is a non-complicated upper cervical facet syndrome, and she is doing well.

12. Mr D is a 38-year 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 could not 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 should not be treating the elderly most medical sites state but that is so much bunkum.

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