Lost of extension of thumb and pointer finger. Weakness in wrist.

by Shelia Kuhn
(Newport Beach, California USA)

Hello,
Over the last 20 years, I have lost the ability to extend my right thumb and forefinger. My wrist is very weak. I cannot even pick up a glass of water. I have had multiple MRI's of my shoulder and cervical spine. Nothing has been found. On the last MRI report they reported "Concurrent bilateral uncovertebral joint degenerative change is seen. Disc material and uncovertebral joint degenerative change cause mild left neural foraminal narrowing. Bilateral exiting nerve roots are normal. Disc deformity measures 2.3 mm in neutral 1.9 mm in flexion and 2.3 mm in extension position."

Are Luschka's joints normal for everyone? And, I am thinking that my radial nerve is getting pinched at the cervical spine as the same issue is starting on my left hand. I have had little luck with anyone coming up with what the issue is. I was wondering if you might have some insights.

This issue started 20 years ago and has been insidiously progressing. The loss of function has happened so, so, slowly you almost don't know it's happening until you can't so something with your hand that you used to.

Any insights you have would be greatly appreciated! I attached the latest MRI report.

Warmly.

Hello Shelia,
Every cervical spine has joints of Luschka, sometimes call paravertebral joints, or neurocentric joints, or uncovertebral joints. They guard the nerve root as it exists from the intervertebral foramen.
Unfortunately after whiplash, especially T-boned from the side, they are subject to degenerative change that in itself can affect the nerve root. You have only mild narrowing, so may well not be the cause.

Unfortunately the images and reports are too small to read. Please look: is there any mention of cervical ribs?

You make no mention of neck pain or tingling in the arm. If you raise your arm above your head does it bring on symptoms in your arm, as in hanging curtains or the washing? If so, ask your neurologist if Adson's test has been done.

There are of course other muscle wasting diseases but if after twenty years no other have been affected then very unlikely.

Is there only weakness, but no pain or tingling, or numbness in the arm?

Let me have some answers and we see where this goes. Perhaps I can contribute something.

Dr B.R. Lewis DC

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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've left alone. After seven treatments his pain and stiffness is 50 percent better, and he's 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's 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 painfree. 

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's well pleased; sixty five percent better after three treatments.

5. Mr T is a wise man; he's 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 walk 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.

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. Xrays 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 year 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's a non complicated upper cervical facet syndrome, and she's doing well.

12. Mr D is a 38 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 couldn't 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 shouldn't be treating the elderly most medical sites state but that's so much bunkum.



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