Ulnar Nerve Pain Leading to Entire Arm/Shoulder, Confusing MRI Results

Posted by radar614 @radar614, Nov 7, 2025

Almost 13 weeks ago, I woke up with numbness and tingling in my ring and pinky fingers and bottom half of my hand (left hand only). This went on for 4-6 weeks, and was constant. Bracing the elbow at night did not help, neither did the nerve gliding exercises and chiropractic visits. Only after about 5-6 weeks did I start to have any pain in my elbow and slightly in my forearm. At 8 weeks, I had an EMG that indicated no ulner nerve entrapment at the elbow, but indicated possible issues higher up and imaging of my cervical spine was recommended. Insurance denied this request, and I was sent to physical therapy. By the time I completed 2 weeks (4 sessions) of physical therapy, I had pain from my hand all the way to my neck and throughout my shoulder. I could barely use my arm, had lost nearly all grip strength, etc. (Not blaming this on the physical therapy, just that it all happened at the same time). I also started having an issue where my hand turns cold and purple when I let it hang at my side or just down in general. So as of today, almost 13 weeks in total, I have constant numbness and tingling in my ring and pinky fingers and bottom of my hand, constant pain in my elbow, arm, shoulder, and sometimes neck. I basically can't use my arm for much of anything - I can't write or eat without significant pain and difficulty (I am left-handed), and if I let my arm hang at my side or down toward the floor, my hand turns purple.

Finally got insurance to approve the MRI, and the results are confusing. At C5-C6, mild to moderate spinal canal stenosis with small amount of CSF remaining. At C6-C7, moderate to severe spinal canal stenosis with minimal CSF remaining. Both locations indicate posterior disc osteophyte complete flattening and mild facet arthropathy. At C7-T1, however, no spinal canal or neuroforaminal narrowing. These results do not seem to follow along with the initial symptom being ulnar nerve pain in the hand. Any help/input is appreciated! (I do have a follow-up scheduled with my doctor next week to discuss.)

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3sew1 | @3sew1 | May 7 2:26pm

Sorry to hear of your arm and hand issues, especially the pain. Is your doctor your PCP or a specialist? The color and temperature changes might suggest a vascular component- has Thoracic Outlet syndrome been considered? A brachial plexopathy issue? Keep asking questions.Good luck.

ekelly | @ekelly | May 8 12:44pm

Have them rule out Thoracic Outlet Syndrome. This can be very serious as it reduces blood supply to the limb.

loriesco | @loriesco | May 9 9:35am

Ulnar pain is FROM your elbow not your hand as you mentioned.ulnar pain may not be related to your cervical problems. That is where the confusion comes in. You could have had a separate ulnar problem, different than your cervical problem. I did you could also have a misdiagnosis of an ULNAR problem when it was your cervical problem all along.

It does not look like you have had a correct medical process unfold for you. The insurance company wants to see a progression of investigations. They set you up to go through a hamster maze of crossing things off the list until there is no choice but for you to be in the surgeon’s office. So you get lots of misdiagnosis. I suggest you need to see a cervical spine surgeon. They will correctly diagnose your problem which from your MRI may only be resolved by an orthopedic spine surgeon. Not that you necessarily need surgery, your problem may be vascular in nature, but your problem looks to originate in your cervical spine because of the numbness and tingling of your hand — matching you MRI (what you wrote here.) A chiropractor, a primary care doctor, a pain management doctor— they are all ill equipped to deal with your problem until you’ve got a diagnosis from the cervical orthopedic spine surgeon. If you’re not at Medicare age, you will need a referral to get there. If you have a qualified doctor, they will send you there. If you don’t have a qualified doctor, they will continue to send you through the hamster maze. I suggest you do your homework before you go to your doctor appointment so you can get that referral.

I went through years upon years of cervical spine, deterioration and management. Surgery was the answer. In fact I needed two. So your confusion was very clear to me. You’re not in the correct place to get a proper diagnosis yet. You need to start at the top instead of staying mired at the bottom. Good luck.

cliffdweller | @cliffdweller | May 10 12:02pm

In reply to @racerboy "Hello. My first post here. I am going through a very similar experience as described by..." + (show)

