Tingling in hands and arms as well as chest ache

by shane
(London, U.K)

Dear Doctor, I would very much appreciate some advice for an issue that has really concerned me for a few years now.

More recent symptoms have been tingling and numbness in my left hand (ring finger and little pinkie finger only), along with a generalized aching in the upper left arm, intermittently while at rest.

These symptoms are predated by intermittent dull aching and pain on the left side of the chest, roughly where the heart/breastbone is I would say. This pain/aching in chest area regularly comes and goes and is unrelated to exertion, and normally occurs when I am at rest. It has occurred for a few years now. Sometimes the chest pain/ache is relatively strong and uncomfortable and at other times it is mild and barely noticeable.

My doctor in the past has guessed at a possible gastro/reflux related cause. GP examinations, resting ecg testing by the doc, as well as at my local hospital, have not uncovered anything abnormal. Chest Xray, examination and blood test at hospital also showed no abnormalities. I am a 42 year old male, light smoker (3-5 per day). Thank you for your time doctor and I look forward to hearing from you.

Dear Shane,
Run your fingers down your chest just on either side of the sternum; are one or more of the costo-sternal joints on the left signficantly more tender that those on the right? Is there a palpable lump? I suspect a condition called costochondritis, which if it worsens can turn into Tietze's syndrome. Use the Site Search function at Chiropractic Help to understand these terms.

There is often associated mid back, near the shoulder blade, discomfort or pain.

The pinkie and ring finger belong very specifically to the C8 dermatome; do you have any lower neck pain; any weakness in the hand such as in removing a tight bottle lid? If you turn your head to the left, and simultaneously look up, what happens?

This can also be caused by what is known as a 'thoracic outlet syndrome.' Then, when you get tingling and numbness in your hand, if you raise your hand above your head, it will usually get worse.

Conversely, from a pinched nerve in the neck, raising your arm brings relief.

Get help from a friend to do the 'upper limb tension test.' See below.

I'm simply throwing out thoughts; if you want useful help, then give me very specific answers to the questions above.

Dr B



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» Tingling in hands and arms as well as chest ache.




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Mar 24, 2019
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Is it coste chondrites?
by: Guli

Hello! Your advice will be very helpful to me? I'm 31 year old. I had a burning sensation in my left chest and tenderness. The pain seemed to be localized around the 4th and 4th rib cage area and I felt tenderness when I touched it. Also sometimes the pain would radiate to my entire left chest as well ass the left arm , neck and left upper back. I felt breathless as well and anxious. Tho doctor checked my heart, did EGK on me and my heart is fine. he diagnosed me with costochondrites. he prescribed medicine for pain and inflammation caused by athritis. After taking the medicine the burning pain went away but tenderness is still there and numbness in my left arm and shoulder as well face come back on and off. I feel short of breath as well. I feel better during the day but symptoms come back mostly at night time. Is it really costochondrites? Should I get MRI for the further analysis? I appreciate your response!

Mar 26, 2018
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Diagnosed with costochondritis, tingling all throughout body (mainly in feet hands and arms) pain in left arm
by: Monica

Dear Doctor B,

I have been diagnosed with Costochondritis by my GP last month, and over the past week I’ve been having more symptoms that have been affecting me. I have tingling feelings in my arms legs hands and feet and sometimes even in my face. The doctor believes it’s just anxiety, but I have had this with ongoing arm pain for weeks and weeks. They just saw it’s muscular.

Do you think it could be something serious?

I have had an ecg, blood work and chest x ray and everything was normal just my vitamin D was low.

I am constantly thinking this could be something worse and when I lie on my side which is more painful and sore at night my arm hurts even more and I’m not sure why.

Hello Monica,
The tests for muscular pain are fairly specific and too many to mention. The gist is that you activate the muscle, without any movement of the joints; known as an isometric contraction. Did your doctor come to this conclusion after examining you, or just an opinion? One is scientific, the other very subjective, and obviously I don't know.

Tingling suggests that there is a nerve irritation component, and again there are tests. A pinched nerve in the neck generally is worst at night.

Tingling in the face, and especially around the lips requires tests for calcium levels and your parathyroid gland.

Does it hurt if you move your arm. Raise it above your head, behind your back, up and down. Does it hurt?

