Random numbness in arms.

[Dennismonsewicz]

For the past 6 or so weeks I've been having issues (mainly in my left arm) with random patches of numbness in my upper arm and tingling in my fingers. If I flex my left arm I feel an achy pain down my tricep. The only other pain I experience is a dull ache in my left shoulder. I have scoliosis and kyphosis. Could these issues caused nerve damage in my shoulders somehow?

[Dennismonsewicz]

Thanks for your suggestions and help! I should probably elaborate a little more on my symptoms.

I got into doing some pretty heavy weight lifting and about the time the numbness started in my arms was about the same time I hit about 335 lbs on the bench press. I noticed it a few days after my workout. The numbness typically occurs on the outside of my arm (outside of the bicep, closer to the tricep) and the numbness extends down to the outside of my hand. I typically feel the tingling on the outside of my pinky finger. And its not consistent on being more prominent in one arm over the other. It's like my body randomly chooses a side and goes with it, LOL.

I do feel some tightness in my neck and have experienced some numbness in my upper back (normally after extended periods of walking or sitting).

Again, thanks for your help thus far!

[Christopher R Newey, DO]

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 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.

A cause of numbness of the index finger and middle finger is carpal tunnel syndrome. It usually also has sensory changes of the palm at the thumb, index and middle fingers, and the ring finger on the side near the middle finger. I am not sure if you have these other features or not, but I will elaborate on carpal tunnel syndrome.

Carpal tunnel syndrome is a compression/entrapment syndrome of the median nerve at the wrist. It usually results from excessive use of hands and occupational “microtrauma”.  Other causes include hypothyroidism, amylodosis, and arthritis to name a few. It may also arise during pregnancy and resolve after delivery of the child. The sensory changes usually are worse at night. Patients may complain of having to shake their hand to wake it up. Over time, you may develop atrophy of muscles of the thumb supplied by the median nerve.

With regard to the scoliois and kyphosis, it is possible that you may have developed a herniated disc. The vertebrae (bones of the spine) have material between them to cushion and allow for mobility. This material may be squished out. This is called a herniated disc. It can be squished out centrally or laterally. In most people the pain associated with a herniated disc may resolve within 4-6 weeks. A minority of patients do not respond to medical/conservative management and require surgery.  Symptoms suggesting the need for urgent surgery include muscle weakness, loss of bowel or bladder control, loss of sensation, and progressive pain.

Lastly, you may have a small fiber neuropathy. With small fiber neuropathies, symptoms include burning or buzzing or other vague symptoms starting in the feet and hands then in some cases spreading to other parts of the body. The EMG/nerve conduction studies (NCS) (tests done to check for neuropathy) will not show an abnormality, and a definitive diagnosis can only be made with a skin biopsy so that the number of nerve endings can literally be counted. There are other tests of the function of small nerves that can be ordered, such as QSART testing which looks at how much sweat the skin makes, since sweating is in a sense of function of these small nerves. There are several causes of small fiber neuropathy, including diabetes, vitamin deficiencies, and autoimmune problems.

I would recommend that you follow up with your local neurologist. He/she will perform a specific neurological examination focused on the peripheral nerves of the upper extremities. The neurologist may also elect to perform an EMG/NCS to evaluate the motor and sensory components of the median nerve as it crosses the wrist. Depending on the findings on the examination and history, additional blood testing and/or neuroimaging (such as an MRI) may be recommended.

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