@racerboy

Hello. My first post here. I am going through a very similar experience as described by @radar614 and @jenniferhunter above. About 4 weeks ago I woke up feeling the same tingling in my left pinky and ring finger and numbness in that part of the palm. This slowly progressed to coldness in those fingers and significant pain/tightness in the ‘pinky side’ of my forearm and some general pain (not as severe) in my elbow. This all occurred after two events that I thought may have caused it. One was an incident with a battery-powered hand drill where I was drilling through some thick plate steel (should not have been using a hand drill for this) and the drill bit got caught and torqued my left arm quite severely. I was pretty certain that as soon as it happened that I broke my wrist. This happened on April 4, but everything seemed ok, until a day or two later, when I first noticed the tingling in my fingers. The other event around the same time was I was holding the halter on a horse getting ready to give her medicine and she snapped her neck back, pulling my left arm with her. As the symptoms/pain got worse, I went to see the orthopedist (Apr 29) who had just rebuilt my wife’s rotator cuff back in March. He also cleaned out bone spurs in my left shoulder a couple years back. He x-rayed the elbow and saw no broken bones. He also pressed his fingers in to all the joints to see if there were any detached tendons. He basically said I had some soft tissue sprains in my wrist/forearm, gave me a wrist brace and an Rx for Celebrex, and said I’d be fine in a couple of weeks. Since then, I have been experiencing very significant pain in my left shoulder blade. So bad, that I am unable to drive or even sit upright. The driving position definitely seems like it aggravated it the most. Neither the Celebrex or NSAIDs seem to kill the pain. While I always feel it, it is definitely worse at the end of the day, except for my forearm. I am unable to grip a razor and shave my face in the morning due to the tightness I feel on my forearm/elbow. But if I do this in the shower at night, I have no issue. After reading what @jenniferhunter wrote about the fascia, I am wondering if my forearm is less affected later in the day because I have been using it all day (we have a horse farm and there is a lot of physical labor) and that loosens it up.

Despite the severe pain (mostly in my shoulder blade), I have not really lost any strength or range of motion. Though I do notice a lot of crunching in my shoulder blade when I raise my arm over my head. I do that because it helps to alleviate the shoulder blade pain. I was going to call the Ortho today (May 4) to let them know that I am worse than I was a week ago, and am wondering if I should ask him about the TOS. I’m not sure he will know that. He was somewhat dismissive of the tingling/numbness in my fingers because I still had all the strength in them.

Apologies for the super long post, but this is the first place I’ve seen where folks have experienced the same thing as me. I do believe mine is due to the acute injury based on the timing. I also pulled muscles in my triceps, serratus, and pectoral muscles from the drill incident, but that pain has gone down pretty significantly.

Jump to this post

@racerboy
THORACIC OUTLET SYNDROME!
I had surgery (rib resection) for thoracic outlet syndrome 17 years ago and your symptoms sound so much like what was going on with me!

After having numbness and tingling with simple things like opening a bottle of wine, squeezing limes, walking my dogs on a leash, I went to see a Hand Specialist who treated me like I was crazy and told me that I needed to lift weights! The worst advice for thoracic outlet!!

When symptoms became more severe with very cold, numbness, tingling, and color changes in my hand, I went to Urgent Care. The doctor there said she didn’t want to risk me losing my hand and sent me to Emergency for an Ultrasound. Ultrasound was normal and I was released. I checked in
with primary care who asked why I was there because ultrasound was normal. I recalled that several years prior I went to emergency room with similar symptoms and they thought it was carpal tunnel and referred me to a neurologist, but I never went because I never saw the referral note on the back
of the discharge instructions until I was moving and going through some old papers and found the discharge paper. At the time, ER doctor focused on my anxiety, and the supposed carpal tunnel/Neurology referral was not emphasized. My primary care reluctantly referred me to a neurologist.
The neurologist did a EMG/Nerve Conduction Study and that was normal. I vividly recall a phone message from my neurologist saying “Just an afterthought, you might want to consider a consult with a vascular surgeon.” I
Saw the vascular surgeon after the nurse conducted testing which showed vascular compression. He recommended surgery right away.

I believe I once read that average time to diagnosis is 7 years and that’s about what mine was.

Undiagnosed/untreated thoracic outlet can lead to
stroke. Don’t wait on this! Get a referral to a vascular surgeon asap!!

My surgery was successful and I am grateful for the neurologist who took detailed notes of everything that was going on with me and considered all possibilities.

cliffdweller | @cliffdweller | May 10 12:10pm

Consider that you can have a cluster of problems: spinal plus thoracic outlet. I forget to mention my neurologist also did a spinal MRI which showed disc degeneration and canal narrowing at C5/C6.

cliffdweller | @cliffdweller | May 10 12:49pm

Symptoms in ring and pinky fingers are a hallmark of Thoracic Outlet:
https://medlineplus.gov/ency/article/001434.htm
Arterial thoracic outlet is the rarer type and physical therapy is not going to help. Too much of the conversation is on PT which gets confusing. It will not help and only delays diagnosis and treatment for those with arterial thoracic outlet.

I was also having ulnar issues and upper shoulder and neck pain.

Please see a vascular surgeon to at least rule out arterial thoracic outlet.