Expert: J.R. Strecker, B.S., D.C. - 3/16/2010

Question
Hi I hope you can give me some insight to why I have numbness down my right arm and into my frist three fingers(thumb, pointer, and middle)and I can't raise it above my head. I did have a chunk of ice fall and hit me on the right side neck/back in Dec. 09'. I went to a Dr. who ordered a MRI and a EMG both test were fine. The Dr told me there was NO numbness in my arm and hand and no reason for the lack of movement. I asked about PT and if a Chiropracter could help and got no real answer if they could help he told me the tests show nothing so there is no problem. There  is something wrong my arm and hand feel like they are asleep and if I lay on my back to sleep the numbness goes into spots in my shoulder. Thank you for your time.

Answer
Disclaimer: please do not take any of my advice without at least consulting with your doctor(s) first. If necessary, print this email in its entirety for your doctor(s) to read. In addition, please do not attempt to use this website or my advice as a substitute for your healthcare needs, as a substitute for the advice of your doctor, or as a substitute for any legal advice. There is no way a thorough health evaluation or assessment of any medical condition can be properly made via email. Please only use the contents discussed as a guide or tool to address your health matters with your doctor(s). If any of the information I provide conflicts in anyway with the information your doctor(s) provide, it is always best to default to the information provided by your consulting doctor(s) or to seek additional opinions from qualified, licensed healthcare providers as needed.

Hello N.,

Perhaps the MRI was ordered in an area that is not pinching the nerve.  For example, conditions involving the neck and shoulder can both cause your symptoms.  If the problem is in the neck but a shoulder MRI was ordered, then your MRI may be normal.  Also true, if the problem is in the shoulder, but a neck MRI was ordered, again, your MRI may be normal.  It may take extensive orthopedic testing to determine exactly where the nerve irritation is.  However, the EMG is generally a good test to determine nerve irritation.  This doesn’t mean 100% that everything is normal.  Rather, it may mean that further investigation is warranted, depending on your doctor’s evaluation.  You may want to consider following up with your doctor again, expressing your persistence of symptoms, and if you feel you are not getting more answers, you may want to seek a second opinion.  

Regarding PT and chiropractic treatment, your condition is a very common symptom that we treat.  However, the difficulty for your situation right now is that you don’t have a diagnosis.  Without a diagnosis, treatment is relatively blind.  Many knowledgeable chiropractors, especially those with additional orthopedic training, are quite helpful at accurately diagnosing your type of condition.  So if you feel you are not moving forward, you may want to consider a consultation with a chiropractor.  If after further evaluation and testing everything still appears to be “normal,” you may also want to consider other complementary therapies, such as acupuncture and massage.  These treatments are also successfully used for your symptom, especially when there is no known cause or diagnosis evident from medical testing.  

I would strongly recommend you to seek a practitioner that can give you a diagnosis and/or follow up with your current practitioner for more testing or referral to a specialist.  If you talk to a hundred different practitioners, you can sometimes get a hundred different opinions.  Without a solid, evident diagnosis, finding a treatment that will work is going to be a “gunshot” approach, leaving all treatments to chance, which can become very exhausting.  Consequently, your first goal should be to find a correct diagnosis, whether through your current doctor, referral to a specialist, or a second opinion from another doctor, and then seek opinions about different treatment options for your specific condition.  (Unfortunately, it is impossible for me to diagnose you over the Internet).

In closing, if you feel your symptoms are real, don’t necessarily give up just because a couple tests are normal.  Often times, patients become hopeless after everything is determined normal and never return to their doctor, when in actuality, doctors prefer to know that the symptoms are still present.  Your persistence guides the doctor to search deeper for the correct answer.  

I hope this helps a bit.  Best of luck!
Dr. JR Strecker, DC