Chronic pain in right rhomboid and tingling down to hand

by Gary
(Amble, England)

I got out of bed one morning and as soon as I stood up I collapsed back down with what felt like a massive cramping sensation in my right rhomboid. I have sporadic tingling and numbness radiating down the back of my triceps and along my flexor carpi to my little, ring and middle fingers. This has subsided somewhat.

I have had osteopathy to no avail, he has suggested everything from cervical radiculopathy, two ribs fixed and not moving, an infection from a shoulder tattoo and even my rhomboid muscles coming away from my scapula!!

I have been prescribed diazepam and tramadol by my GP but I'm constantly drowsy on these although they do get rid of the pain.

Could this be something as simple as a knotted rhomboid muscle?

I regularly do weight training and I am a personal trainer and very physically fit and healthy.

I am becoming quite depressed with this as it has been going on for 12 days now.

Any advice would be greatly appreciated.

ps I have been using ice packs and doing gentle exercise.

Thank you,

Hello Gary,
The most likely scenario is a pinched nerve in your lower neck; that area supplies both the rhomboid area and the arm. Having said that the areas don't quite fit neurologically.

The rhomboid muscle is supplied by the dorsal scapular nerve which is pure C5. There is no nerve root that supplies the pinkie, ring and middle finger, but they belong to the C7 and C8 dermatomes.

Probably the more likely villain of the peace is a thoracic outlet syndrome which can affect multiple levels; then, raising your arm above your head would increase the pain and tingling. Adson's test would also be positive but it's a difficult and subjective procedure for the inexperienced.

Compare that with the 'shoulder abduction relief' sign; use the search function at chiropractic help.

Do any movements of your neck provoke the pain? Do the 'upper limb tension test' with the help of a friend and let me know the result.

If there are any of these 'hard' neurological signs, then at least an x-ray including obliques, and preferably an MRI are indicated.

Did any of the doctors treating you test the reflexes, look for muscle paresis and prick your arm for sensory changes? The triceps is most often affected. Press ups?

Perhaps it's time to look for another osteopath, or a chiropractor?

I hope this contributes.

Dr B

» Chronic pain in right rhomboid and tingling down to hand.

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