Numbness in left arm, fingers and shoulder blade



Entrapment in the thoracic outlet may affect the blood and nerve supply.
Does raising your arm increase or relieve the symptoms?

Numbness in left arm, fingers and shoulder blade suggests a pinched nerve in the neck in the first instance.

Hello,

For around 4/5 months I've been getting constant throbbing, numb like pain in my left arm with a pins and needles like sensation going into my fingers and thumb. The pain seems to be mostly around the inner forearm and around the funny bone like when you hit your funny bone and the electric shock type feeling.

I also have a constant dull pain in my left scapula especially noticeable at night when I'm laying in bed and when there is pressure applied upon it. I get occasional pain in the upper left chest also. In the past month or so I have noticed the pain also radiating into my upper arm where my bicep is. This pain occurs only on the left hand side and is the side which I don't use very much.

I'm an electrician and do a lot of twisting and turning and around 10 years ago I broke my left wrist and have had several electric shocks in the past but I am not sure if that has anything to do with it.

I've had an x-ray done of my left upper chest and left scapula which both came back fine. I have been waiting nearly 3 months for a referral to the orthopaedic department of the hospital but am not sure if this is the proper way to go. Please help as this pain is starting to wear me down and get in the way of my daily lifestyle now.

Regards.

Hello William,
Symptoms radiating to both the hand and the midback, suggests the source is somewhere in the lower neck, or what is called the thoracic outlet. With the former, the neck, the symptoms in your arm are likely to be relieved when raised above your head, but an impingement in the thoracic outlet worsens when working up high. Which is it?

Take note of exactly which fingers are affected; this is critical to a correct diagnosis. Carpal tunnel syndrome for example will affect the thumb, index, middle and ring fingers.

Then, does turning your head to the left, and then looking up provoke any symptoms in the midback or arm? This is called Spurling's sign.

Ask your wife to help you do the upper limb tension test; this would confirm you have a pinched nerve in the neck. The triceps muscle is likely to become weak; watch out for that; elbow extension as in doing pressups. Was there any change in the reflexes when your doctor examined you?

Try pricking your arm, and comparing with the right, using a pin; is there a significant difference.

That upper chest pain; is there any tenderness, or a lump where the ribs or collarbone meet the sternum? Compare right and left.

The last test is a difficult one for you to do, but you might try. Locate the pulse in your left wrist with your right fingers; now turn your head to the left, look up and take in a deep breath; does it affect the pulse; does the pulse return when you breathe out and return your head to the neutral position?

It's called Adson's test. Use the 'Site search' in the navigation bar at Chiropractic Help to find terms like these explained.

With your left elbow against your side, grasp your wrist with your right hand, and pull outwards. Is it as strong as your right arm?

I would recommend an x-ray of your neck, including the oblique views. Let me know if these tests turn up anything interesting.

I hope this contributes.

Dr B


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Mar 27, 2018
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Left scapula pain persists
by: William

Hello Dr,

I have now been for 3 MRI scans all of which have came back normal. Two of the brachius plexus (one with arms by my side and one with arms above my head with a die through my veins) the first was of my cervical spine and neck. Ive also been going to msk physio every couple of months for almost a year. I’ve been given multiple exercises to do at home with tension bands tied round door handles etc etc and told to improve my posture but nothing seems to work. I tried to go for nerve studies but couldn’t take the pain so had to withdraw. I’m an electrician so the shocks are nothing new but my senses were heightened somewhat. The doctors and physios keep telling me it’s a posture thing. I’m not so sure. I am really round shouldered though and I am constantly on my mobile phone (left hand always) and that is the side the pain is on. My ortho doctor also said I have nerve irritation on my ulnar nerve as I jump when it’s touched. One of my physios reckons I have a touch of thoracic outlet but the MRI’s have stated otherwise. There is a real raise in pins and needles when I raise my left arm above my head. My right side is totally normal.

Regards

William

Hello again, William,
Understand that I am unable to examine you, and as a rule of thumb, any diagnosis, recommendations and suggestions by Dr Google need to be greeted with a great deal of doubt.

A subluxated first rib, in my book the most common cause of the thoracic outlet syndrome, associated with spasm of the anterior and medial scalene muscles, can not be evaluated on an x-ray or MRI; nothing abnormal is ever seen.

The cardinal sign is increased pins and needles when raising your arm above your head; something I presume an electrician is doing all the time.

The usual test to confirm TOS is Adson's, as mentioned before. But it's a subjective and difficult test. There is a better way; have a doppler test done on the radial pulse to see what changes there are when you turn your head to the left, look up and then take in a deep breath. This procedure closes down the interscale triangle through which the brachial plexus and subclavian artery pass; so one can get both vascular and neuralgic signs and symptoms.

Read the thoracic outlet syndrome page at Chiropractic Help again carefully and thoroughly.

I've lost the thread of this a bit over the months; you've never consulted a chiropractor, right? Time to have your first rib examined, and the scalene muscles.

