Arm twitching/elbow injury

31 year old male-

I have a combination of symptoms in my left arm. The first problem is that I developed twitching in my upper arm. Sometimes it is in the bicep, sometimes the tricep. I thought this was from over use due to both a strenous exercise cycle, and playing musical instruments that use the muscle group on a daily basis. The twitching never brought on pain, but did make my biceps muscle extremely tense.

The second issue with my left arm occured while had the above symptoms. I smashed my elbow into a door frame moving furniture. I got what I know as a "stinger" from playing sports. Not exaclty a funny bone hit because it was the outside part of the elbow joint. This caused numbness, pins/needles, and now twitching right at the point of the injury and just below it.

I've been seeing a chiropractor which has helped a little on the upper part of the arm, but hasn't cured anything. My GP told me to take ibuprofen and rest and it will take care of itself. It's been a couple of weeks, and although some of the symptoms have improved - none of them seem to be going away. The numbness in the hand has mostly subsided. The upper arm still feels like it's trembling or irritated. It's hard to describe. I also get the upper spasms still, though not very much anymore.

The elbow nerve/muscle still twitches a lot. I don't have any loss of strength, but the left arm does experience fatique quicker than it used to when playing music or doing other activities. My motor skills seem to be completely normal.

Does this stuff just take a long time to heal, or should I be more concerned? It's really starting to weigh on my mind at this point, and I don't like taking all this ibuprofen every day.

[Neuro Forum]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine you and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

Twitching in the muscles of the arm, if they are fasiculations, can occur with repetitive use, due to muscle irritability, and may simply indicate the need for rest. However, in athletes that have sustained injuries, one concern would be for radiculopathy, or pinched nerve. The spinal cord is encased by bones called vertebra. Nerves start to form as they come off the spinal cord and exit through holes formed between the vertebra. If a nerve is compressed on as it exits through these holes, particularly in an area called the nerve root, a radiculopathy results. The compression could be due to arthritis of the spine or due to a herniated disc or other lesions. The symptoms include pain at the level of the problem (i.e. neck or back etc) and pain that may radiate down the arm or leg (depending on where the problem is). In more advanced cases, muscle weakness or sensory symptoms such as tingling or numbness may occur. A radiculopathy is often diagnosed based on history, physical examination, and MRI of the spine.

Injury at the elbow would not cause symptoms in the biceps and upper arm muscles, but could explain the symptoms in your hand; compression or stretching of the nerve to the hand would be the cause, and most often symptoms resolve over time (several weeks) with rest of the limb. However, radiculopathy, or nerve lesions more proximaly, in such areas as the brachial plexus) can also lead symptoms in the hand (i.e. the elbow injury may or may not be related to your  main symptoms).

It is recommended that you be evaluated by a neurologist; imaging of the neck may be indicated, as may be a study called EMG/NCS which tests how nerves are conducting electricity and how the muscles respond. The EMG/NCS can assess whether or not there is nerve injury, where the injury is, how severe it is, and therefore what is the likelihood of improvement, and what steps need to be taken to prevent injury and allow for healing.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.

[Jayson650]

First - thank you for answering my questions the best you could given the information. Youre help really is appreciated.

To follow up - the symptoms from my elbow down have gotten much better since my initial question. I think they are finally starting to heal a bit. Most of the twitching is gone, and the pins/needles type of feelings in my hand are much less frequent.

My upper arm (left) is still experiencing symptoms, though different than before (mostly in my bicep). It has a bit of dull pain in it, and it still seems very jump even though no visible spasms or twitching is occuring.

I have an obvious issue in my upper back & neck that my chiropractor thinks is contributing to my biceps issue. He has been attempting to address that.

Given your experience, does my progress indicate that I'm healing (albeit slowly) now?