Skin Pain and Numbness in the Arm: A Neurological Perspective

Skin prickling and finger numbness?

Hello, my symptoms started on April 17th with a tingling sensation and occasional sharp pain in the inner skin of my left arm when lightly touched or rubbed against clothing.
On that day, I also experienced general fatigue and a mild headache.
From April 18th to April 19th, I only had the tingling and occasional sharp pain in the inner skin of my left arm.
On April 20th, the tingling and sharp pain spread to the skin on the upper left chest near the armpit, along with weakness in my left hand and numbness in my left pinky and ring fingers.
Today, I also have a mild headache, and in the evening, I felt like I had a low-grade fever with a temperature of 36.9 degrees Celsius, but it returned to normal shortly after.
I couldn't find any similar cases online, so I would like to consult a doctor.
Thank you.

EDEN, 30~39 year old female. Ask Date: 2023/04/21

Dr. Jiang Junyi reply Neurology

Dear Ms.
Eden,
You mentioned that on April 20th, the areas of pain and discomfort, in addition to your left arm, include the skin on the upper left chest near the armpit, along with weakness in your left hand and numbness in your left pinky and ring fingers.
This may suggest compression or inflammation of the first thoracic nerve root.
If you are experiencing fever, it may indicate an inflammatory or infectious issue.
Symptoms of peripheral nerve abnormalities include:
1.
Pain characterized by burning or electric shock sensations.
2.
Symptoms that have a specific dermatomal distribution, which can be triggered by touch or pressure.
3.
Accompanied by muscle soreness and weakness.
Examinations for peripheral nerve issues typically involve electrophysiological studies to assist in diagnosis.
Nerve conduction studies assess the conduction velocity and waveform of large fiber nerves.
Electromyography (EMG) evaluates muscle responses in the areas supplied by the affected nerves.
I recommend that you visit a neurology clinic for further evaluation and follow-up.
It would be beneficial to consult a physician specializing in peripheral nerves, as they have more experience with EMG testing.
Thank you for your inquiry.
If you have any further questions, feel free to discuss them!
Wishing you good health and peace,
Dr.
Jiang Junyi, Department of Neurology, Taoyuan Hospital

Reply Date: 2023/04/21

More Info

Your symptoms suggest a potential neurological issue, particularly involving the peripheral nerves. The tingling, sharp pain, and numbness you are experiencing in your left arm, along with the weakness in your hand and the discomfort in your chest area, are indicative of possible nerve compression or irritation. This could be due to several factors, including a pinched nerve in the cervical spine, thoracic outlet syndrome, or even a condition like carpal tunnel syndrome, which can cause similar symptoms in the arm and hand.

The fact that you are experiencing these symptoms after a period of fatigue and mild headache could suggest that your body is under stress, which can exacerbate nerve-related issues. Stress can lead to muscle tension, which may further compress nerves, leading to the symptoms you describe. Additionally, the sensation of pain upon light touch or clothing contact is known as allodynia, which is often associated with neuropathic pain conditions.

Given the location of your symptoms, it is essential to consider the possibility of thoracic outlet syndrome, where nerves or blood vessels are compressed in the space between the collarbone and the first rib. This condition can cause pain, tingling, and weakness in the arm and hand. Another possibility is cervical radiculopathy, where a nerve root in the neck is compressed or irritated, leading to pain and sensory changes in the arm.

To address your concerns, it is crucial to seek a thorough evaluation by a healthcare professional, preferably a neurologist or an orthopedic specialist. They may recommend imaging studies, such as an MRI or CT scan, to assess for any structural issues in the cervical spine or thoracic outlet. Additionally, nerve conduction studies or electromyography (EMG) can help determine the functionality of the nerves and identify any areas of damage or compression.

In the meantime, there are several self-care strategies you can implement to help alleviate your symptoms. These include:
1. Posture Correction: Ensure that your posture is optimal, especially if you spend long hours sitting or working at a computer. Poor posture can contribute to nerve compression.

2. Stretching and Strengthening Exercises: Gentle stretching of the neck and shoulder muscles can help relieve tension. Strengthening exercises for the shoulder girdle may also provide support and reduce symptoms.

3. Heat and Cold Therapy: Applying heat can help relax tense muscles, while cold therapy can reduce inflammation and numb pain.

4. Stress Management: Engaging in relaxation techniques such as deep breathing, meditation, or yoga can help manage stress and reduce muscle tension.

5. Ergonomic Adjustments: If you work at a desk, ensure that your workstation is ergonomically designed to minimize strain on your neck and arms.

6. Vitamin B12 and Other Nutrients: Ensure you are getting adequate nutrition, particularly B vitamins, which are essential for nerve health.

7. Avoiding Repetitive Movements: If your activities involve repetitive motions, try to take breaks and vary your tasks to reduce strain on your nerves.

In conclusion, while your symptoms may be concerning, they can often be managed effectively with appropriate medical evaluation and treatment. It is essential to address these symptoms promptly to prevent further complications and improve your quality of life. Please consult a healthcare professional as soon as possible for a comprehensive assessment and tailored treatment plan.

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