Numbness in arm and pain in shoulder

by Wendy


My question is around both cure and prevention of my injury/condition.

My shoulder is painful, more of an ache than an outright pain, but bad enough that by the end of the day I feel slightly nauseous. The center of the pain appears to be under my collar bone and towards my neck, on the left side of my body.
I can feel a slight crunching feeling sometimes when I move. I just feel like I want someone to give my arm a good tug.

Recently, I have been waking up with my left arm completely numb, as if it is no longer part of my body, which is very disconcerting. Some mornings, I just have a numbness in my pinkie and ring finger. But there is numbness/tingling/loss of sensation every morning.

I normally sleep on my right side, in a relaxed fetal position but I have been waking up recently lying flat on my back with my left arm in the position a traffic policeman would use to stop traffic! Needless to say I also feel very tired.

I've noticed that my shoulder doesn't "look right", so I've attached a photo for you.

About me:
Female. 41 years old. Height 5' 7". 61 kg. Right handed. Work involves sitting in front of a computer. I don't remember a specific incident that happened to cause it, but I have been putting up with the pain/annoyance for some months.

And finally to the question! Is there enough information for you to know what this is? How do I fix it and how to I prevent it from coming back?

Many thanks in advance,

Hello Wendy,
Some questions:
1. Is the SC joint, arrowed, tender and is there a swollen lump?

2. Exactly where is the tingling and numb feeling in your arm and hand? The ring finger and pinkie belong to the C8 dermatome from your neck, but can also be affected in a thoracic outlet syndrome.

3. Is it painful out on the shoulder proper, and in the midback. Does using your arm hurt? Where? What movements?

4. It would seem that raising your arm relieves the ache. is that right? If you put your hand on your head, do you get relief, or is it worse? Do it when your arm is tingling.

5. Are any movements of your head and neck painful? Where and which movements?

In short, you really need a careful and thorough examination. If it goes down the arm then I usually recommend an xray of your neck and perhaps your chest. Any cough? Any lumps and bumps above the collarbone, in your neck, in the armpit?

Whilst this is a condition that chiropractors treat on a daily basis, it might be an idea to get an examination by your doctor; don't let him just prescribe you pills. What's needed is a diagnosis. Ask for an xray.

Let me know.

Dr B

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Jul 27, 2015
Answers to questions
by: Wendy

Hi Dr. B,

Thanks for reviewing my contribution. Here are the answers to your questions:

1. I can't feel a lump at the SC joint, but it is tender to touch.

2. The tingling in the pinkie and ring finger are from the knuckle to the tip, and all the way around the fingers. On the occasions that the arm goes completely numb it is from the top of my shoulder to the tips of my fingers.

3. The shoulder aches, so it's difficult to pin point the source, but the soft tissue between the neck and shoulder to the left of my spine is very tender. Pain during movements is easier to define:

I'm unable to raise my arm laterally past the 90 degree angle.If I reach behind me and try to raise my arm the range of movement is limited to about 45 degrees. The arm feels weak overall.

4. I seem to raise my arm only in my sleep, but the pain of it coming back down usually wakes me, however, I do feel that it feels less painful in that position but only when lying down on my back, when it's fully supported.

5. Head and neck movements are fine.

No cough, no lumps or bumps! I will take your advice and book a visit to my GP and press him for an x-ray. Many thanks, I had been thinking that an x-ray would be the best course of action and you've certainly convinced me.

Hello Wendy,
Certainly the C8 dermatome is affected, and that could either be in the nerve root as it emerges from the spine, or in the thoracic outlet where the lowest most nerve fibres, C8, lie on the first rib.

The fact that movements of your neck are painless points away from the spine and towards a "thoracic outlet syndrome". This however is in conflict with the fact that at night you raise your arm for relief. That's more typical of a neck condition.

Are you unable to raise your arm because of pain, or just weakness? This is critical in making a diagnosis.

What's needed is a comprehensive examination including Adson's test to rule in or out a thoracic outlet syndrome and make a correct diagnosis. Don't just accept pills to cover up the symptoms. Insist on a proper examination.

Good luck, and let me know how you get on.

Dr B

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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.

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Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

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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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