Right Arm Pain and Numbness: When to Seek Medical Help

Q: Right Arm Pain and Numbness: When to Seek Medical Help

Hello, Ms. <br>Ruby：<br>The symptoms you mentioned seem to indicate two issues combined. <br>You noted that "the palms and fingers also feel numb, and at their worst, even the vibrations while riding a bike can cause the entire palm to go numb and unable to grip." This symptom re

Right arm swelling and pain extending to finger numbness?

Hello, I have been working in the food industry for a long time, and recently my right wrist appears more swollen compared to my left wrist and is less flexible.
It hurts whenever I exert force, and I even struggle to push myself up when sitting on the ground.
I went to a nearby rehabilitation clinic where an ultrasound confirmed inflammation, but the rehabilitation has not shown much improvement.
Additionally, my palm and fingers also experience numbness; at its worst, even the vibrations while riding a bike cause my entire palm to go numb, making it difficult to grip.
Recently, I have had slight improvement through acupuncture and manipulation from traditional Chinese medicine, but the numbness in my palm and occasional weakness in gripping still affect my sleep and work, and my arm always feels swollen...
(I find that the compression from the blood pressure cuff provides some relief for me).
Today, while lying down at home, I noticed that my shoulder unconsciously tenses up, causing my right shoulder to be higher.
When I stretch my arms out in a T-shape, I feel a swollen and painful sensation in the area of the posterior deltoid near the triceps on my right arm, which extends down to my fingers, and soon my fingers become numb.
I would like to ask which department I should visit for further examination and how I should describe my symptoms? Previously, when I mentioned my hand numbness to the rehabilitation department, they told me that everyone experiences hand numbness...

ruby, 30~39 year old female. Ask Date: 2022/09/28

Dr. Jiang Junyi reply Neurology

Hello, Ms.
Ruby:
The symptoms you mentioned seem to indicate two issues combined.
You noted that "the palms and fingers also feel numb, and at their worst, even the vibrations while riding a bike can cause the entire palm to go numb and unable to grip." This symptom resembles carpal tunnel syndrome, where the median nerve, which runs through the wrist, passes through the "carpal tunnel" formed by the wrist bones and ligaments.
The clinical symptoms are caused by compression from the ligament located above the nerve.
The median nerve is responsible for the movement of the thumb and provides sensation to the thumb, index finger, middle finger, and part of the ring finger.
Carpal tunnel syndrome typically occurs in individuals who perform repetitive wrist movements.
You also mentioned "a feeling of swelling and soreness extending from the back of the right arm near the deltoid to the triceps down to the fingers," which resembles discomfort associated with cervical radiculopathy, including pain in the shoulder or arm, as well as numbness, tingling, and weakness in the palm and fingers.
Cervical spine disorders may cause neck pain and stiffness, leading to pain due to compression of nearby nerve roots, which can extend to the temples, shoulders, arms, and hands, causing discomfort.
Symptoms of peripheral nerve compression include:
1.
Pain characterized by burning or electric sensations.
2.
Symptoms with a specific dermatomal distribution, which can be triggered by touch or pressure.
3.
Accompanied by muscle weakness and fatigue.
I recommend that you consult with a neurologist or a rehabilitation specialist to discuss examination and treatment options.
If the situation is particularly troubling, it may be beneficial to seek out a neurologist specializing in peripheral nerves, as they have more experience with electromyography diagnostics.
Thank you for your inquiry, and feel free to discuss any related questions! Wishing you good health and peace.
Dr.
Jiang Junyi, Taoyuan Medical Center, cares for you.

Reply Date: 2022/09/28

More Info

When dealing with persistent right arm pain and numbness, especially in the context of a physically demanding job like working in the restaurant industry, it’s crucial to understand the potential underlying causes and when to seek further medical evaluation. Based on your description, it seems you are experiencing a combination of wrist swelling, pain, and numbness in your hand and fingers, which can significantly impact your daily activities and quality of life.

Understanding Your Symptoms
1. Swelling and Pain in the Wrist: The swelling in your right wrist, coupled with pain during movement, suggests a possible inflammatory condition. This could be due to repetitive strain injuries, which are common in professions that require frequent wrist and hand movements. Conditions such as tendinitis or tenosynovitis could be contributing to your symptoms.

2. Numbness and Tingling: The numbness and tingling in your fingers, especially when exacerbated by activities like riding a bike, may indicate nerve involvement. Conditions such as carpal tunnel syndrome, where the median nerve is compressed at the wrist, or ulnar nerve entrapment could be potential culprits. The fact that you experience relief from pressure (like when measuring blood pressure) suggests that your symptoms may be related to nerve compression.

3. Shoulder and Arm Discomfort: The observation that your right shoulder appears elevated and that you feel discomfort in the triceps area extending to your fingers could indicate a postural issue or muscle imbalance. This can occur when one side of the body compensates for weakness or pain on the other side, leading to further discomfort and potential nerve irritation.

When to Seek Medical Help
Given the persistence and severity of your symptoms, it is advisable to seek further medical evaluation. Here are some steps you can take:
1. Consult a Specialist: You should consider seeing an orthopedic specialist or a neurologist. An orthopedic doctor can evaluate musculoskeletal issues, while a neurologist can assess nerve-related problems.
2. Describe Your Symptoms Clearly: When making an appointment, be specific about your symptoms. You might say, "I have persistent swelling and pain in my right wrist, numbness in my fingers, and discomfort in my shoulder and arm. These symptoms have been affecting my ability to work and sleep." Mention any treatments you have tried, including physical therapy and acupuncture, and their effects.

3. Request Diagnostic Tests: Ask your doctor if imaging studies, such as an MRI or ultrasound, are necessary to assess the soft tissues, nerves, and joints in your arm and shoulder. These tests can help identify any structural issues that may be contributing to your symptoms.

4. Consider a Comprehensive Approach: In addition to seeing a specialist, consider a multidisciplinary approach that includes physical therapy focused on strengthening and stretching exercises, ergonomic assessments to improve your work setup, and possibly occupational therapy to help you adapt your activities to minimize strain.

Conclusion
In summary, your symptoms warrant further investigation, especially given their impact on your daily life and work. Seeking an appointment with an orthopedic or neurologic specialist will provide you with a clearer understanding of your condition and appropriate treatment options. Early intervention can prevent further complications and help you regain function in your right arm. Remember to advocate for yourself and ensure that your concerns are taken seriously, as persistent symptoms should not be dismissed as a normal part of life.

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