Every week I get a.few patients who tell me their hands starts to go a little numb, especially since they started working from home. Is this something you should be concerned about? After all, if you ask around, it’s not too common for healthy people to have numbness or tingling in their hands. I want to talk about a commonly misdiagnosed cause of hand numberless!
The many causes of hand numbness
Hand numbness can come from issues in the neck, or entrapped nerves in the shoulder, elbow or wrist, or from a trigger point in the shoulder referring pain. The problem is most doctors only look at issues in the neck with MRI and completely dismiss a good hands on physical exam to check nerve entrapment and trigger points.
Like everything else in medicine it can get a little complicated. Figuring out the cause can be tricky for your regular doctor because they will rely on tools like MRI, which while useful, also causes a slew of misdiagnosis. You see, simply taking a picture (although a very detailed one in the case of MRI) doesn’t paint the whole picture. You simply can’t point to an artifact on a picture and correlate it to someone’s symptoms.
In fact, there have been multiple studies where researchers have taken MRI’s of totally healthy people with no pain and found that ~50% of them had some kind of herniation or bulge but no pain. Of those ~10% had findings so severe that if they had symptoms it would warrant a timely surgery. So the conclusion is that findings on MRI don’t correlate to the pain or symptoms people feel – which means they generally aren’t the cause of the pain.
We will focus on nerve entrapment in another post, because they are a common issue that I treat at my dry needling and prolotherapy clinic in Tampa, FL, but today I want to hone in on trigger points causing referred pain and numbness down the arm.
Trigger Points – A common cause of numbness in the hand
The infraspinatus, a shoulder muscle, commonly causes reproducible numbness in the pinky finger and along the arm when there is an active trigger point present. So let’s dive in to see how this happens.
C6 Cermatome and How The Infraspinatus are connected
As you can see below, the suprascapular nerve innervates the infraspinatus and comes off of the C6 nerve root. Coincidently C6 is a common nerve root involved in ~25% of cervical radiculopathy cases. This connection might explain why nerve ablations and cervical surgery might not completely resolve a large number of cervical radiculopathy cases – because these treatments are overlooking the Infraspinatus muscle and Suprascalular nerve sensitization as a cause of the pain.
Maybe the C6 herniation made the infraspinatus hypersensitive, maybe the irritated infraspinatus cause inflammation in the C6 nerve root. I commonly find that if you only treat the nerve root at the spine and ignore the active trigger point in the muscle that the pain, numbness, and tingling continually come back.
The good news
Regardless of the cause of hand numbness / tingling / pain, it can be treated with non-invasive treatments like dry needling or perineural injections. At my dry needling clinic in Tampa, FL I successfully treat this condition on a daily basis. Don’t settle for bandaid care that doesn’t get to the root cause of your problem.