Rhomboid knot, numbness tip of index finger

by Melvin
(Bridgeport, CT USA)

The yellow portion belongs to the C5 dermatome.

The yellow portion belongs to the C5 dermatome.

Rhomboid knot, numbness tip of index finger may be two separate conditions.

I had a large knot on the left side of my upper back between the shoulder blade and spine. Felt like a knife was sticking me and a pretty large knot was present.

Is rhomboid muscle knot/pain normally accompanied by some index finger numbness? The knot went down after some self massage and naproxen but the area is still sore. What type of exercises can I do? My wife noticed right before my knot happened that I was walking slouched over but my pecs don't seem to be tight. I'm still in pain, not as bad as it was when the knot was present but the pain is still sharp and persistent. I purchased a Wahl electric massager that also has an option for heat. How long do these things/pain normally last?

Hello Melvin,
No, a rhomboid knot is not normally directly accompanied by numbness in the index finger; however there are some ifs and maybes.
An active trigger point in a muscle may refer well away from the area, and even down to the hand, but it won't actually cause any numbness; more likely some other condition is causing the rhomboid knot and the numbness in your hand.
Here lies the dilemma; the rhomboid muscle is supplied by the dorsal scapular nerve which is pure C5; it also goes to the side of the upper arm, but not down to the hand.

And then sharp pain in the midback is usually caused by a subluxated rib head, and not secondary to a nerve root entrapment, particularly if it's associated with deep breathing.

Numbness in just a finger tip is a little mysterious; I'd be checking the first rib as a condition called the thoraco outlet syndrome can affect anyone of the dermatomes, or all of them; and also the entrapment areas of the median nerve in the shoulder and arm. But then you'd expect it to affect more than one finger tip.

In short, neurology is complex and mysterious and doesn't always follow the expected rules. I'd start with an examination of the rib head, and the lower cervical spine and first rib. No amount of anti inflammatory pills or massage will fix these.

I hope this contributes; let me know.

Dr B



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Aug 28, 2016
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Weights over my head
by: Melvin

Weights over my head can lead to neck pain.

Barrie, thank you for your thoughts and expertise. It is now Sunday the 28th 2016 and I have an appointment on the 30th with a physiologist for other issues I have. I didn't mention that I exercise 3-5 times a week and some of that involves strength training on nautilus style machines. Anyway I am also an avid runner that injured an ankle some 30 days ago. I've been doing elliptical which requires me to pull and push the handles, I've also been doing rowing type exercises on the nautilus as well as exercises that strengthen the shoulders, i.e. sitting and pushing weights over my head.

I'm hoping that whatever it is (and I'll get an idea on Tuesday the 30th) that it's just over use and not serious. I'm going to print your reply and give it to my therapist. Thanks again for taking the time to respond to my post and for having such an informative site.

It's a pleasure, Melvin, and I hope it takes you a step forwards. For what it's worth, some of the very severe neck patients we encounter in the practice have been doing pull downs, and in general weights above the head.

One little thought; in my humble opinion exercises should be done to improve one's health and well being; when that's not happening, is it not worth stepping back and asking a few questions?

Dr B

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