weak index finger tip

weak index finger tip

I am a guitarist who developed a pain in my forearm and some hand symptoms in my left (fretting, guitar-neck-holding) hand about 15 days ago. I had been practicing some songs for several days that required an unusual amount of squeezing the thumb against the neck and a concomitant mashing of the index finger against the front of the neck. This was strenuous, but did not hurt; there was no direct foreshadowing of the syndrome I have now.

But after one practice session I awoke the following day with an occasional flashing pain in my left forearm. Prior to these symptoms, I had noticed some tightness in my left chest, but I knew what that was (muscle tension). But I do think that scalene area tightness is significant.

My chief symptoms wanting relief are
a) a pain on the little finger side of my left arm. This pain is typically only activated by my fully extending my left arm--especially to left side. The pain is in the forearm between the elbow and the hand.

Putting the arm fully extended before my chest is not painful.

b) after about a weak of these symptoms, the pain in the arm diminished by about 30% but remained, but a new symptom arose, the most bothersome one. My hand is basically pain free, but the end of my left thumb is slightly weak, and the end of the left index finger more so. I haven't found anything that improves this. (All of the other left digits are normal and strong; no numbnes or pain in them, either).

I had one chiropractic session before the finger symptom arose, at about day 5. I have iced the forearm a lot, including ice dips in a bucket of ice water. I think trigger points are involved in this syndrome, and I am dubious that lots of cold is the best treatment.

I had a massage session on the arm at about day 12, but that actually made the elbow-area pain a bit worse and did not change anything else.

I think there are overlapping issues: the scalene area is somewhat in play, if not mostly to blame. There is some kind of inflammation near the elbow, but I am dubious that this is mostly "tendinitis."

One reason I say this is that Ben Gay and other things that should affect that elbow area if it were a focal point really don't change anything.

I typically have very strong fingers. This weak index finger tip is thus very odd. There is: no pain, or tingling there--a tiny bit of numbness. I am still able to grip things fairly tightly with that thumb and index finger. It is more specific finger-tip action that shows the weakness, like typing; guitar playing is out with that effect.

Can you recommend a creative treatment to a) treat the forearm pain b) treat the index finger weakness?

Thanks.

Hello PLB,
Thank you for a very detailed report. It helps enormously.

This is almost certainly neck related. I say that for three reasons.

1. You obviously have some neck pain. Does turning to the left and looking up cause any neck or arm pain or tingling?

2. That stretching out of your arm to the side is the basis of a test called the Upper Limb Tension Test ... try it, and see if it confirms things.

3. And thirdly the thumb and index finger are very specific pertaining to the C6 nerve root.

There's no way one chiropractic treatment, or any other for that matter, will fix this in one session.

You don't tell me your age, or anything about old trauma but often there's stuff happening in your neck that's the cause. An X-ray of your neck, especially "obliques" or better still an MRI would tell us.

I suggest you go back to the chiro who treated you. Did s/he do a good exam of your reflexes, muscles strength, weakness?

Musicians have to go through a very special warm up/ cool day routine, just like any sportsman. Disciplined. Do it before and after you play. My son is a guitarist so I understand exactly the frustrations you are having.

I hope this contributes.

Dr B


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Oct 24, 2013
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update II
by: PLB

I should add: my neck is not painful. I tilt and stretch the neck in combination with my arm/ hand stretches and the neck is not pangy or painful. I still think tight scalenes play a role in this issue, but likely not a causal one. There is some collateral upper back pain, but that is intermittent and did not accompany the outset of this issue.

[Remember the rhomboid muscles, and levator scapular in the upper back are also supplied by the neck. It may be part of the problem. Deep upper back pain ...

Dr B]

Oct 24, 2013
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update
by: PLB

I am now at about day 28 with this issue and I discovered that heat and "nerve flossing" exercises targeting the median nerve have helped the left arm pain by 95%. I am able to toss a tennis ball over or underhand and catch it with the left arm/ hand without issue. That was unimaginable until about a week ago (Another chiro online recommended that as a nerve flossing exercise; it helps). The arm is now almost pain free--there is a bit of oddness near the elbow remaining at times. However, the weak left index finger tip is still an issue. I can't find anything tender or "electrical" feeling in the kinetic chain from the hand to the neck other than some mild trigger points; the base of the web of the left hand has some slight tingling if probe it with my right thumb. I will see my chiro again and report back.

[Hello again P,
Muscle strength takes much longer to return. First less pain, then less tingling, finally strength returns.

This is what I call a double crush syndrome, often affected in the neck, or interscalene triangle, and in the elbow or wrist.

Anyway, getting better; take it quietly for a bit. You're obviously in good hands.

Dr B]

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