Rhomboid knot, numbness tip of index finger

by Melvin
(Bridgeport, CT USA)

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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