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Upper Extremity Pain
Pain, Numbness, Tingling, and Weakness of the Upper Extremities
When a patient is experiencing pain, numbness, tingling or weakness in the arms or hands and they do not have a distinct injury in the same area, there are typically three possible causes for those symptoms. The first cause is nerve irritation. The second cause is decreased circulation or some type of blood flow problem. The third cause is musculoskeletal pain referral. In my clinical experience nerve irritation has been the cause of these symptoms a majority of the time. This page will discuss nerve irritation as a cause of upper extremity pain, numbness, tingling, and weakness. Click here for more information regarding musculoskeletal pain referral.
Skin sensation (pain, numbness, tingling) reflexes and muscle control are all controlled by nerves. Nerve damage or irritation can cause alterations with any or all of those three functions. An example of nerve irritation is hitting your "funny bone." When one "hits their funny bone," they are actually hitting a nerve that passes through the under side of the elbow. This direct pressure irritates the nerve causing numbness and tingling in the pinky and ring fingers, both areas where that nerve travels to. The nerves in the arm are very long, traveling from your neck all the way to your fingertips. They can be irritated anywhere along their pathway.
Below are a few examples of possible causes of nerve irritation in the upper extremities.
Intervertebral Disc Injuries
As a nerve exits the spine it passes by the intervertebral disc. If there is a disc bulge, protrusion, or herniation injury the disc may be touching the nerve causing irritation. Even if the disc injury is not causing the disc to touch the nerve, it can irritate the nerve by crowding it. The disc injury may also cause a chemical reaction leading to nerve irritation. For more details about disc injuries click here.
What are a few possible causes of an Intervertebral Disc Injury?
Traumatic Spinal Sprain/Strain Injury
As a nerve exits the spine and after it passes the intervertebral disc it then passes the spinal facet joint. If the spinal facet joints have been injured there can be excessive fluid from swelling that may apply pressure by crowding the nerve. There may also be tight or spasmed muscles that apply pressure on the nerve. For more details about sprain/strain injuries click here.
What are a few possible causes of a Traumatic Spinal Sprain/Strain Injury?
Thoracic Outlet Syndrome
Thoracic outlet syndrome is an example of both nerve irritation and decreased blood flow causing numbness and tingling in the arm. The "thoracic outlet" is an area between your neck and shoulder where all of the major nerves and blood vessels converge and begin to travel down the arm. If the nerves and blood vessels are pinched or compressed this will irritate the nerve and decrease the blood flow.
What are a few possible causes of a Thoracic Outlet Syndrome?
Carpal Tunnel Syndrome
The carpal tunnel is an area in the wrist. It is described as a tunnel because the 8 bones in the wrist form an arch, like the arch of a tunnel. A major nerve that supplies the hand travels under the carpal tunnel. If the carpal tunnel collapses the bones of the wrist apply direct pressure to the nerve underneath it. This irritates the nerves causing numbness, tingling, and weakness in the hand. Nerve conduction testing is the best way to definitively diagnose carpal tunnel syndrome.
What are a few possible causes of a Carpal Tunnel Syndrome?
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