Dealing with arm/hand numbness
 

Six weeks ago I was in a bad car accident. I went to the ER right away to make sure nothing was broken and had a really sore neck. Next morning, I wake up and I have intense pain in my right shoulder and numbness/tingling in my hand. Its mostly concentrated in the index finger and thumb. Its been hard to pick up anything over about a gallon of milk, pushing doors open really seems to be a problem too. I've been trying to avoid using it and irritating it.

I had a CT and MRI done and it showed herniation at C5/6 with no significant impingement and to a lesser degree C4/5. Just had an EMG today and while I haven't gotten the final report, the neurologist pretty much said it looked normal. I've been doing PT for 4 weeks now and it seems to have helped with the muscle tension/spasms but my arm is still the same. Range of motion is improving. I'm getting pretty frustrated with my doctors. I have gotten zero answers and very little improvement. My PCP keeps saying that the cervical herniation is not the problem and that the numbness is caused by tight muscles. Neurologist today said to continue with physical therapy. All they do is load me up on muscle relaxers and NSAIDs, but the medication doesn't even touch the pain. I still think its in my neck. My PT is convinced its my neck, but her opinion doesn't seem to matter much to the PCP.

How long is reasonable to say that muscle tension would be causing arm numbness? I was under the impression that six weeks was sort of the standard healing time. Any other treatments/tests that may help? Basically, where do I go from here? I feel like I'm hitting a wall with finding out whats going on.

Hi Ozzy, Welcome to NT.

Standard healing time for what? Trauma to nerves can take a very long time to heal. I can think of a couple of things that might help; others may have other suggestions.

You might ask for a referral to a physiatrist (a.k.a. rehab medicine specialist)

Another possibility is that, rather than muscle tension, it could be one or more myofascial__trigger points, which can also press on nerves, cause symptoms similar to those you describe, telegraph pain/numbness to locations distant from the injury/source, and can last indefinitely without treatment. In my experience, this is best treated by a (Google: ) Certified Myofascial Trigger Point Therapist

Doc

Thanks for replying. I guess the six weeks I was referring to was that my pcp had told me that the majority of herniated discs not causing impingement heal then and muscle tension should subside. I don't really feel like I have much muscle tension in the neck anymore (it has improved significantly) yet the numbness persists.

I searched my hospitals website and I couldn't find any mds listed specifically as physiastrists. Do they sometimes call them something different? There is a Spine Health and Pain Management Center though. Would they probably be a good option to get a referral for?

One thing that REALLY helps Raynaud's in the hands/feet, or other circulation problems is soaking in epsom salts. The magnesium in them opens up the little blood vessels very effectively and can even be better than most drugs.

So give it a try. A pan or sink with 2-3oz of epsom salts and warm water. Twice a day, and see how that goes. We use it on the Peripheral Neuropathy forum here all the time with good results.

AFAIK, they may be called the things listed in the Wiki article (neuromuscular medicine, sports medicine, physical medicine and rehabilitation, etc.) You could google: physiatrist and see if any other names/titles turn up.

Spine Health and Pain Management Center sounds reasonable. Has your PCP offered any suggestions? They usually have the role of coordinator (or are supposed to) rather than other specialists, but I'd listen to/consider suggestions from wherever they come from, then do some homework and try to work out a plan with my PCP's help.

These things can get complicated - the spine & nervous system are complicated. We have to educate ourselves and become our own advocates. Fortunately there are some folks here with some experiences that may help shorten the learning curve a bit.

Doc

What kinds of things are they doing at the PT sessions?

low level laser, ultra sound, IF stim, massage/trigger point?
any of those?

So far, PT has consisted of arm biking (I feel like I've lost some strength) where I let my left arm mostly do the work and the right just follows along, stretching, ultra sound, some massage but not too much. I've been placed on light, light duty by my PT since I can aggravate it by picking up just about anything (wet laundry, milk jug, pushing open heavy door, throw ball for my dogs, etc. etc.). Getting frustrating since I'm 24, good health, no underlying health problems, no prior injury. I had to turn down my dream job, government, 401k, insurance!!! because I can't be in the backcountry (carrying a pack, equipment) for weeks at a time. I shouldn't whine too much because I'm sure a lot of people are in a lot more pain than me, but its getting pretty upsetting. I'm seeing my PCP on Mon. to see if we can't change my meds to something a little more effective, or at least something that allows me to sleep. This is when I'll pop the pain management

I love the suggestion, but I do not live in a home with a bathtub :( Since its my neck/shoulder/arm I don't know if a sink would work, but I might have to try it because my mother used to soak in epsom salts when she was dealing with impinging lumbar discs and leg numbness. It seemed to help her and at the very least gave her some time to relax.

Start with soaking that hand in the sink. You can get a plastic dish pan at walmart or a smallish plastic storage container. ($3).

When I was on vacation I made a saturated solution in a pan,
and soaked a cloth in it, and put that on my knee (at the time).
It has to be renewed every 15 minutes or so.

You can also get topical magnesium lotions and liquids you can rub on now. I use a lotion from CVS (I bought 3 bottles) but they are discontinuing it due to lack of consumer interest.

Here are some types of topical forms:

http://www.epsomit.com/products.html
The body lotion is what is best I think. This is available on the net at Amazon and other places at discounted prices.

and
http://www.swansonvitamins.com/SWU485/ItemDetail

There is also Kirkman's cream:
http://www.amazon.com/Magnesium-Sulf.../dp/B005FMZSDW

I had a patient just before I retired, with scleroderma. Her hands were turning black, and none of the drugs or doctors' treatments worked. I was counseling her on her new medication from a specialist in Texas, and mentioned the epsom salts.... she started and within a week her hands returned to normal color! She then started oral supplements too.

What happens is that magnesium cannot get into the hands and feet from the blood because the vessels clamp down with inflammatory processes. This causes more spasms of the blood vessels and then the tissues suffer. Open them up with magnesium and the blood flows better bringing in nutrients and taking by products of oxidation away. Magnesium also blocks NMDA pain receptors which may be over firing causing more pain.

It would be a good idea to avoid MSG... in foods. This activates that NMDA pain receptor and can make nerve pain worse.

I have a magnesium thread here:
http://neurotalk.psychcentral.com/thread1138.html

And magnesium is a topic we discuss often at our Peripheral Neuropathy forum here.

This is inexpensive and very effective for many people. So do consider trying it.