Hello ~ am new to this site. Has anyone have their left index finger numb & tingly plus have tennis elbow in left arm? I had a cervical fusion C5-C7 and foraminotomy (2008) and left shoulder surgery (2010). Some of this is due to structural issues but also due to an overuse injury 4 years ago. I have had 2 cortizone injections this year into my left elbow that have worn off after a few weeks, and still have the finger numbness which is very annoying (there probably is residual from my neck), but I am still hopeful there is something they haven't found yet, perhaps in my elbow? I have had multiple EMGs, MRIs, CT scans, you name it... my last EMG in early 2010 finally said it was Abnormal and consistent with chronic changes persisting following a left C5 cervical radiculopathy. My left deltoid and bicepts muscles showed chronic motor unit changes.

I have done some research online and possibilities are: pronator teres syndrome, median nerve palsy, anterior interosseous syndrome, or posterior interosseous nerve compression syndrome.

Really wonder if it's a median nerve causing my problem (since everything is connected) or nerve compression in my elbow. Am going to the surgeon (to check out my left shoulder/elbow) again on Tuesday, so would be nice to have more info. if you have a similar experience. Thanks!

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: http://orthopedics.about.com/u/ua/in.../cortisone.htm
Ask whether you should give therapeutic massage a try before going under the knife again.

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!

Hi Goldie,

Since you mention the 30 yrs of office work , I'd like to suggest you read on our Thoracic outlet syndrome forum (TOS) for short...

here's the link to the useful sticky thread tone of info-
http://neurotalk.psychcentral.com/thread84.html

Even if symptoms don't fit for you- many of the therapies & tips are good for anyone.

Pec minor pain/tightness
ring/pinky finger sx
neck/shoulder pain /tightness

Do you have a forward head/shoulders posture??
Often happens when long term desk/office work.
If so it closes down & crowds the area that provides blood flow & nerves to arm & hands.

Just sharing what may, or not, be helpful. An oncological radiologist shared his story with a short session of acupuncture eliminated an elbow soreness that he had, which had been tentatively diagnosed as carpal. He also said that acupuncture had been helpful for patients whose muscles did no recover well from radiation. Often, these muscles act as if frozen...not moving easily... and acupuncture has been definitely helpful for many of them... as attested by this physician. PS - I was surprised that this particular acupuncturist only charged $60 per session... as opposed to nearby practicioners who charge $100.