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Ulnar Nerve Pain Leading to Entire Arm/Shoulder, Confusing MRI Results
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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This could be unrelated, but I am reminded of my condition (Brachia radial Puritis) which is similar in that it begins in the C spine with vertebrae disc making contact with the Brachial nerve (like sciatica from lumbar disc contacting the sciatic nerve). My wife also suffers from chronic pain involving the same nerve but results in pain from her neck down the shoulder into the arm.
All to say, if it was a similar scenario with another nerve.
We find some relief ( complete relief for me partial relief for her). Using traction to separate the vertebrae and allowing the disc to pull back from contacting the nerve. See my post in Brachia radial puritis
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3 Reactions@restisaweapon
I had a similar experience. Thought Carpal Tunnel was fingers and wrists painful. After appt Dr. said I only had very mild Carpal Tunnel and sent me to have brace made. Ultimately, the neck and cervical disks were the culprit. It would be helpful for you to get a nerve anatomy on internet. Once you see that you'll understand what the MRI of your neck meant. I hope you feel better.
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2 Reactions@morkat I have complete relief now morkat. I developed a neck stretch exercise that keeps the disc off my brachial nerve
I think it’s time to get a spine surgery consultation
@radar614 I think you are describing the symptoms of thoracic outlet syndrome as I had the same symptoms. I am not a medical professional, so you will need a knowledgeable provider for a diagnosis. That is almost the same as my story. I had a C5/C6 collapsed disc with bone spurs and compression of the spinal cord. My hand was turning blue and getting cold because I also have thoracic outlet syndrome that compresses the ulnar nerve and also the blood vessels going into the arm. Usually the best thing for TOS is physical therapy with myofascial release to loosen tight fascia. Strengthening exercises usually make it worse by tightening the muscles. Posture is very important both for TOS and spine issues. I was in PT at the time my spine issues became evident and I returned to PT after spine surgery. The symptoms of TOS got worse after cervical surgery because of inflammation very close to where the TOS tightness exists.
TOS is most often missed because they don’t spend much time on it in med school. The best specialists are usually thoracic vascular surgeons at medical centers that list TOS as a condition they treat. Mayo has a vascular lab and specialists knowledgeable with TOS. Forward slouching posture is bad for TOS. Turning your head with TOS may cut off circulation and stop the pulse in your neck. That is one of the diagnostic tests for it. A neurologist may diagnose this and usually nerve testing is normal. It may be caused by a whiplash or repetitive stress. The MayoClinic.org website has good information on this and also MSKneurology.com in the Articles pages.
Do you have a TOS specialist in your area?
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1 Reaction@restisaweapon
Glad to hear you found something that works for you. I keep trying sometimes it works, sometimes it doesn't. Good luck.
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1 Reaction@jenniferhunter I have been reading about TOS and also think it seems to fit most of my issues. I actually am now wondering if it is more than one issue....the original nerve pain in my hand signaling a compression somewhere, but then I feel like PT very much exacerbated my shoulder/neck issues. I'm not sure about specialists locally, so I'm hoping to have guidance at my follow-up Tuesday. Thank you for the reply!
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2 Reactions@radar614 Yes, absolutely it can be more than one issue contributing to pain and that tends to confuse the diagnosis. If you look at teaching medical centers in your area, see if you can look up TOS on their websites. That may lead you to a specialist. You can travel to see a good specialist. The doctors that understand TOS are kind of few and far between. If you have a neurologist, they may have a suggestion. Your case is like mine with many similarities. TOS can cause pain in hands. I can get a muscle contraction on my palm on the pinky side. I have been able to bring on symptoms with my neck position. This also affects my ability to breathe properly because it tightens my chest wall and it doesn’t expand as much on one side.
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4 Reactions@radar614 here is a dermatone of the arm and how the nervous system feeds the arm.
https://duckduckgo.com/