Deep stabbing or aching pain in upper back and numb left tip of index finger

by Jen
(Ottawa, Canada)

Deep stabbing or aching pain in upper back and numb left tip of index finger.

Hello! 4 weeks ago I started to get really bad pain on the left side of my upper back by my shoulder blade. The pain would either be a stabbing/sharp pain or deeply ache most of the day, which radiated into the back of my upper left arm. I did massage therapy twice weekly since it started and tried cupping and acupuncture as we thought it was a knot.

2 weeks ago I developed numbness in the tip of my left index finger and the pain in my back continued. This week I was at my desk and a movement caused a pain to shoot down the back of my left arm and into my middle and ring finger. The pain at my elbow when that happened felt like I hit my funny bone.

Today I still have the pain in my back. It hurts more when I look left and down but also hurts (just less) when I look right and down. Does not get affected by looking left or right or left up or right up. When it is not a stabbing pain, it feels like a very deep ache (like i will never be comfortable again). Over the course of the day the pain worsens. I have no pain in my neck. There is a dull ache in the upper back part of my left arm and slight tingling in my left thumb and left index finger, which still is numb at the tip. Any ideas?

Hello Jen,
The pain in your arm is not following a 'dermatomal' pattern; the thumb and index fingers are supplied by a quite different nerve root to the middle and ring fingers; in fact even the middle and ring fingers normally belong to different roots. So, it's not clear.

That deep upper back pain needs to be assessed. It may be coming from your neck down the dorsal scapular nerve (C5) or it may be a rib or mid spine problem.

The upper limb tension test will give you an idea as to whether it's a true pinched nerve. Use the site search function at Chiropractic Help.

Does turning your head to the left and then looking up hurt? Does it then immediately radiate into your arm?

I'd start by having a really thorough examination from your doctor or chiropractor, don't just take NSAIDs, proper assessment and some x-rays of your neck and midback. If you're a smoker then a chest x-ray too. A pancoast tumour could do this, but very rare in non-smokers.

I hope this helps, let me know what comes of it.

Do you sleep on your tum?

Dr B

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Feb 03, 2018
Response to questions
by: Jen

Thank you for your reply. I have had an assessment with a chiropractor and he is not sure. He thinks it may be pinched. I get electric pulsing treatment and ultrasounds since I've started. He has taped my shoulder back and has advised that it seems movement and stretching triggers the pain. He is concerned about the numbness in my finger.

I did look left and then up and it triggered the stabbing pain and radiated to my arm. This is called Spurling's sign.

I do not sleep on my stomach, always on my sides and I am not a smoker. Does this information help more? Should I have x-rays if it not bone related?

Yes, I think an x-ray of your neck is important; a positive Spurling's sign is always tricky.

Dr B

Spurlings test

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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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