Dr B

Mar 05, 2018
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Pain
by: Anonymous

I have pain from my left shoulder blade which goes down my left arm; I have tried creams and ibuprofen but nothing works; am not sleeping well either; my left hand also has a tingling feeling.

Please turn your head to the left and then slowly look up; do it gently. Tell me exactly what you feel?

Dr B



Jun 30, 2017
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Shoulder blade and left arm tingling
by: William

Hi,
I've had two X-rays. One of my upper chest (left hand side) and one of my shoulder and back. Both came back normal. I'm going to book an appointment to see my msk physio. Also a small thing I considered was that could maybe my left wrist which has been broken in the past have anything to do with it.

Hello William,
I doubt the wrist fracture is relevant, but at the same time you may have injured your shoulder or chest.

Is it definite that you have pressure over the scapula, not the area between the scapula and the spine?

We have a saying: if yours is not a chiropractic problem, chiropractic won't help; but if it is a chiropractic problem, nothing else will.

Is it time to start hunting for a thorough, conscientious chiropractor; ask your GP for some names.

Dr B

Jun 27, 2017
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shoulder blade pain
by: William

Yes, when I raise my arm the tingling increases. When it's low by my side, not so much. I haven't smoked for 3 years but do use an electronic cigarette. I just can't quite fathom why my left shoulder blade feels numb when pressure is applied to it. Also my left arm feels really weak and abnormal and I feel really lightheaded when the circulation is stopped I.e when the nurse applied the tourniquet to take bloods I felt as though I was going to pass out or when I roll my jacket sleeve up to my bicep. The right side is fine. It's only the left. Still getting the occasional stabbing like pains in the chest also. I went for an endoscopy last year and suffer from quite bad acid reflux so I take omeprazole which I suspected might be contributing to the chest pain but as I said earlier, it's the shoulder blade and arm pain that I want to get to the bottom of as they are constant.

Hello William,
Start with a chest x-ray. Ask specifically for any mention of the word Pancoast.

Adson's test is a difficult subjective test, but you can try doing it on yourself. The key for me is the pulse must fade, and return when you bring your head back to the neutral position.

Breastbone pain? Tietze's syndrome causes many of these symptoms.

Acid reflux; eat no bread at night, and drink nothing with or after dinner.

What you describe fits with a thoracic outlet syndrome; there are numerous causes. A subluxated first rib, or scalene spasm is the most common cause, but Pancoast needs to be considered in a smoker.

Adson's test is what will confirm it.

dr B

Jun 26, 2017
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Numb feeling in shoulder blade
by: William

Hello, I have just recently had an MRI on my neck and it has shown up as everything being clear in my neck and spine but yet I still have this constant pain in my left scapula which I mainly feel when laying up in bed at night. I still also have the dull pain in the left side of the chest and nerve like pain radiating down the arm and into the fingers. I can't find any relief and will certainly be taking another visit to my GP.

Hello William,
Take note of exactly which fingers are affected.

And, when you have the pain radiating down the arm, raise your hand above your head; does it relieve or increase the tingling?

It sounds very much like a rib condition if it's radiating around the chest, but if raising your arm INCREASES the tingling, then I would consider a thoracic outlet syndrome; it's caused primarily by a fixated first rib, though there are other conditions too that should be considered. Any cough and are you a smoker? Adson's test would confirm it.

Do you have any breastbone pain?

Time to see a chiropractor?

Dr B


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Feb 24, 2017
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Front sleeper
by: William

Thanks for the advice. I've tried the pulling on the elbow and seems normal in relation to the other arm. I've also tried holding my left pulse outward arm and bending my neck to the left and rotating while taking a deep breath and it feels as though my pulse stops briefly then returns. That's probably normal.

The pain is no different when raising my arm or when is by my side as the pain is sometimes worse than others but by the same token isn't aggravated when doing light work.

Only heavy lifting on the left arm gives a burning sensation under my left armpit after a couple of minutes For example, walking several hundred metres with a small drum of cable on each arm.

My GP has done strength tests etc and says he hasn't seen anything of immediate concern but also something that definitely needs further investigation into hence the referral to specialist dept.

I do have some lightheadedness and have occasional pain in my neck also which could be the way I sleep as I am a front sleeper with my head tilted on pillow.

Regards.

Hello William,
Ah, here we have it. Eureka! Sleeping on your tum is an absolute no-no. It may well be the cause of all your problems, and very difficult to change, but it's important to do so.
The cartilage discs in the cervical spine get much of their nutrition during the night when there's no axial pressure from gravity. You actually get taller.

By twisting your neck for long hours like that at night there's no reduction in the pressure, preventing proper absorption of nutrients; your neck will become arthritic.

Try putting a pillow in front and behind you at night; folk tell me it takes about two weeks of very restless sleeping to change this very bad habit.

Let me know how you progress, and whether the specialist comes up with something.

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'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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