Elbow pain, numbness down to ring & pinkie finger, swelling
19 year old female, college softball pitcher. Been pitching since I was 11. No major issues until March 2018. In games, the training staff had to massage my right arm to get me through a game. Had like a severe cramp through forearm, whole arm swelling, tingling through ring & pinkie finger. The staff doctor told them to keep pitching me and I pitched another month with worsening symptoms. Then consulted personal medical doctor. Originally diagnosed as overuse injury, probably tennis elbow but did not respond to PT. Xrays & MRI of elbow were negative. Next stop was chiropractic. 6 weeks x 3 times a week treatments and adjustments and numbing shots to relax neck and shoulder did not improve symptoms. Possible scapulae involvement was mentioned. Was suggested that next step should be massage therapy on neck shoulders and right scapulae area. Minimal short term results from massage therapy. I don't know where to turn now. I am hesitant to seek a surgical answer because there is no going back from surgery. Still not sure if I have a good diagnosis and I would really like to get back to pitching, but I am physically unable to. Any advice is appreciated.
It's my job to be the Devil's Advocate, remembering that I'm not there to examine you, so what follows has only partial value.
I'm also not convinced that all your doctors have made the right diagnosis.
Three features of importance:
1. The cramp in your arm.
2. The swelling of your whole arm.
3. Tingling in the C8 dermatome, very specifically in the pinkie and ring finger.
Please do the following for me, write down your answers as you do them, and we'll take this further then. Be as specific as you can in your answers. Wishy washy replies will take us nowhere. If it tingles, pain, feels numb etc, tell me EXACTLY where.
1. Turn your head to the right, and then simultaneously look up. What happens?
2. This is a hard test, you will need to practise it, and may still not be able to give me a good answer, but if you can, we have the diagnosis. Ask your doctors if anyone did Adson's test. Find the radial pulse where it's really strong in your right wrist using your left index and middle finger. If you can't locate a strong pulse, then no point going further, move your fingers around until you can locate it. Now turn your head to the right again, look up, and then take in a deep breath, and hold it. WHAT HAPPENS TO THE RADIAL PULSE? When you again breathe normally and return your head to neutral, what happens to the pulse?
3. When there's tingling in your fingers, raise your hands above your head. Does the tingling increase or decrease?
4. As a rule, if you work with your hands above your head, as in hanging washing, changing a light bulb, are the symptoms increased or lessened?
5. In the Search this Site function in the navigation bar at Chiropractic Help, type in 'upper limb tension test'. Find a helper and do the test; as accurately as you can, tell me what the result is. Be specific.
6. Have x-rays of your neck been taken? Ask if you have a 'cervical rib'. Send me the report and better still a digital copy of the x-rays (take photos with your camera if they are on plain film), and send to brlewisatmwebdotcodotza. If none have been taken, then do that now; important.
7. Are you a smoker, and do you have a cough?
8. Do you know if any of your doctors found a change in muscle strength, or prick your fingers looking for changes in sensation? Reflexes? Ask.
There's a lot of work there, Devyn. Build up a little dossier, accurate answers to ALL the questions, and then reply here, not to the email above, rather than in bits and pieces. I have a tentative diagnosis, but everything depends on your accurate and specific replies.
Do your best, or don't bother replying. I'm not being rude; I get questions like this all the time, and folk won't take the time to go through the process, and waste both their and my time.
Thought: this might be a lot easier, if you printed this out, and went to the chiropractor who treated you, and ask them to help with these tests.
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