Numbness

[Shenanigans]

Hi,
I need advice. I have a client that describes here pain as "My hand started going numb last night before bed and then woke me up several times thru the night with a burning sensation and numbness both. It was mainly in my ring and middle fingers, with some aching in the ring finger joints also". She's pretty much a train wreck of tight muslces on her neck, shoulders and upper back so I've worked the entire area. I must be missing something since it'll help for for a couple of days and then be back. She doesn't do the homework stretches or use the heat pad that I loaned her either. I guess that I should add that she's gone to a chiro a couple times in between appointments with me. Any advice or suggestions? I'm thinking of forwarding her to a Rolfer here in town. I realize she won't get better if she doens't help herself but I'm guess I'm asking if there is something I could do to be more effective? Thanks for letting me blather. :?
Karen

 

[yotu]

Try working the pectoralis minor (it probably will be very sensitive to your client) in addition to everything else. It seems to get overlooked. Often, When it is hypertonic it impinges the brahial plexus causing the numbness down the arm and hand.

Also, suggest to your client to do pec "doorway" stretching several times a day.

Hopefully that will relieve the symptoms over a few sessions.

 

[:))]

Thanks, I'll focus some extra attention on the pec minor.
As for the stretches...the doorway pec stretch is what I gave her as homework.

 

[HOV Ranch]

I find it helpful to remind my clients that I have them only one hour out of the entire week, and while we can do a lot of good work in an hour, they will not get to keep their good work unless they follow up with their stretches.

Compliance is pretty good with my people, (either that or they are too scared of me to tell me the truth... :? )

 

[Rae-May]

Do you do any positional release? I find that the medial and lateral elbow releases, combined with either the anterior OR posterior AC joint position, do wonders for my client who has exactly these symptoms. (I would suspect anterior AC tender point -- that's the one that signals you to release pec minor.)

Might not be the whole story -- scalenes might need a shortening/release too, esp. at the 1st & 2nd rib attachments . . .

 

[HOSS]

Has she been checked for bone spurs on her cervical vertebrae?

 

[agent 007]

numbness

Along with the other great advice, I would ask your client if she sleeps on her side in the evening. It is possible to re-train yourself to sleep on your back when you are in pain, and this would prevent any further tightening of the pec muscles over the brachial plexus.

 

[cookie25]

Hi, SimplyBee!

Check out TOS (Thoracic Outlet Syndrome) -- That was what was causing my neck/shoulder/arm/hands to be in pain and go numb especially at night. I still find that once in awhile they will go a bit numb -- only if I am sleeping on either side. I just switch to lying on my back and the numbess disappears.

After seeing MDs and getting tests for almost four months (with no real results) it was an MT that figured out the problem! I was so impressed that I went back to school at age 53 to become an MT!

(By the way, Walt Fritz, it was a JFB-MFR Specialist who solved it on the very first visit! Two more visits and it was totally gone! He also encouraged me to go back to school. He will forever be my favorite therapist! )

Best, Sherry

 

[Willow]

Thanks everyone. We have a rolfer in our office so I'm going to refer her. I worked on pretty much everything I can think of. I've done stretches...given her homework, educated her on body alignement etc...
She emailed me this morning and not much change. I know I'm missing something, I just don't know what. She's also seing a chiro. Here is a piece together of her emails.
To start with it was just the right hand. It is usually still just the
right hand that goes numb, sometimes there will be some light tingling in
one or both hands, but never the arms. The tingling occurs on and off
throughout the day, but the numbness only seems to happen at night after I go to bed and first thing in the morning after I get up.
It is predominantly the ring finger and then the middle finger in the right
hand, but not always and when it goes completely numb it is all five. The
left hand has only gone numb once, but the tingling is mostly in the first
finger. The palms sometimes get tingly in both hands as well, mostly the
right one.
To answer your questions:
Yes, I suggested that she sleep on her back. Yes, I looked into thoratic outlet syndrome. No, I honestly haven't done much with positional release but I understand it...just haven't applied it. :?: (no good answer as to why) No, I didn't check for bone spurrs last night. I didn't check this thread right before going to the office.
She had major neck tension and slightly raised shoulders the first time I saw her but it was MUCH better this time. So were the tight pecs.
Her left scapula is still winged up a bit even though I worked on the serratus anterior. Right scapula is fine. When she is supine I did a stretch where I lifed arm over her head like she was raising her hand. She had pain along along Ulnar nerve in the shoulder and the inside of her arm. She had also said that she could flick out her wrists out at night, or press on her elbow, and it would help the pain. I think the wrist flicking was actually being effective at the elbow. She is diabetic and she has slight weakness in her wrists but said it' s nothing new since she wore wrist braces years ago.
It's a nerve problem but I'm not getting it licked.

 

[Pompal 09.]

This reminds me *a little bit* of Cubital tunnel syndrome...

http://www.massageplanet.com/forum/viewtopic.php?t=2440&highlight=carpal+tunnel+syndrome

This is a paragraph from a great article from Dr. Timothy Jameson, at this link http://www.museweb.com/ag/cubital.html

Cubital Tunnel Syndrome begins with pain in the elbow area, along the inner side of the forearm. The pain can travel downwards towards the pinky, and can be accompanied by tingling or numbness sensations to the pinky side of the hand. ...This syndrome will usually only involve the ring and pinky fingers, since these fingers receive their nerve supply from the ulnar nerve.

This doesn't address all symptoms, but maybe will help a little.

 

[California Girl!]

Thanks for the info and links....very interesting.
I talked to her yesterday and she said that the numbness was better. It was less severe and easier get 'un-numb'. Her neck is still sore though. I guess she's been standing in from of a paper shredder getting rid of year end documents so I'm sure that isn't helping her.