Tingling in arms and hands and aching at night.
Adson's test for Thoracic Outlet syndrome
Hi I am contacting you in regards to my husband. For many years he has fallen asleep watching television, his head always falls to the side and forward slightly. I don't know if this could have anything to do with his complaint.
Anyway he has been getting tingling in his arms and hands. His hands are swollen, cold and have at times no colour (pale almost white). He gets woken up at night with pain and finds he is only getting some relief from when standing. He has been to see the doctor and has had xrays and blood tests where there has been no result, everything seems ok apart from some wear and tear (he is 51).
I would be greatly appreciative if you could get back to me with possibly some avenue we could follow next.
Thankyou very much in anticipation.
Leonie Hello Leonie,
First thing to consider is Reynaud's syndrome, where the fingers change colour red, blue, white. It's a problem of the autonomic nervous system that controls the blood supply to the hands. But Reynards usually happens in cold weather, mid summer with hands under the blankets doesn't quite fit. But if the hands literally go white, then must be considered.
The swollen hands, rheumatoid arthritis should be considered. If the joints are painful.
Does it affect the pinkie? Then it's NOT carpal tunnel syndrome. But CTS certainly causes these sorts of symptoms in fingers 1-4.
Then I'd want to know what the result is from Adson's test. But, it's a very difficult test to administer. It takes quite a long time to do the test effectively and accurately. The question is: is the arterial supply to the arms being affected in the "interscalene triangle".
Lastly, a cervical rib can affect the arterial and nerve blood supply to the arm. This a patient currently under care here for symptoms simular to your husbands. But it's not common...
You make no mention of neck pain, but falling asleep in the sitting position is certainly not good for the neck, and may be the problem.
Then there are a variety of "medical conditions" that could cause it. Clots, tumours in the apex of the lung (Pancoast tumour) - smoker? - and I should think many others. An aneurism...
It's important to follow this up.
Most likely? Carpal tunnel if it doesn't affect the fifth finger. Entrapment of the median nerve in the wrist, forearm and neck.
Use the Search this site function at C-H for more info about these terms.
Hope this has contributed.