Tingling in thumb and index finger

by dr suwansh meshram
(male,maldives)

Neck and midback pain and tingling in index and thumb fingers

I used to have pain in my left back since 5 years after an injury during gym. But now the pain has increased since 4 months and now since 15 days it is severe on left side also on right back and neck.

Since 5 days I am having tingling and numbness of left index and thumb finger, also easy fatiguability and twitching of left arm muscles.

Good evening Dr Meshram,
Mid back pain is notoriously difficult as it can originate from C5 (via the Dorsal Scapular nerve) which supplies the Romboid and Levator Scap muscles, causing deep upper back pain ... However, rib and thoracic spinal conditions also cause pain in the area, as do lung and other organic conditions.

The index finger and thumb tingling, however is very specifically pure C6 dermatome. And likely to affect the Brachioradialis and triceps muscles, causing loss of reflex, sensory change and possibly fasciculations, the source of your "twitching".

This injury is often provoked by pull-downs in the gym.

Three questions:

1. Does raising the arm increase or relieve the pain and tingling in the arm? The so-called Shoulder abduction relief sign.

2. Does turning the head to the left, and then looking up provoke pain and tingling in the neck and arm?

3. Is the Upper Limb Tension test positive?

This could be a disc protrusion, UncoVertebral Joint Luschka hypertrophy or a facet syndrome, amongst others.

It's a condition treated frequently with chiropractic manipulation of the lower cervical spine. However, the condition itself is usually very painful, disruptive of sleep, and manipulation is not always successful.

Are there X-rays? Cervical ribs and a first rib fixation, or scalene spasm can also be involved.

I hope this contributes.

Dr B


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