Quote:
Originally Posted by GaryA
Goldie, sorry to be replying so late. If it were just the finger, I'd suggest it is carpal tunnel. However, since you also have problems in the elbow, it could be pressure on the nerve, either within the nerve sheath somewhere along its path from the neck down into the hand, or by nerve compression caused by the brachial plexus's covering muscles--the scalenes that lift the 1-2 ribs when you inhale, or by pectoralis minor (beneath your pec major), or, rarely, by the coraconbrachialis which attaches to the coracoid process of scapula and to the upper arm bone.
As for the nerve sheath, nerves are meant to glide freely within the sheath. Standing, if you lift your chin, extending your neck as high as you can and as far away from the affected arm as you can stretch it, and simultaneously extend the affected arm as far as you can, and move the hand into flexion and extension, if the nerve is impinged within the sheath, you may feel tingling/numbness in the elbow or down into the fingers.
With all the research you have done, you're familiar with the term TOS, I assume. The pronator teres is lower than the elbow, so is unlikely to be the cause. Likewise, the interrosseus. So, if it isin't a problem in the spine due to your surgeries, I think it likely stems from thoracic outlet syndrome.
Trigger points within the aforementioned TOS muscles can cause hypertonicity and compression of the brachial plexus nerves.
Cortisone injections into painful joints are common, have been for a time. But research I've read posits the theory that cortisone is actually harmful to the structures of joints, that it causes degeneration of tendons and bursa. Ask your doctors about this research:
Ask whether you should give therapeutic massage a try before going under the knife again.
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Response:
Hello Gary,
Thank you for the information, just saw your note. I only have tingling on the bottom side of my left index finger for the most part (which is really bothersome & annoying) and slightly on the bottom side/tip of my left thumb. A compression glove I wear often really helps mask the sensation. I put prescription pain patches on the back side of my elbow and forearm when they start hurting~ although at 48 years old I would hope there would be a better longer-term fix. My left shoulder surgery (Arthroscopic Subacromial Decompression & Distal Clavical Excision) was nearly a year ago and very thankfully I am virtually pain-free, except when I recently helped move some lighter weight things in my office... then I knew I had to stop!
I do have some pretty deep pain/tenderness underneath my armpit area on the back side and at the top of my arm where it attaches to my body, if that makes sense, it's very sore actually for quite some time. Perhaps that is from tight muscles?? I am 5'10 1/2" tall but somewhat shortwaisted. I tried your exercise with standing & extending and there was some tightness in my forearm. Some general tingling too in my hand when I pointed my hand upwards when extended out.
So if you don't think it's supinator syndrome or pronator teres compression syndrome (which I have heard is rare), I know it's not carpal tunnel (I have an office job for 30 years), I think it is a nerve somewhere in my either upper arm or elbow area (possibly compressed or entrapped) that is giving me grief, but am not sure where exactly. Don't worry, I won't be having any more cortisone injections into my elbow~ also had them in my neck (3 - no relief) & left shoulder (2) before having the surgery.
My shoulder surgeon will recommend me to a peripheral neurosurgeon, do you think this would be the best next step? I just think there is something yet they still haven't discovered and have been to many specialists over the past 4 to 5 years (some didn't listen so had to seek treatment elsewhere which was very costly & frustrating). Massages I do have access to, although it all costs $ and seems like a temporary fix. I had 5 visits of acupuncture a few months ago in my left hand and forearm and no change in pain level. I don't have a long neck as TOS would indicate or tingling in the last three fingers. Why I would only have pain in my left shoulder/arm/hand is amazing from the neck surgery & fusion in C5-C7, which did not help any tingling issues in my left index finger, although could have stopped the progression of further damage. I have cervical spinal stenosis as well. Am planning to try a TENS unit to see if that helps with the chronic pain.
Thanks much for all your help & suggestions! I look forward to hearing your response. Hope I have given you enough information!