Losing the use of my right hand

by Debby
(Calgary, Alberta, Canada)

Losing the use of my right hand despite medical interventions calls for an in depth chiropractic examination.

About a year and a half ago I started getting tingling and numbness in my little finger and ring finger on my right hand. Finally got in for nerve and muscle testing which revealed the nerves were not functioning properly. I was sent for an MRI which revealed no blockages. Then another MRI for the brachial plexus area (not sure if that is how you spell it) but it too revealed nothing. Then a Pet scan which also revealed nothing.

I had 5 IVIG treatments which did not help and a couple of weeks ago, a spinal tap to see if there was inflammation some where. It too came back with no abnormalities. At this time I have lost most of the use of my fingers. My fine motor skills are less every day and I struggle to do simple tasks. I have muscle atrophy through my hand which now looks almost skeletal. I have constant pins and needles and numbness. When my hand is cold, it barely works at all. I appreciate your time and look forward to hearing from you. I am feeling pretty desperate at this time. Thank you.

Hello Debby,
As you can see from the graphic, the ring finger and pinkie belong very specifically to the C8 dermatome.

There are three sites that I would be looking for an impingement.

1. At the cervico-thoracic juntion. It's good that the MRI of your spine was normal. Do you have neck pain and in particular do you have a positive Spurling's sign; tingling in the arm when you turn your head to the right, and simultaneously look up?

Using the site search function in the navigation bar at Chiropractic Help, find the 'upper limb tension test' page and ask a friend to help you do the test.

If you raise your right arm above your head when the tingling is bad, do you get relief? This is called the shoulder abduction relief sign.

If even one of these is positive, it's a strong indication the problem is in your cervical spine. If all three are positive then it's game, set and match.

Is it absolutely clear that the so-called joints of Luschka, also known as the paravertebral joints are quite normal? They are seen on an oblique x-ray view.

2. In the interscalene triangle. The whole brachial plexus, and the subclavian artery pass through this gap. Whilst in theory any of the nerve structures may be affected, most often it's the C8 that is affected.

Did anyone take the pulse in your wrist and ask you to turn your head, look up, and take in a breath? It's called Adson's test.

Often the tingling is made worse by raising the arm above your head as in hanging washing. The condition is called a thoracic outlet syndrome. Basic medicine really, so certainly somebody should have considered it.

If you're a smoker then a tumour in the apex of lung can produce these symptoms too; bad cough?

3. Lastly, and least likely, the ulnar nerve can become entrapped behind the elbow. Then Tinel's sign would be positive, tapping on the funny bone.

A last possibility is these structures can be caught under the pectoralis minor tendon, but I doubt it would produce these severe symptoms.

Perhaps it's time for a visit to an experienced and thorough chiropractor; ask friends and family and your doctor for a name. Let me know what comes of it; I'm quite intrigued!

Dr B

» Losing the use of my right hand

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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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