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March 28th, 2024

Gezunt/ On Health

Mayo Clinic Medical Edge: Arm pain may be signaling something much more severe

Patty Atkinson, M.D.

By Patty Atkinson, M.D.

Published Jan. 14, 2015

DEAR MAYO CLINIC: I am a 35-year-old healthy woman. For the past three months I've had a dull, tingling pain that goes from my shoulder to my elbow (feels like my funny bone was hit) and down my forearm. This results in my pinky and ring fingers going slightly numb. It's in both arms and is more noticeable when lying down or sitting for long periods. What would cause this?

ANSWER: Based on your description, your symptoms seem to be coming from your nervous system. Because those symptoms are specific, consistent and persistent, I recommend you see a neurologist for a thorough exam.

Several details in your description point to a neurologic problem. The pain you're feeling sounds like neurogenic pain -- pain that comes from somewhere in your nervous system -- rather than musculoskeletal pain, which is related to your bones, joints or muscles.

Your reference to feeling as if your so-called funny bone has been hit increases the possibility that the pain and tingling are nerve-related. Also, the distribution of your pain -- from your shoulders down to your elbows, to your forearms, and into your pinky and ring fingers -- tracks a specific nerve distribution. Actually, funny bone is a misnomer. The discomfort comes from hitting the ulnar nerve where it passes around the back of the elbow.

In the absence of a nerve problem you probably would not have persistent, identical symptoms in identical locations in both upper limbs.

All of this leads me to think the source of the problem is most likely in your neck, specifically in the cervical spine. Based on the location of symptoms, I would focus on the seventh or eighth cervical nerve roots -- paired nerves that branch out from the spinal cord, one on each side. To give you a sense of their location, if you bend your head down and run your hand along the back of your neck, there's one bump that stands out more than the others at the base of your neck. That's the back of your seventh cervical vertebra. The seventh and eighth nerve roots exit your spine just above and below that bump. There's also a small chance that the first thoracic nerve root, which exits just below the eighth cervical nerve root, could be involved.

Your description alone is not enough to pinpoint the cause of the problem. Possibilities include a herniated disk or a degenerative spine problem. These conditions can place pressure on spinal nerves and cause symptoms such as yours. At your age, these conditions aren't as common as they are in older people. But they could happen, particularly if you had some type of mild neck injury when you were younger. Typically, these issues can be diagnosed and effectively treated, and they don't affect overall health.

That aside, a more serious potential source of your symptoms could be a spinal cord problem. A number of neurologic conditions can affect the spinal cord. If one of these is causing your symptoms, early diagnosis is essential, so you and your doctor can decide on next steps before the problem gets worse.

Tests to be considered include imaging of the cervical spine, usually with magnetic resonance imaging (MRI); and electrophysiologic testing of the nerves and muscles with electromyography (EMG) and nerve conduction studies.

The bottom line is that you shouldn't ignore these symptoms. You need to be evaluated by a physician, likely a neurologist, who can examine you and recommend the appropriate testing to diagnose the source of the problem and, if necessary, work with you to establish a treatment plan. -- Patty Atkinson, M.D., Neurology, Mayo Clinic, Rochester, Minnesota

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