Neck Stiffness and Hand Numbness: When to Seek Help

Numbness in the hands and stiffness in the neck and shoulders?

Hello, about two months ago, I started experiencing significant stiffness in my shoulders and neck, particularly when tilting my head forward to the right, which stretches the muscles on the left side.
Initially, I thought it was due to a stiff neck or compensation from improper lifting during weight training, but heat therapy, massage, and stretching have not improved the condition.
Recently, over the past two weeks, I have also developed symptoms of hand numbness.
In my left hand, I feel slight numbness in the shoulder, outer arm, and the back of the hand (most notably in the middle, ring, and little fingers).
In my right hand, while it doesn't seem to be related to the stiff neck, I experience soreness in the outer arm in certain positions.
Should I visit a rehabilitation specialist or a neurologist? Can I go to a general clinic, or do I need to go to a large hospital for a detailed examination? What specific tests should be conducted? Thank you for your response!

Ling, 40~49 year old female. Ask Date: 2021/10/12

Dr. Jiang Junyi reply Neurology

Dear Ms.
Ling,
You mentioned experiencing slight numbness in your left hand, specifically in the shoulder, outer arm, and the back of the hand (most notably in the middle finger, ring finger, and little finger).
This may indicate potential compression of the nerve root at the seventh cervical vertebra.
I recommend that you visit a neurologist or a rehabilitation specialist for evaluation (such as nerve conduction studies and electromyography) and treatment.
The physician will prescribe medication and rehabilitation therapy based on your condition.
Thank you for your inquiry.
If you have any related questions, feel free to discuss further!
Wishing you good health and peace,
Dr.
Jiang Junyi, Department of Neurology, Taoyuan Hospital

Reply Date: 2021/10/12

More Info

Neck stiffness and hand numbness can be indicative of several underlying conditions, and it’s important to approach these symptoms with a thorough understanding of potential causes and appropriate next steps. Given your description of symptoms, including significant neck stiffness, discomfort when tilting your head, and the onset of numbness in your left hand, it is advisable to seek medical attention.

When to Seek Help
1. Duration and Severity of Symptoms: Since you have been experiencing these symptoms for about two months without improvement, it is crucial to consult a healthcare professional. Persistent symptoms, especially those that worsen or evolve (like the addition of numbness), warrant further evaluation.

2. Associated Symptoms: The presence of numbness, particularly if it affects specific fingers or areas of the hand, can suggest nerve involvement. This could be due to cervical radiculopathy, where nerve roots in the neck are compressed or irritated, often leading to pain, weakness, or numbness radiating down the arm.

3. Impact on Daily Life: If your symptoms are affecting your ability to perform daily activities or causing significant discomfort, it is a clear indication that you should seek medical advice.

Which Specialist to See
Given your symptoms, you have a couple of options:
- Physical Medicine and Rehabilitation (PM&R) or Rehabilitation Specialist: These specialists can assess musculoskeletal issues, provide rehabilitation strategies, and help manage pain. They may also recommend physical therapy to improve neck mobility and strength.

- Neurologist: If there is a concern about nerve involvement, a neurologist can perform a detailed neurological examination and may recommend tests such as electromyography (EMG) and nerve conduction studies to assess the function of your nerves and muscles.

- Orthopedic Specialist: An orthopedic doctor specializing in the spine may also be beneficial, especially if there are concerns about structural issues in the cervical spine.

Diagnostic Tests
When you visit a healthcare provider, they may recommend several diagnostic tests to better understand your condition:
1. X-rays: To check for any structural abnormalities in the cervical spine.

2. MRI: This imaging test provides detailed images of soft tissues, including discs and nerves, and can help identify herniated discs or other issues that may be compressing nerves.

3. EMG and Nerve Conduction Studies: These tests assess the electrical activity of muscles and the speed of nerve signals, helping to determine if there is nerve damage or compression.

4. Blood Tests: Sometimes, blood tests may be ordered to rule out inflammatory or autoimmune conditions that could be contributing to your symptoms.

Conclusion
In summary, given the persistence and nature of your symptoms, it is advisable to seek medical attention promptly. You can start with a visit to a general practitioner who can then refer you to the appropriate specialist, whether it be a rehabilitation specialist, neurologist, or orthopedic doctor. Early intervention can lead to better outcomes and help alleviate your symptoms more effectively. Don't hesitate to advocate for yourself and ensure that you receive the comprehensive evaluation and care that you need.

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