Tingling and burning in left hand and arm.

Thoracic outlet syndrome

Thoracic outlet syndrome

Tingling and burning in left hand and arm.


Hello,

I am a 28 year old male experiencing tingling, burning, and numbness in my left hand and arm. The sensation radiates from my inner biceps, inner elbow, and into both my middle and pinky fingers. I am also have pain and stiffness specifically along the left side of my neck and upper back.

The tingling began very subtly about six months ago and has increasingly gotten worse over time. It is made worse when I sleep and while doing any movement, above my head, or stretching, especially along my inner bicep. An MRI of my head & neck showed no abnormalities and a EMG test by a neurologist was negative.

For what's it's worth, I have no blood test that seem to suggest any abnormalities or cause for concern. I just want my arm back. Can you help? Thank you.

Greetings,
There are two significant features here.

1. The tingling, or paresthesias in medical jargon, does not follow a dermatomal pattern, seeing that the pinkie, presumably ring, and middle fingers are affected. That means the problem is probably not in your spine.

2. And secondly that the tingling gets worse when working above your head. With a spinal problem, raising your arm above your head usually relieves the paresthesias; the so called shoulder adduction relief sign. Yours gets worse.

I take there is no specific loss of reflex, numbness to pin prick or weakness of a specific muscle group. The triceps is most commonly affected.

I'd like you to do three specific tests for me and write down precisely what you feel if you want a sensible answer from me.

1. Turn to the left, and then simultaneously look up; what do you feel and where; precisely.

2. Using the site search function at chiropractic help and look for the "upper limb tension test". You need a helper. Tell me precisely what you feel.

3. This next one, called Adson's test is difficult and requires a lot of experience to distinguish between a negative and a false positive. Find the left radial pulse with your right hand. Turn your head to the left and look up, and then take in a deep breath, and hold it. Does it affect the pulse, and does the beat in the wrist return when you breathe out and look forwards. Using that search function you find a Youtube film of the procedure.

Precise answers please.

Ask your specialists if a thoracic outlet syndrome has been considered.

Dr B


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