[49F] Experiencing intermittent tingling pain below left collarbone and thumb

Patient Description

A 49-year-old female reports a one-week history of intermittent tingling pain below the left collarbone and in the thumb. The pain is rated as a mild 2 out of 10 in severity and does not change with movement or position. The patient has a history of spinal degeneration diagnosed approximately 5 years ago and performs repetitive movements with her arm or neck. She experiences no other symptoms, such as weakness, changes in sensation, or reflexes in the arm or hand. The patient's medical history includes the use of Seretide and Ventolin for asthma, taken daily and as needed, respectively. There are no known allergies to medications, and no use of over-the-counter medications, vitamins, or supplements.

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Arora's Assessment

What might be happening

Based on the information you've provided, the following conditions could be causing your symptoms:

  • Thoracic Outlet Syndrome (TOS): This condition occurs when blood vessels or nerves between your collarbone and your first rib (thoracic outlet) are compressed. This can cause pain in your shoulders and neck and numbness in your fingers. Common causes of this condition include physical trauma from a car accident, repetitive injuries from job- or sports-related activities, certain anatomical defects (such as having an extra rib), and pregnancy.

    • Treatment for TOS typically involves physical therapy and pain relief measures. In more severe cases, your doctor may recommend surgery.
  • Cervical Radiculopathy: This is a condition where nerve roots near the cervical vertebrae are compressed, causing loss of nerve function. Symptoms can include pain and numbness in the neck, shoulder, and arm, as well as weakness and lack of coordination in the hand and fingers.

    • Treatment for cervical radiculopathy can include physical therapy, medications to reduce pain and inflammation, and in some cases, surgery.
  • Carpal Tunnel Syndrome: This condition is caused by pressure on the median nerve, which runs the length of the arm, goes through a passage in the wrist called the carpal tunnel, and ends in the hand. Carpal tunnel syndrome can cause tingling and numbness in the hand and arm.

    • Treatment for carpal tunnel syndrome can involve wrist splinting, medications, and surgery.

Please note that these are potential explanations for your symptoms, but the actual cause may be something different. You should consult a healthcare provider for an accurate diagnosis.

What you can do

Here are some steps you can take to manage your symptoms:

  1. Try to rest and avoid activities that worsen your symptoms.
  2. Over-the-counter pain relievers such as ibuprofen or acetaminophen may help relieve your pain.
  3. Gentle stretching exercises may help relieve compression in your neck or wrist.
  4. If you work at a computer, make sure your workstation is ergonomically set up to reduce strain on your neck, shoulders, and wrists.

What you should look out for

Please seek immediate medical attention if:

  • Your pain becomes severe or unbearable.
  • You experience sudden weakness or numbness in your arm or hand.
  • You have difficulty moving your arm or hand.
  • You have difficulty breathing or experience 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 accurate information.

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9 mo ago


People Also Ask


What are the common symptoms of Thoracic Outlet Syndrome?

Common symptoms of Thoracic Outlet Syndrome include pain in the shoulders and neck, numbness in the fingers, and sometimes weakness in the hand. These symptoms occur due to compression of nerves or blood vessels in the thoracic outlet area.


How is Cervical Radiculopathy diagnosed?

Cervical Radiculopathy is typically diagnosed through a combination of physical examination, patient history, and imaging tests such as MRI or CT scans. These tests help identify nerve root compression near the cervical vertebrae.


What are the treatment options for Carpal Tunnel Syndrome?

Treatment options for Carpal Tunnel Syndrome include wrist splinting, especially at night, medications to reduce pain and inflammation, physical therapy, and in severe cases, surgery to relieve pressure on the median nerve.


Can repetitive movements cause nerve compression issues?

Yes, repetitive movements, especially those involving the arm or neck, can lead to nerve compression issues such as Thoracic Outlet Syndrome or Carpal Tunnel Syndrome. These movements can cause inflammation or structural changes that compress nerves.


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