Tricep pain when moving head, numb pinkie/ring fingers when i wake

[g18c]

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

[CCF-Neuro-M.D.-SH]

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.

[mike1105]

my personal experience tells me that this issue is most likely stemming from your neck. Also, it sounds to me like it is muscular, but I'm sure if you keep seeing doctors you'll have an MRI which may or may not show a hard tissue (bone) issue, which in turn may or may not be the casue of your pain.

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.

[g18c]

Thanks for the fast reply. I didnt have space to mention I went to see a neurologist who scheduled MRI and NCS/EMG. The NCS/EMG was normal (arms straight, and after arms bent for 5 minutes), no changes or muscle loss. The MRI revealed mild spondylitic damage, loss of curvature to the C spine and damaged dried out discs between C5-C6, C6-C7, with a small bulge on the left side of C5-C6 (i dont have any bicep symptoms). I also have hypermobility in C5, C6 area.

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.

[mike1105]

you can get the curvature back--- it's postural. You need to release triggerpoints, and then stretch the muscles that are short and tight (scalenes, upper traps, pecs, SCMs) and strengthen those that are weak and elongated---mainly the muscles of your mid and upper back (rhomboids and posterior scapular stabilizers, serratus anterior). All this will (de-round your posture and get you standing straight all the time) Exercises for these muscles are all over the internet, and involve the pinching of your shoulders together. Get Clair Davies book, and also get "Fix your pain without drugs or Surgery" by Jolie Bookspan. This is the one book that helped me the most. Also go to her website.

[g18c]

Hi Mike, i ordered the books you recommended, the davies trigger point one has arrived. I have some questions regarding this book. The book talks about little pea sized trigger points in muscle but in my case i cant find them, and although i get a lot of discomfort when pressing on my tight muscles of my neck i dont get any reffered pain. I do however, reading from the book, believe i have a lot of these issues, further more a few muscle fibres on my left side of neck (scalenes) are rock tight like a metal chain or can be pinged like a guitar string. Is this a trigger point? I cant find a lump along the muscle as it feels tight all the way along.

Can you recommend any places which may specialise in trigger point therapy (sports massage specialist etc?) or any resources on the web where i could find one worldwide (im in the UK) so i could consulte them and learn howto treat myself?

Many thanks for your help, your comments are spot on. I have started seeing a physio (and stopped the chriopracter) and she says i have a massive muscle inbalance, i have very little posture muscle in my upper back left side compared to the right, my trapezius and front neck muscles are in tight/spasam because they are exhausted from supporting my head... just as you said. The trouble is all this muscle tightness is causing some compression and stopping joints from moving properly in my neck.

Im doing the perscribed excercises 20 mins morning, 20 evening (some consisting of shoulder squeezing as you said). I also changded my chair at work with a headrest, i now keep my head on this as ive caught myself leaning my head forward to often, doing this ive had a massive improvement so i think overall years of bad posture has bought on this problem.

I really apreciate your time, you have been one of the people who have helped me the most and given me a hope of getting rid of this problem or at least minimise it.

Thank you so much,

Chris