Intense numbness and tingling in the hand, arm and shoulder

Patient

Q: I have had frequent (at least 10x a day) intense tingling and numbness in my left arm for a couple months. The numbness and tingling start in my hand and go slowly up my arm to my shoulder and then it feels like something balls up around my shoulder blade. Is this something I should be concerned about or could it wait til my doctors appt on March 23? Its been so intense at times that I think there is permanent nerve damage in the tip of my pointer finger because now that is always numb.

Doctor

A:   Dear Linda:Most likely the tingling and numbness in your hand, arm and shoulder as you described it may be due to a cervical nerve compression , but it would be also important to rule out inflammation the peripheral nerves. In the younger patients, cervical radiculopathy may be a result of a disc herniation or an acute injury causing impingement of an exiting nerve. In the older patient, cervical radiculopathy is often a result of spinal canal narrowing from bone (osteophyte) formation, decreased disc height and degenerative changes due to aging process. The treatment strategy usually includes: physical therapy program aimed to reduce pain and inflammation, and the use of anti-inflammatory medication (“Motrin”, “Aleve”), also a re-education of your habits and posture to improve quality of life. You should be independent in a stretching and strengthening program and continue with these exercises under the periodic supervision of a physical therapist initially and then completely on your own. Patients whose condition fails to improve with a comprehensive rehabilitation program and selective injections should be presented with a surgical evaluation. Often, patients should show progressive improvement over the first 6-8 weeks with conservative treatment. If there is no significant improvement in this time frame, consider a surgical evaluation.

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