reply to doctor b. Re:tingling in hand and arm as well as chest ache

by shane
(London,U.K)


Dear Doctor B,
Thank you for your very helpful reply and all the useful information. In answer to some of your specific suggestions and questions: yes running my fingers down my chest does reveal a small specific spot of slight tenderness/soreness just about 1 inch to the left of the very centre of my chest. When i rub this specific small bony area firmly with fingers i experience a feeling of soreness. There is no lump. This is pretty much the same spot from where I have experienced the dull chest ache over the years. Sometimes when rubbing this area in the past, the soreness/tenderness feels fairly pronounced and strong, yet at other times the soreness/tenderness is not present at all, which i find confusing. I have also at times experienced a little discomfort and aching in other areas, such as the back near the shoulder blade as you describe, as well as in the shoulder and upper arm area, but this is not common. The main discomfort is normally that specific spot in the chest. It very much comes and goes, from time to time. From your experience doctor, do you think i can safely rule out any type of heart or cardiac issue at play here? If so, this would obviously be a relief to me. As I previously stated, ecg, xray, blood test and gp examinations in the past have not revealed anything of concern. Also, reading up on costochondritis, it seems to be suggested that most cases of this condition clear up on their own within a few months or a year, whereas I have had my chest discomfort coming and going for a number of years now. I wonder what your thoughts are on this.

Regarding your questions relating to my pinkie and ring finger numbness doctor, no i do not have any lower neck pain nor any weakness in my hand. And turning my head to the left and looking upwards has not provoked any noticeable effects so far.
Doctor, if i wished to further investigate these issues and try to confirm a diagnosis, where would you recommend i go. A local Chiropractor, or to a hospital/private clinic perhaps? Thank you very much for your time and advice doctor. Shane, London, U.K

Hello Shane,
Would you mind copying and pasting this, following the original thread of your first letter; starting a new thread confuses other readers, and me too!

I'm not in a position to make a diagnosis or pronouncement about your chest pain, but I'd say it's highly likely you have a chronic costochondritis.

I don't recall the exact figures but research of folk presenting at the emergency rooms with chest pain reveals that something like 40% of them have costochondritis. In the light of the negative medical tests you can be reasonably be assured this is not something life threatening.

Most chronic pains come and go; nothing unusual about that.

You need to start hunting for someone who specialises in the treatment of costochondritis and Tietze's syndrome. It's really a mini-specialty that I happen to be interested in but not every chiropractor or medical doctor would share that.

It's good that head movements do not provoke the numbness in your fingers; if it's provoked by working above your head then a problem in the inter scalene triangle is likely.

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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