Is there pain in your neck, and particularly does it radiate to your arm if you turn your head to the left and then look up?

A patient generally knows when they've been properly examined, and when the doctor is just shooting the breeze. Which is it?

The fact that you are getting tingling not only in your arm, but also in the face and the legs suggests to me that this is probably medical rather than chiropractic. Perhaps it's time to ask to see a neurologist.

I hope this contributes.

Dr B

Apr 21, 2017
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reply to doctor b
by: shane

Hello Doctor B

Yes I will seek a good, skilled chiropractor and ask him to be careful regarding any mid back manipulation, and i'll take on board all the really good advice you have given me. Thank you doctor, it is very much appreciated. All the best.

Shane, London U.K.

Pleasure, Shane.

Apr 14, 2017
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costochondritis-reply to doctor b
by: shane

Hello Doctor B

Turning my head to the left and looking up seems to make no real difference to the symptoms. And raising my arm above my head doesn't seem to make any difference either. I have also now done the upper limb tension test, following the instructions on the site carefully. There was no detectable difference between either arm. The test did not bring on any of the symptoms, such as tingling or pain, either in the arm, hand or neck.

I think my next step will be to look for a good local chiropractor, to hopefully try to finally address these issues.

Funnily enough doctor, I would say that it is not the actual symptoms that have been particularly troublesome or painful, it was more the anxiety/ worry of where these symptoms are occurring on the body, and in not knowing what the problem was, even after all the doctor/hospital tests. I guess that lots of people with similar symptoms can relate to that! Thanks again for your help.

Hello Shane,
It's obviously great that you have no strong nerve impingement signs; nevertheless a diagnosis is necessary.

Costochondritis sometimes leads on to Tietze's syndrome and, if that affects the sternoclavicular joint certainly can provoke a thoracic outlet syndrome; that is characterised by worsening of the tingling if you work with your hands above year head; and loss of the pulse in the wrist if you turn your head to the side, look up and take in a deep breath. It's known as Adson's test but is not easy to do objectively; it takes lots of practice; ask the chiropractor you consult to check it.

Good luck, and remember to ask him NOT to thump you hard in the midback.

Dr B

Apr 11, 2017
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reply to doctor B about costochondritis
by: shane

Hi doctor B
Thank you. It is a relief to finally know what condition I am likely to have after all these years of not knowing!

I have examined the area where the collarbone joins the sternum, doctor, and there is no tenderness or pain there. The tenderness/chest ache comes only from the area described, which is a little further down the chest.

Also raising my arm above my head does not seem to make any difference to the symptoms so far. Although putting consistent weight on the arm (such as using my hand to lean against a wall or against my desk), does tend to increase the symptoms.

To summarize, my symptoms are: left sided chest ache in a fairly specific spot, mild ache in upper left arm, and tingling/numbness on left side of hand,including pinkie and ring finger. Any further thoughts on what I may have in addition to the costochondritis are most welcome. All the best doctor B. Shane, London, U.K.

One little caution, Shane. Remember I have not examined you, so you can never rely on anything you find from Dr Google! But it's highly likely you have costochondritis.

The arm and hand pain is potentially more difficult. If you turn your head to the left, and then look up, what happens?

When the tingling in your hand is bad, does raising your arm bring no relief? That's a good sign.

Dr B

Apr 10, 2017
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reply to doctor B
by: shane

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 help doctor. Shane, London, U.K

Hello Shane,
I wish I could share that optimism of the page you read about costochondritis; which is almost certainly what you have, rather than a heart condition. It has a tendency to become chronic, as yours has. The folk I treat come for a monthly adjustment and that brings considerable relief, but the discomfort comes back.

One caution is that a heavy manipulation in the middle of the back will worsen the chest pain; it needs to be gently, skillfully done, rather than with brute force and ignorance.

Fortunately it's not forming a Tietze's syndrome.

Has this chest pain also affected the joint between the collarbone and the sternum? Is that joint also tender? Then it's likely to affect the lowermost trunk going to your arm as it passes through the so-called interscalene triangle. Typically then the tingling in the hand increases if you raise you hand above your head. The first rib needs a chiropractic adjustment.

You've had this for a long time; take your time finding the right person to treat you; talk to friends and family, colleagues and your doctor.

Good luck, I hope this resolves.

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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