Some part of my upper body is unhappy. Is it my arm, or is that a red herring?

July 8, 2008 6:13 PM

"Cold" feeling along both sides of my forearm, becoming achy. Doctor's appointment already made, but now I'm researching for ideas on relief -- and nothing seems to quite fit the symptoms!

I've developed aching and pain along the outer (pinky) side of my forearm and the inner (thumb) side. It sometimes spreads to the whole back of my forearm, and the feeling is just like the "cold" feeling you get from evaporative cooling, or a xylitol-sweetened mint.

My doctor cancelled on me, so I won't get to see her until the 22nd.

Until then, I took the blunderbuss approach to symptom relief (so I don't know what has worked here and what was coincidental):
- Icing of my upper torso (clavicle area and neck)
- Icing forearm, elbow and wrist
- Ibuprofen 600mg as needed (right now, 1x daily)
- Standing up straight with arms dangling at sides (complete relaxation of shoulders, arms, wrists and hands) seems to reduce the tingling. I still have to work, so I can't stand upright all day.
- Workrave (30 seconds pause every 5 minutes, and 5 minutes stretching every 25).
- Sleeping in wrist splints seems to change nothing. Wrapping the arm also does nothing helpful.

Diagnostic 'tests' at home:
- My wrist extensors and flexors don't feel any tighter than usual.
- Palpating the muscle on the outside of my elbow feels like a bruise. The inside of my elbow doesn't hurt any more than prodding a muscle normally would.
- Phalen's test (reverse prayer with back of hands together) - 25 seconds and I began to feel a tingle.
- EAST test (for TOS): 30 seconds before my wrists go "cold" and numb (the diagnostic test calls for 3 minutes, I can't last more than 1). Related: standing with my arms over my head for longer than a minute or two has caused me to faint, ever since childhood.


Questions:
Could these signs and results come from one cause, or are there possibly multiple things going on?
Are there any more avenues of self-care/home treatment to explore before my appointment?

(You are not my doctor.)

posted by subbes to health & fitness (12 comments total)

Could you have compressed a nerve in your elbow or elsewhere? That's the first thing I thought of when you said cold.
posted by robinpME at 6:19 PM on July 8, 2008

I was wondering about that, because the coldness on both sides implies more than one nerve but I can't think where the pinching might be to get both sides. Unless nerve pinching can generalize itself that far, or pinching in the carpal tunnel could be showing itself in the forearm rather than the hand? Perhaps I am over-thinking this.
posted by subbes at 6:39 PM on July 8, 2008

Hmmm ... I don't know much about it, but I really doubt it's as straightforward as you're making it seem - it's not like you pinch something on the left side of your elbow and the left side of your hand goes numb. The reason I thought of a compressed nerve is because it happened to me (presumably in my knee), and I lost a lot of sensation in my whole foot, not just one side. See what the doctor says, but my money is on it being something simple like that.
posted by robinpME at 6:57 PM on July 8, 2008

It's probably a pinched nerve, and the pinch is at the vertebrae in your neck, not the elbow. There are probably two separate pinches going on, one's causing the pinky-side sensations and one the thumb. See this rundown on C6 and C8 impairments.

If you can't see a doctor for a while, try hot-cold treatments rather than just icing. Five minutes of heat, five minutes of cold, repeat 3 times every couple of hours. And keep up the ibuprofen around the clock for a few days, not just when "needed."
posted by beagle at 7:17 PM on July 8, 2008

i'm thinking nerve issues in your shoulders or neck. you've got one nerve that goes to your thumb, index and middle finger and other nerve that goes to you're second-to-last and pinkie fingers.

simple stretching and strengthening (and a doctor) are the place to start:
good book: treat your own rotator cuff
posted by zeek321 at 7:53 PM on July 8, 2008 [2 favorites]

N'ing, likely just one of the two main nerves that run along the arm. They can be weird. I've had some carpal tunnel issues. Some Tylenol, and admittedly non-intuitive, a cold compress of some sort might help. Probably just a question of where to best apply it. Google some RSI stuff (not the issue here I don't think), but that will give you more info on where the nerves are, and experiment from there.

Have you tried just dunking them in warm water?

/standard disclaimer that I'm not a doctor and don't play one on TV either
posted by hungrysquirrels at 10:58 PM on July 8, 2008

Beagle, I'd love to but there seems to be no link in your comment.

I have a chiropractor's appointment this afternoon. Hopefully that can shed some additional light on how my body works, and give my doctor some extra info if it finds anything.
posted by subbes at 7:23 AM on July 9, 2008

Definitely consider the possibility that the root problem is in your neck, not your arm. I had similar symptoms, and it was a bulging disk at the C7 level that was infringing on the nerve that went down my arm.

A doctor will also ask you about numbness and weakness in the same area, and if you feel it when he/she pokes you with a pin in various spots on your arm. This test (along with other strength tests) helps him/her determine if it's a nerve issue, or something else.

In the meantime, an adjustment will probably help, and be extra-vigilant about your posture. Check the ergonomics of your desk and car, two very common places for bad posture.
posted by SuperSquirrel at 8:22 AM on July 9, 2008

Sorry about that, try this link.
posted by beagle at 2:43 PM on July 9, 2008

Possible cause, pending neurologist's input: compression of the brachial plexus by swelling of the scalene muscles due to slouching and my medical freak status -- turns out I have cervical ribs (extra ribs in the neck).
posted by subbes at 10:43 AM on July 13, 2008

The neurologist concurs that I probably have TOS, and has scheduled testing in the next couple of weeks to determine if it's nerves or vascular bundles that are getting compressed.
posted by subbes at 2:19 PM on August 22, 2008

I officially have TOS. It's vascular (loss of blood flow) and positional and my nerve function is good.

There, that was a fun way to spend 1/4 of my health insurance's out of pocket maximum for the year.
posted by subbes at 12:01 PM on September 17, 2008