Nerve Like Symptoms in the Arm

Serratus Anterior

Serratus Anterior

I had a patient come in last week with symptoms I recognized but had not seen in a while. It seems he “injured” his neck while shoveling a great deal of gravel before the holidays. He works as an excavator and was trenching a septic system. His chief complaint was “numbness and tingling” in his middle, ring and little fingers as well as the inside or medial part of his arm.

He was seen by his family physician who referred him to an orthopedist for evaluation of possible neck problems. His orthopedist ran a series of x-rays to rule in or out possible disc problems. What was discovered from his x-rays was early arthritis with not much to speak of regarding a disc injury. Because he was having what was seen as radicular (pain/numbness running down his arm) symptoms, he was referred for physical therapy for his neck problems.

Having seen this pattern many times and being able to relate this to his functional motion of shoveling, I remembered the symptom referral pattern of the serratus anterior muscle located along the rib cage and the underside of the shoulder blade; http://www.triggerpoints.net/muscle/serratus-anterior. This patient although he had some limited range in his neck was moving way to well and had good strength for a disc problem. His symptoms of tingling in his arm and fingers as well as pain and tightness along his side and shoulder blade was textbook. Stretching of this muscle recreated his symptoms and he was significantly better even after the first day. Today on his second visit, although he still was experiencing some radicular “like” symptoms, they were less frequent and less severe.

So it is not always what it may appear to be when looking at pain as well as tingling and numbness. At Appalachian Physical Therapy, we have the experience and knowledge to move through a complete musculoskeletal evaluation to help weed out problems such as these.

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