[40F] Experiencing numbness in fingers and upper back pain

Patient Description

A 40-year-old female has been experiencing numbness in her thumbs, index fingers, and occasionally her middle finger, accompanied by pain for about 6 months. The numbness occurs daily upon waking and intermittently throughout the day during regular tasks. She regains sensation by rolling her shoulders backwards. The patient also suffers from upper back pain with a burning sensation and feels the need for her back to be 'popped,' which worsens with prolonged standing. She has a history of a left shoulder injury from a fight a year ago, which led to limited movement and strength, and was treated with naproxen. She has a mild case of high blood pressure and allergies to latex, folitab, and B-12, which cause hives. She is not currently on any medications. Her family history includes arthritis in her mother and mild scoliosis in her daughter.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible explanations for your symptoms include:

  • Carpal Tunnel Syndrome: This condition is caused by pressure on the median nerve in your wrist, leading to numbness and tingling in the thumb, index, and middle fingers. It can be aggravated by certain wrist positions and repetitive hand movements.

    • Treatment typically involves wrist splints, avoiding activities that worsen symptoms, and physical therapy. In severe cases, surgery may be necessary.
  • Cervical Radiculopathy: This condition occurs when a nerve root in the cervical spine (neck) becomes inflamed or damaged, resulting in neurological symptoms—like numbness and weakness—in the hand and arm. This could potentially be related to your previous shoulder injury or your reported back pain.

    • Treatment often involves physical therapy, medications for pain relief, and potentially surgery in severe cases.
  • Thoracic Outlet Syndrome: This condition is caused by compression of the nerves or blood vessels that pass through the thoracic outlet—an area between the collarbone and first rib. It can result in numbness in the fingers and pain in the shoulder and neck.

    • Treatment typically involves physical therapy to strengthen the shoulder muscles, improve posture, and increase range of motion.

Please note that these are potential explanations based on the information you've provided, but only a healthcare professional can provide a formal diagnosis.

What you can do

  1. Schedule an appointment with your healthcare provider to discuss your symptoms. They may refer you to a specialist, such as a neurologist or orthopedic surgeon, for further evaluation.
  2. In the meantime, try to avoid activities that worsen your symptoms, such as prolonged periods of standing or certain sitting positions.
  3. Gentle stretching exercises may help alleviate some of your symptoms. However, it's important to consult with a healthcare provider before starting any new exercise regimen.

What you should look out for

Seek immediate medical attention if you experience:

  • Sudden, severe pain in your back or neck
  • Loss of bowel or bladder control
  • Sudden weakness or numbness in your arms or legs
  • Difficulty walking or maintaining balance
  • Difficulty breathing or chest pain

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, diagnosis, and treatment.

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9 mo ago


People Also Ask


What are the common symptoms of Carpal Tunnel Syndrome?

Common symptoms of Carpal Tunnel Syndrome include numbness, tingling, and pain in the thumb, index, and middle fingers. These symptoms often occur during activities that involve wrist movements and can be worse at night.


How can a previous shoulder injury contribute to current symptoms like numbness and pain?

A previous shoulder injury can lead to changes in posture or movement patterns that may contribute to nerve compression or strain, potentially causing symptoms like numbness and pain in the arm or hand.


What lifestyle changes can help manage symptoms of Thoracic Outlet Syndrome?

Lifestyle changes that can help manage Thoracic Outlet Syndrome include improving posture, avoiding repetitive overhead activities, and performing exercises to strengthen shoulder muscles and increase range of motion.


When should someone seek immediate medical attention for back or neck pain?

Immediate medical attention should be sought if there is sudden, severe pain in the back or neck, loss of bowel or bladder control, sudden weakness or numbness in the arms or legs, difficulty walking or maintaining balance, or difficulty breathing or chest pain.


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