By: Dr. Amanda Meyers
Have you ever woken up in the middle of the night and you can’t feel your arm? Have you ever picked your own arm up to hang it over the side of the bed so the feeling comes back? Is this happening to you during the day? Although it can be humorous when your arm feels like you you’ve permanently hit your “funny bone,” it is important to determine the cause of such sensations.
An individual may experience numbness and tingling in the arms due to a number of possibilities… but why is it happening to you?
When a patient describes symptoms of “numbness and tingling” the first piece of the puzzle is found. Nerves are the primary suspect. Different pain or discomfort descriptors are associated with different structures or systems in the body. For example, when a patient complains of “throbbing,” the vascular system is considered. Numbness and tingling in the arms or hands? The search begins to answer the following questions: what nerves are being affected? Where are the nerves being affected?
Let’s take a trip… starting in the neck and ending in the fingers. In the neck, spinal nerves originate from the spinal cord and exit through the vertebrae. Each spinal nerve from the neck, or cervical spine, and upper back, thoracic spine, represent a particular sensation pattern in the arm known as determatomes. For example, the 7th cervical spinal nerve supplies sensation to the middle finger. Each spinal nerve can be injured or compressed by structures surrounding the area of which they exit the spine:
From injury to the spinal cord
From a disc condition, possibly a bulging or herniated disc
From compression within the hole or “foramen” where the nerve exits the spinal column
From soft tissue and musculature where the nerve exits the spinal column
Next we follow the spinal nerves to a bundle where the nerves join together and proceed to split to become “peripheral nerves.” For example, the Median Nerve contains portions of the 5th, 6th, 7th and 8th cervical spinal nerves and also the 1st thoracic spinal nerve. The Median Nerve provides sensation to half of the hand begins in this bundle called the “brachial plexus.” As seen in the picture, the brachial plexus is an extremely complex matrix of nerves that travels through the neck, shoulder and chest before breaking off to supply the arm. A condition commonly known as “Thoracic Outlet Syndrome” can result in the compression of nerves associated with the brachial plexus. The following structures can cause possible compression:
- The group of scalene muscles in the neck
- The muscles of the rotator cuff in the shoulder
- The first few ribs
- The pectoral muscles
Further down the pathway, nerves continue to divide. Muscles in the arm, such as the biceps and triceps can entrap the traveling nerves. For example, the Ulnar nerve follows a path down the back of the arm and can “get caught” by the triceps in a groove in the bone known and the “ulnar groove.”
Once we pass the elbow, more muscles such as Pronator Teres and the muscles that move the wrist and fingers, can tighten and compress the nerves.
Finally we reach the wrist and the Carpal Tunnel, of which many people are familiar. When a person experiences Carpal Tunnel Syndrome, a particular pattern of symptoms are present. Even the tiny muscles in the hand can contribute to sensations of numbness and tingling.
As illustrated by the diagrams, the pathway from neck to hand contains many opportunities for your arms to “fall asleep.” In fact, more than one area of entrapment can be experienced at a time, complicating the diagnosis and treatment.
Chiropractors specialize in the anatomy and nervous system of the body in order to solve the puzzle and find non-invasive treatment possibilities for patients to experience relief. During an exam, a chiropractor performs neurological and orthopedic testing along with manual palpation of the muscles and joints to locate the origin of the numbness and tingling symptoms. Determined by the doctor’s findings, a treatment plan is implemented to alleviate symptoms by affecting not only the joints, but also the soft tissue (muscles, tendons and ligaments).
Personally, finding the pieces of the puzzle and relieving the areas of injury and compression is a satisfying and rewarding way to spend my day. If you experience symptoms of numbness and tingling, find out where it comes from by asking your chiropractor.