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Neurology (Expert Forum)
Tricep pain when moving head, numb pinkie/ring fingers when i wake
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Tricep pain when moving head, numb pinkie/ring fingers when i wake
by g18c, Jan 20, 2007 12:00AM
Hi, im 26 years old and in relative good health. In July 04 had a motorbike crash, sort neck but was ok. Jan 05 worked late on laptop and woke with burning in right arm and right tricep twinge when moving head to the left. After a month of diclofenac and excercise it went away.
In Jan 06 I slept funny after reading with my neck propped up behind a number of pillows. Woke up with an extremely stiff neck, and worse pain in my right tricep (same place as Jan 05) when moving my head around in any position, and pain between shoulder blades. Excercise made it worse this time.
In Oct 2006 I started getting electric tingling sensation into my left pinkie and ring fingers, and numbness in my left pinkie/ring fingers and outer palm when waking (sometimes my right too ring/pinkie). Numbness go within 5-10 seconds. I noticed when scratching/rubbing the inside of the upper arm I would get electric sensation down into my pinkie/ring fingers. I have tried splinting to keep arm straight at night and this has helped a lot, stopping waking numbness.
Saw a physio who says i have some tethering in my right arm, i get a stretch in certain positions at the exact point in my tricep where i get the twinge. I dont know if the problem is in my neck, shoudlers or arm. So i have a few questions:
What nerve root level affects triceps?
The chrio i have seen has helped me a lot, is it safe to continue cervical manipulation given i have a disc buldge?
Is neck tension likely to be a cause of a lot of the tricep pain?
I'm told its not serious but a year of pain for me is.
Many thanks
In Jan 06 I slept funny after reading with my neck propped up behind a number of pillows. Woke up with an extremely stiff neck, and worse pain in my right tricep (same place as Jan 05) when moving my head around in any position, and pain between shoulder blades. Excercise made it worse this time.
In Oct 2006 I started getting electric tingling sensation into my left pinkie and ring fingers, and numbness in my left pinkie/ring fingers and outer palm when waking (sometimes my right too ring/pinkie). Numbness go within 5-10 seconds. I noticed when scratching/rubbing the inside of the upper arm I would get electric sensation down into my pinkie/ring fingers. I have tried splinting to keep arm straight at night and this has helped a lot, stopping waking numbness.
Saw a physio who says i have some tethering in my right arm, i get a stretch in certain positions at the exact point in my tricep where i get the twinge. I dont know if the problem is in my neck, shoudlers or arm. So i have a few questions:
What nerve root level affects triceps?
The chrio i have seen has helped me a lot, is it safe to continue cervical manipulation given i have a disc buldge?
Is neck tension likely to be a cause of a lot of the tricep pain?
I'm told its not serious but a year of pain for me is.
Many thanks
Doctor's Answer
by CCF-Neuro-M.D.-SH, Feb 07, 2007 12:00AM
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.
The symptoms and story that you provide are consistent with a compressive lesion (probably from the neck) that is affecting your C7 (triceps) and C8 (ulnar nerve) nerves. You did not mention any imagin of your neck, but you did mention a 'disc bulge'? If you have not had an MRI of your cervical spine, I would recommend one. Dysfunction in the cervical nerve roots (C7 and C8 in your case) can occur at different levels. When there is trauma to the neck it may result is disc herniation/protrusions. A disc protrusion can put pressure on the nerve roots prior to their exit from the vertebral column. You can also have foraminal narrowing (impingment of the nerve as it exits the vertebral column (due to degenerative disesease, arthritis etc-less likely in your case). There are also multiple places that nerves can become entraped peripherally, in the brachial plexus, the sprial groove of the humerous( radial nerve), the elbow (ulnar nerve), the wrist (carpal tunnel syndrome-median nerve). To evaluate for these compression syndromes I would suggest an EMG (nerve muscle test) that will be able to locate the specific site of your lesion and give you some information reguarding whether it will completely recover. It many cases of mild injury the best treatment is physical therapy and time, but is some cases there are suregical options to consider.
I hope this has been helpful.
The symptoms and story that you provide are consistent with a compressive lesion (probably from the neck) that is affecting your C7 (triceps) and C8 (ulnar nerve) nerves. You did not mention any imagin of your neck, but you did mention a 'disc bulge'? If you have not had an MRI of your cervical spine, I would recommend one. Dysfunction in the cervical nerve roots (C7 and C8 in your case) can occur at different levels. When there is trauma to the neck it may result is disc herniation/protrusions. A disc protrusion can put pressure on the nerve roots prior to their exit from the vertebral column. You can also have foraminal narrowing (impingment of the nerve as it exits the vertebral column (due to degenerative disesease, arthritis etc-less likely in your case). There are also multiple places that nerves can become entraped peripherally, in the brachial plexus, the sprial groove of the humerous( radial nerve), the elbow (ulnar nerve), the wrist (carpal tunnel syndrome-median nerve). To evaluate for these compression syndromes I would suggest an EMG (nerve muscle test) that will be able to locate the specific site of your lesion and give you some information reguarding whether it will completely recover. It many cases of mild injury the best treatment is physical therapy and time, but is some cases there are suregical options to consider.
I hope this has been helpful.
The nerve involved in your case is the ulnar nerve which I believe is c7/t1. However, if your problem is muscular, and it sounds it, this should not concern you. The way to fix it is by deactivating trigger points in MUSCLES, and maintaining ideal muscle length. you should get a trigger point book by Clair Davies, and you should start learning the anatomy of the muscles and nerves in the neck. I'd bet this is muscle related and probably was triggerred by your traumatic incidence on the motorcycle, and then the hunching on the computer. I'd also bet your scalenes are the culprits-- many nerves to the arm and even the chest run through and around these muscles. When the muscles go into spasm and become hard as a rock around nerves, well....you get the idea. I had the same nasty pain in my triceps which caused bad tightness around my elbow, which then resulted in a 16 month loss of ulnar sensation when I stretched the nerve while exercising.
It's all about muscle memory and posture. see website by Jolie Bookspan and read her stuff on neck pain. also dont get discouraged-- you aint gonna fix this over nite.
I believe you are correct in that it may be a combination of things, the muscle tightness in my neck is not helping. Pain has got less as muscle tightness has decreased but pain remains persistent despite neck stretches i have been doing for the past 3 months.
Because of my neck position/tightness maybe this is irritating nerve root for my right tricep, and the ulnar from tight neck/shoudlers as you say? In Jan 06 My left shoulder was visibly contracted in the mirror, now it just feels super tight.
I will get those books, physio seems the answer. Ideally i would like to get the curvature back in my neck, can this be done with excercise? I think my poor posture is just as much to do with this as the bike crash... now i look back over the years its never been good... i need to fix this to stop future problems or progression. Thanks so much for your reply.