Right hand burning pain and numbness.

Posted by mebee @mebee, Jun 23, 2023

I’m new to this site, this is all new to me, two months ago my right arm, hand and fingers were hurting. Now, my fingers are numb with tingling, pain, and weakness. My hand goes through stages of excruciating burning sensations. I’ve had back/neck x rays and an MRI. Can’t get an appointment for a couple of months with a neurologist . I see a hand specialist next week. My chiropractor is giving me radio wave therapy. I’m taking gabapentin which doesn’t seem to work. Any advice or recommendations would be appreciated. Thank you.

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Profile picture for docgus @docgus

Follow up: I was able to see my PT yesterday afternoon and she did some tests and confirmed TOS! She feels like she can get my symptoms resolved before my neuro appointment in February. I will update my GP and see how much she knows about TOS.
So glad I found this discussion yesterday! Thank you @jenniferhunter and @mebee for posting!

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@docgus That sounds like progress and an answer after a long search. From my experience, TOS isn’t quick to resolve and there may always be some issue with it. Going forward, posture and stretching PT exercise is very important. Good for you for advocating for yourself!

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Profile picture for Jennifer, Volunteer Mentor @jenniferhunter

@mebee and @loribmt

Your descriptions of hand swelling and arm/hand numbness at night suggests symptoms like those in Thoracic Outlet Syndrome or TOS. I have TOS, and there are variations of it, but basically it causes a compression of nerve and blood vessels under the collar bone (between collar bone and rib cage). These are small spaces. I have treated TOS with a physical therapist who does myofascial release for several years. It helps to loosen up that overly tight tissue that is further restricting the small spaces where the nerves need to be able to glide. My hands used to turn blue and get cold. When you are sleeping, such as on your side and possibly with an arm in the raised position, the shoulder can get compressed cutting off circulation. Turning the head also cuts off circulation in the neck. Having your shoulders forward such as in reaching while typing on a keyboard also compresses the front of the chest wall, so getting the shoulders back with good posture is important to help alleviate symptoms.

The diagnostic tests for TOS can be Doppler ultrasound studies that show diminished circulation when raising the arms, and cut off circulation turning the head when the doc listens to your pulse. I was told this is a "rare" condition by a doc who didn't understand it and the results of the Doppler imaging he ordered, but what is rare is finding a doctor who understands the condition. When I was at Mayo for spine surgery, they confirmed my TOS diagnosis in their vascular lab. Treatment for TOS most often is physical therapy and myofascial release. Some basic PT stretching would be to stretch the front of the chest and arms by laying on your back on a foam roller with outstretched arms or using a doorway to lean against while standing.

@mebee Since you have upcoming appointments, it is worth asking about TOS. It is most often missed by doctors because it isn't covered well in med school and is misunderstood. It is somewhat common and can also be caused by repetitive stress injuries or a whiplash. There can also be other conditions that could exacerbate TOS. I had a hand surgeon who did carpal tunnel surgery completely miss my TOS condition and blame me when I told him that I still had my hands tingling after his Carpal Tunnel release surgery. He took my pulse and told me I was fine. Even after I went back to him after getting a proper diagnosis, he wouldn't help me by sending me to physical therapy. He claimed he wouldn't be able to judge if therapy would help me or not because he didn't know about TOS. It is common for the TOS diagnosis to be missed for several years.

Here is some information.

"How to truly identify and treat thoracic outlet syndrome (TOS)"
https://mskneurology.com/how-truly-treat-thoracic-outlet-syndrome/
Diseases and Conditions - Thoracic Outlet Syndrome (Mayo Clinic)
https://www.mayoclinic.org/diseases-conditions/thoracic-outlet-syndrome/symptoms-causes/syc-20353988
Here is our discussion on Myofascial Release.
-Neuropathy - "Myofascial Release Therapy (MFR) for treating compression and pain"
https://www.mayoclinic.org/diseases-conditions/thoracic-outlet-syndrome/symptoms-causes/syc-20353988

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@jenniferhunter it's an eye opener for me suffering from severe neuropathy pain onhands for the last 3-4yea

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Profile picture for handpain @handpain

@jenniferhunter it's an eye opener for me suffering from severe neuropathy pain onhands for the last 3-4yea

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@handpain
Jennifer thank you for all the information. I find it very useful.

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Profile picture for docgus @docgus

Follow up: I was able to see my PT yesterday afternoon and she did some tests and confirmed TOS! She feels like she can get my symptoms resolved before my neuro appointment in February. I will update my GP and see how much she knows about TOS.
So glad I found this discussion yesterday! Thank you @jenniferhunter and @mebee for posting!

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@docgus
Dear Doc Gus,
How are you doing?
It took more than a year before finally a solution. I’ve been great ever since my carpal tunnel surgery. Hopefully your issues have been resolved.

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