Numbness And Tingling, Arlington Texas
Numbness And Tingling: Finding Where The Nerve Is Caught
The short answer
Numbness and pins and needles mean a nerve is involved somewhere along its length, and the useful question is where. A nerve root can be irritated where it leaves the spine, and the same nerve can be squeezed further along at the shoulder, the elbow or the wrist. The pattern on your skin narrows it down, which is why it gets mapped rather than guessed at from where the ache is. Not all of it is mechanical: diabetes, thyroid problems and vitamin deficiency all cause it, and those belong with a physician.
The Mechanism
A Nerve Can Be Caught At More Than One Place
A nerve runs from the spinal cord out to the skin, and it can be irritated anywhere along that route. Where it leaves the spine, the opening is bounded by a disc in front and a small joint behind, so a disc that has bulged or a joint that has thickened with age can narrow it. Further along, the same nerve passes through tunnels at the shoulder, the elbow and the wrist, and it can be compressed at any of them.
Where it hurts and where it is caught are frequently not the same place, which is why the numb patch tells you more than the ache does.
- Which fingers, or which part of the foot, because each nerve level supplies a defined strip of skin
- Whether specific muscles have lost strength, tested one at a time
- Whether the reflexes at that level have changed
- What position brings it on, and what makes it stop
That is what an examination is for. A numb patch over the thumb side of the hand points somewhere different from a numb patch over the little finger, and treating the sore spot without knowing which is the reason some of these run for months.
What The Research Says
Most Of It Settles, And Most Of It Had No Injury
The population study on this is from the Mayo Clinic, published in Brain in 1994, covering every case of cervical radiculopathy in Rochester, Minnesota over fifteen years. It found 561 patients, an average annual incidence of 83.2 per 100,000, rising to a peak of 202.9 per 100,000 in people aged 50 to 54.
Only 14.8 percent had any physical exertion or injury before it started. The great majority of these arrive with no event to blame.
- A confirmed disc protrusion was responsible in 21.9 percent of cases
- 68.4 percent were related to spondylosis, a disc, or both together
- The C7 nerve root was the most commonly involved, then C6
- At last follow-up, 90 percent were free of symptoms or only mildly affected
- It came back in 31.7 percent, and 26 percent went on to surgery
Two honest things sit in those numbers. The outlook is genuinely good, and it recurs in about a third of people, which is the argument for finding out what loaded that level in the first place rather than only settling the current episode.
Why muscle testing is part of the examination here
Dr. India Monet is certified in applied kinesiology, and manual muscle testing is used as an examination tool. On a nerve problem that is exactly the right question to be asking, because objective muscle weakness at a specific level is one of the findings that changes what should happen next. In the Mayo study, radicular pain together with a sensory deficit and objective weakness was what predicted a decision to operate.
Being Straight With You
Plenty Of Numbness Is Not A Spine Problem
Nerves are affected by the body's chemistry as well as by pressure. Diabetes is the most common medical cause of numbness in the feet, and thyroid disease and B12 deficiency both do it too. Those produce a different pattern, usually symmetrical and starting in both feet, and no amount of treatment here changes any of them.
If the examination points that way, you are told to see your physician and what to ask them for. There is no imaging and no blood testing in this building, so pretending otherwise would only cost you time.
Read This First
Numbness That Belongs In An Emergency Room
If You Notice Any of These Warning Signs, Please Seek Emergency Room Care Right Away.
- Numbness in the saddle area, the parts that would touch a bicycle seat
- Numbness in both legs at once
- Weakness that is getting worse rather than staying the same
- Any change in bowel or bladder control, including not being able to feel it
- A foot that drops, or a hand that cannot grip
- Numbness with fever and spinal pain, or with a history of intravenous drug use
- New numbness with a history of cancer
- Numbness that started after a fall, a collision or any significant trauma
- Sudden numbness down one side of the body, or with speech or vision change
Saddle numbness, numbness in both legs, worsening weakness and any bowel or bladder change together indicate cauda equina syndrome, which is a surgical emergency measured in hours. Go to an emergency room. Do not book an appointment here and do not wait for it to settle.
Common Questions
Numbness And Tingling, Asked And Answered
Does numbness mean nerve damage?
Usually it means a nerve is irritated rather than damaged, and irritation recovers. In the Mayo population study 90 percent of people were free of symptoms or only mildly affected at last follow-up. Weakness that is getting worse is the finding that changes the urgency.
Why do you test my strength if the problem is numbness?
Because a nerve carries movement as well as sensation, and objective weakness at a specific level tells you which nerve and how much it is being affected. In the Mayo study that combination was what predicted a decision to operate, so it is worth measuring rather than assuming.
I did not injure myself. Can it still be my neck?
Yes, and that is the usual story. In that study only 14.8 percent of cases had any physical exertion or trauma before onset, and 68.4 percent were related to spondylosis, a disc, or both.
Could it be a trapped nerve at my wrist instead?
It could, and the two are told apart by which strip of skin is numb and by where the symptoms are provoked. The same nerve can be caught at the neck, the shoulder, the elbow or the wrist, so the pattern gets mapped rather than assumed.
Do I need an MRI?
Not usually, and not first. Imaging answers a specific question raised by an examination. There is no imaging equipment in this building, so if your findings raise a real question you are referred for a scan rather than treated around it.
Do you take insurance for this?
Insurance and paying directly both work. Call 817-800-7136 and ask before you book, and you will be told how it works in your case. Appointments only, so a visit has to be booked.
Sources
Where The Numbers On This Page Come From
- Epidemiology of cervical radiculopathy. A population-based study from Rochester, Minnesota, 1976 through 1990. Radhakrishnan K, Litchy WJ, O'Fallon WM, Kurland LT. Brain 1994;117(Pt 2):325 to 335. Records-linkage survey of 561 patients over fifteen years. Source of every figure quoted: average annual age-adjusted incidence 83.2 per 100,000, peak 202.9 per 100,000 at ages 50 to 54, preceding exertion or trauma in only 14.8 percent, confirmed disc protrusion in 21.9 percent, spondylosis or disc or both in 68.4 percent, C7 the most frequent root followed by C6, recurrence 31.7 percent, surgery 26 percent, and 90 percent asymptomatic or only mildly incapacitated at last follow-up.
Get The Pattern Mapped Properly
Call and describe exactly where it goes and what brings it on, or book online and pick a time.
3825 W Green Oaks Blvd, Suite 710, Arlington, TX 76016. Appointments only.