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


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