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Splinter sensation in finger
Earlier this week, I was sitting on the sofa using my laptop, and out of nowhere, I had a splinter feeling in my right ring finger, on the left side of the front segment. The sharp pain is typically felt when the area is brushed (e.g. a finger or something else slides against it, even gently), not pressed. The pain was worst the first day, but persisted to today, and seems to worsen or become more noticeable after washing hands or showering (not sure if due to touching it more or the water). No other sensations in that finger or the others.
No splinter was found, by myself, nor at the urgent care clinic or dermatologist. To try to find a splinter, I tried a warm water soak, baking soda bath, scouring the area for hours, flashlight held against finger. Urgent care doctor said it may look dry, so try vaseline twice a day for 3-4 days. I first applied it yesterday and it did not seem to help; still felt it to no lesser degree hours later. Also, the sensation sometimes feels deeper than the top skin layer. Dermatologist today, who admittedly did a relatively brief look through her magnifying tool, did not even say the skin looked dry; she said skin-wise everything looks fine.
Urgent care doc and a redditor also opined that it's unlikely to be peripheral neuropathy. My B12 level is around 400, down from 600 a few months ago. I've been vegan since Jan, consuming supplemental B12 50 mcg daily, and added an additional 500 mcg 2 days ago. Urgent care doc said B12 deficiency symptoms typically appear only with a profound sustained deficiency. Redditor suggested that since the pain is localized and only felt on a specific type of contact, it doesn't sound like neuropathy to their knowledge. On a couple of nights since January I had numbness and/or pins and needles in one hand or the other but since it happened rarely I chalk that up to sleeping in a bad position.
Does this sharp sensation sound like a neurological issue? Vein issue? Or a skin issue after all? What's the next step if it persists? A neurologist? What kind of imaging could find out what's wrong (ideally not a CT scan due to the radiation amount)? An x-ray is apparently generally bad at finding splinters but could it detect if there's a small injury or other issue here? Or should I continue the urgent care's suggestion of vaseline although the dermatologist found nothing wrong?
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@cmx of course, I’m not a doctor. I do have experience with nerve pain, osteoarthritis, and hand issues. I’ve had 4 surgeries on my left hand. Trigger fingers, carpel tunnel, bone spur, and Sagittal band repair.
I have had pain similar to that. I thought it was just a very sensitive nerve in one spot. It hurt if I lightly touched the spot. It was like a healing sore pain with a tingle.
If I were you, I would do a wait and see. If it happens in other areas, or doesn’t go away, I think your Primary Care Doc will know how to help.
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If I was you, I would go to a neurologist for EMG/nerve conduction study (NCS) of upper limbs. I might even ask for a MRI of my cervical spine to make sure I did not have any spinal cord or nerve root compression since you have had some hand numbness. You could also have carpal tunnel syndrome and this would be pick up by the EMG/NCS.
I hope you can get answers soon.
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My full-body MRI last year showed some spinal issues (summary pasted below), mild overall, but since it was whole-body I guess might not have been detailed enough to show spinal cord or nerve root compression that may affect a finger, like a more detailed cervical MRI might.
The tingling/numbness on all fingers in morning was very rare, like 1-2 times in the past half year, and went away within 5 minutes of getting up; I think may have just been due to going to sleep in a bad position. Last occurred in late March.
Otherwise no noticeable tingling/numbness, just the splinter sensation that randomly popped up which I'm having a hard time finding sources confirming localized contact-only pain like this could be neuropathy since the vast majority of sources seems to suggest it would be tingling/numbing and/or ongoing.
But I agree with going to a neurologist if it's there by next week without noticeable improvement, and/or ask for imaging (x-ray, ultrasound, MRI). I guess I may show them the spinal results below in case it makes a difference to their analysis. Ideal scenario is this is just a very old non-infectious splinter slowly making its way to the surface.
SUMMARY OF SPINAL FINDINGS IN FULL-BODY MRI EARLY 2024:
Multilevel degenerative changes seen in spine, as described in following, without significant spinal canal or spinal canal narrowing:
Spondylolisthesis identified in spine: retrolisthesis of C4 on adjacent inferior vertebral body (consider flexion extension X-rays to see if there is active slippage with positioning, and a consultation with a neurosurgeon particularly if symptoms consistent with finding).
Mild scoliosis of spine: curve is centered in thoracic spine, convexity to right, compensatory minor curve centered in lumbar spine (No action if asymptomatic, otherwise talk to doctor about physiotherapy treatments to prevent degenerative changes from developing/progressing. Scoliosis series standing Xrays are the best way to quantify the extent of spine curvature by reproducibly measuring the Cobb angle between affected vertebrae; MRI-measured Cobb angle is not as accurate and reproducible when patients are lying down).
Degenerative spondyloarthropathic changes in cervical spine (no follow-up needed but prevent these changes from progressing via good posture and spine care): C5/C6 level: central disc herniation detected, mild hypertrophic degenerative changes visualized in right side facet, mild hypertrophic degenerative changes visualized in left side facet; C6/C7 level: symmetric disc bulge detected.
Moderate degenerative spondyloarthropathic changes in lumbar spine (if progressive constant symptoms, discuss with doctor; if intermittent, use good posture, physiotherapy, and spine care to prevent progression).
@cmx
Based on your MRI, it shows you have your C4 vertebrae slipping over the C5 vertebrae. The radiologist recommended you get a flexion extension X-ray to check for active slippage. Did you get that done and see a neurosurgeon as recommended?
Did you get the scoliosis X-rays as recommended due to what showed up in your thoracic and lumbar spine? Did you get the physical therapy as recommended?
You do show c5/c6 and c6-c7 disc herniations/bulges which can press on spinal cord/nerve roots and cause pain/weakness/numbness symptoms. This could include a feeling like pins and needles/sharp pain in hands. See image below.