Pain in both triceps

by Jared

I am a 26 year-old male, very active in sports and weightlifting. Almost 4 months ago, I started having severe pain in my right tricep that presented itself when reaching behind me or extending the elbow behind my back. However, this increased over the course of a few days to the point where the pain (a sharp, burning, tingling sensation, from the back of the elbow about halfway up my upper arm)happened with any sudden arm movement, even with the arm swinging while walking. Doctors thought I had a tricep strain, was given anti-inflammatory,and had an MRI which came back normal.

The pain lessened after several weeks and I then began physical therapy. The therapist had concerns with my posture and identified my neck as a possible source of the issue. I am guilty of being a self-manipulator in the past but have since smartened up in terms of this behavior. After giving the okay to return to the gym, and after a few light lifting days, I am now having the same severe, burning pain in my other tricep, presenting the same way as it had on the original arm. My question is if you think this is a spine-related issue. I have been searching desperately for answers or possible treatments to help with this. Thank you for your time.

Hello Jared,
Thank you for a nicely presented question.

I'm glad you've stopped manipulating your own neck; it graunches the cartilage because you can't simultaneously distract the spine, and inevitably leads to an irritated nerve.

So, yes it could be your neck. Also the pain you describe certainly sounds like nerve pain.

Was the MRI of your arm or neck?

Do any movements of your neck, particularly turning to the same side and simulaneously looking up cause pain in the neck or tingling in the arm?

Using the search function at C-H type in upper limb tension test and let me have the result. Difficult when you have symptoms in both arms, but try it anyway.

Try pricking your arm. Are there any sensory changes? Did your doctors find a change in the triceps reflex?

The triceps is the most commonly affected muscle when a nerve in the neck is irritated; it's worrying that you have it in both arms.

Let me have some answers, keeping to this thread.

Dr B

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Aug 21, 2014
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by: Jared

Dr. B,

Thank you for your response. As far as the bilateral symptoms are concerned, it's almost as if something as shifted as my right arm is almost completely pain free, although it has taken a few months. The pain in my left tricep didn't start until the right arm was almost healed.

I tried the upper limb tension test to the best of my ability, relieving only positive signs of nerve issues on my left side. I can actually reproduce pain along the nerve path just by dropping or pushing on my left shoulder or by leaning my head over to the right side.

The MRI that I had was on my tricep, showing no results. My physical therapist had been working on my neck with massage, postural adjustments, and traction. I didn't have any changes in reflex and there is nothing unusual from pricking the arm. I really don't have any significant loss of strength either. I'm also on an anti-inflammatory but have been since problems started with the other tricep. From what I'm seeing, I'm really thinking that it's a pinched nerve in my neck, probably from a combination of bad ergonomics and past self-manipulating. I'm just hopeful that it can be fixed non-surgically with time, postural adjustments, and physical therapy. Again, thank you so much for your time.

Hello Jared,
Yes, I hope so too. After a period if you aren't getting results, see a different PT, or even a chiropractor! We all have our different skills and one helps one patient better than another.

Don't start clicking your neck again!

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.

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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