Numbness in the Thumb and Back: Causes and Concerns

Mild numbness in the right thumb and slight numbness in the back?

Doctor, I started experiencing a slight tingling sensation around my right thumb yesterday (similar to the feeling of a foot falling asleep but not going away, though it's mild and only noticeable when touched).
Only my right thumb is affected.
Today, I've also felt a bit of tingling in my back, but I'm unsure if it's psychological since I've never experienced this before.
Is this a serious issue? Will I need surgery? Thank you.

Additionally, I previously had shoulder and neck pain and consulted a doctor who diagnosed me with a herniated disc at the C5-C6 level.
I underwent physical therapy (electrical stimulation, heat therapy, traction, ultrasound) about 6 to 7 times, and the doctor did not recommend surgery.
After my condition improved, I stopped returning for follow-ups.
Could there be a connection between these two issues?

Fuqi de ren, 20~29 year old female. Ask Date: 2021/11/15

Dr. Jiang Junyi reply Neurology

Dear Mr.
Fook Chi,
You mentioned that "there is a slight tingling sensation around the right thumb...
and that you have seen a doctor for shoulder and neck pain, which was diagnosed as a herniated disc at the C6 level." It is important to consider that the C6 nerve root may be compressed, leading to sensory abnormalities.
Cervical spine joint degeneration can cause neck pain and stiffness, and when it compresses nearby nerve roots, it can lead to tingling and pain that may extend to the temples, shoulders, arms, and hands, causing discomfort.
Treatment may include medication: when nerves are compressed, an inflammatory response occurs, resulting in symptoms such as pain, numbness, and weakness.
Non-steroidal anti-inflammatory drugs (NSAIDs) can be used for treatment, as they have both anti-inflammatory and analgesic properties, which can reduce the inflammatory response and alleviate tingling pain.
I recommend changing your posture every 15 minutes to allow the neck tissues to rest.
Maintaining any posture (including a normal one) for an extended period can lead to tissue fatigue and inflammation, so moving around briefly can reduce the chances of muscle inflammation.
I suggest consulting with a neurologist or a rehabilitation specialist to discuss examination and treatment options.
Thank you for your inquiry, and feel free to reach out for further discussion on related issues!
Wishing you good health, peace, and happiness.
Dr.
Jiang Junyi, Department of Neurology, Taoyuan Medical Center

Reply Date: 2021/11/15

More Info

Numbness in the thumb and back can be concerning, especially when it appears suddenly and is accompanied by a history of spinal issues. Based on your description, it seems you are experiencing localized numbness in your right thumb, along with some mild numbness in your back. Let's break down the potential causes and concerns regarding these symptoms.

Possible Causes of Numbness in the Thumb
1. Nerve Compression: Given your history of cervical disc herniation (specifically at the C5-C6 levels), it's possible that the numbness in your thumb is related to nerve compression. The median nerve, which innervates the thumb and parts of the hand, can be affected by cervical spine issues. If the herniated disc is pressing on the nerve root, it can lead to numbness or tingling sensations in the areas it supplies.

2. Cervical Radiculopathy: This condition occurs when a nerve in the neck is compressed or irritated, leading to pain, weakness, or numbness in the arm or hand. Symptoms can vary based on which nerve root is affected. Since you have a history of cervical disc issues, this could be a plausible explanation for your thumb numbness.

3. Peripheral Neuropathy: While less likely given your specific symptoms, peripheral neuropathy can cause numbness in the extremities. This condition is often related to diabetes, alcohol use, or certain medications, but it typically affects multiple fingers or toes rather than being isolated to one area.

4. Repetitive Strain Injury: If you engage in activities that require repetitive motion of the wrist or hand, such as typing or using a mouse, you may develop symptoms similar to carpal tunnel syndrome, which can cause numbness in the thumb.

Back Numbness
The mild numbness in your back could be related to several factors:
1. Muscle Strain: If you have been engaging in activities that strain your back muscles, this could lead to localized numbness or discomfort. Muscle strains can sometimes cause referred sensations that mimic nerve-related issues.

2. Nerve Involvement: Similar to the thumb, if there is any irritation or compression of the spinal nerves in the thoracic region, it could lead to numbness in the back. This is less common but still a possibility.

Should You Be Concerned?
While occasional numbness can be benign, the persistence of these symptoms, especially given your medical history, warrants further evaluation. Here are some steps you should consider:
- Consult a Specialist: Given your history of cervical disc issues, it would be wise to consult a neurologist or an orthopedic specialist who can evaluate your symptoms in the context of your previous condition. They may recommend imaging studies, such as an MRI, to assess for any changes since your last evaluation.

- Physical Therapy: If your symptoms are related to nerve compression, physical therapy may help alleviate some of the pressure on the affected nerves. Therapists can provide exercises to strengthen the neck and improve posture, which can be beneficial.

- Avoiding Aggravating Activities: Pay attention to activities that may exacerbate your symptoms. If certain positions or movements worsen the numbness, try to modify them.

Surgical Considerations
Surgery is typically considered a last resort for nerve compression issues, especially if conservative treatments (like physical therapy and medication) have not provided relief. If your symptoms worsen, or if you experience significant weakness or loss of function, surgical options may need to be discussed with your healthcare provider.

Conclusion
In summary, the numbness in your thumb and back could be related to your previous cervical spine issues, particularly nerve compression. It is essential to seek further evaluation to determine the underlying cause and appropriate treatment. Early intervention can help prevent further complications and improve your quality of life.

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