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Dear
Dr. Meyers
My left hand always feels like it is asleep. This has been going on now for
about a week. Its mainly my ring finger and my little finger. I have no pain
with it but it is just very irritating.Can u please tell me what this might
be.
Mary from Oklahoma
Hello Mary,
There can be many possible reasons why only one hand feels like it is asleep. But because you experience this sensation specifically over the ring and little finger, we can narrow the possibilities down. Most likely there is a compression or impingement of either the nerve that supplies sensation to the ring and little finger called the ulnar nerve, or the multiple spinal nerves (nerves that branch off of the spinal cord directly) located in the neck that combine to form the ulnar nerve. If it is an impingement or compression of one of these spinal nerves (specifically the nerve root of the 8th cervical spinal nerve on the left) it will usually cause sharp, shooting pain into the left ring and little fingers, and the part of the hand and forearm on the same side as the ring and little fingers. However, early stages of nerve root compression may cause strange sensations (such as numbness and tingling, sleeping and/or crawling sensations to name a few) in the same areas. Compression of the nerve roots of the spinal nerves in the neck is usually due to a herniated disc (especially if a trauma occurred), or the formation of a bone spur due to arthritic changes. Chiropractic treatment, consisting of traction, neck stabilization exercise and rehabilitation should benefit one with a mild to moderate herniated disc. In the case of a severe herniated disc or bone spur formation, surgical decompression procedures (open or endoscopic discectomy) is the option of choice.
Another possibility is compression of the ulnar nerve and/or its accompanying artery, called either the subclavian or axillary artery, under certain tight muscles in the neck and shoulder areas. This is called thoracic outlet syndrome. This is usually seen in people who have poor posture, do repetitive, sedentary work for the majority of the day, or who exercise without stretching (especially swimmers or weight lifters). As the ulnar nerve and its accompanying artery starts their decent from the neck down into the arm, they pass under two different muscles. The first muscle that they pass under is the scalene muscle, located in the front of the neck right over the central portion of the collar bone. If the scalene muscle is tight, it “squeezes” the ulnar nerve and subclavian artery, producing strange sensations and possible weakness in the ring and middle fingers and the hand and forearm on that same side. This condition is specifically called Anterior Scalene Syndrome. The ulnar nerve and the axillary artery can also be “squeezed” by another tight muscle called the pectoralis minor muscle. This muscle is located in the part of the chest directly under the shoulder. This condition is specifically called Pectoralis Minor Syndrome, which has the same symptoms as Anterior Scalene Syndrome. Conservative treatment of these conditions is suggested initially, consisting of chiropractic, muscle stretching, and postural exercises to name a few.
The ulnar nerve may be compressed in other locations as it descends down the arm into the ring and little fingers causing abnormal sensation and possible weakness in the ring and little fingers. Two common areas are called the cubital tunnel, which is located deep in the elbow, and the other is called the tunnel of Guyon, found on the wrist bones deep in the palm of the hand. In the case of Cubital Tunnel Syndrome, there is usually a history of throwing activities, however it may be caused by the development of lipomas or ganglions, both are benign soft tissue growths. In the case of Tunnel of Guyon Syndrome, there is usually a history of activities that put pressure on the palm, such as cycling. Treatment includes a decrease of aggravating activities, stretching of the forearm and hand musculature, and possible bracing or splinting. If conservative treatment does not improve symptoms, surgical consult should be warranted.
Mary, it is very important to have this checked instead of waiting to see if it goes away. Consult with your chiropractic or medical physician. With simple testing they should be able to determine why you are having these sleeping sensations. If you start to notice that you are losing strength and are unable to grip objects, consult with your medical doctor immediately. Good Luck.
Dear Dr. Meyers, I think I may have carpal tunnel because my right hand
feels like it is always asleep. What are the options I have for this condition?
First of all, it is very important to make sure that the symptoms you are experiencing are from carpal tunnel. Carpal tunnel is a condition where the median nerve is compressed or irritated by tendons of the muscles located in the forearm or by the wrist bones themselves. The classic presentation of early carpal tunnel is a “pins and needles”, “fallen asleep” or “numbness and tingling” sensation specifically in the palmar side of the thumb, index finger, middle finger and half of the ring finger; however the locations do vary with each individual. If one experiences these sensations in the whole hand, most likely the problem is a possible nerve compression in the neck or shoulder usually by very tight muscles, specifically the scalenes or the pectoralis minor respectively. If the patient experiences the sensations in the fingers previously mentioned, as well as the area of the palm found below the thumb, called the thenar eminence, the nerve most likely is compressed by a muscle called the pronator teres that is overly tight in the forearm near the elbow. Finally, it is possible that these strange sensations may be due to a vascular disorder, hypothyroidism or pregnancy. So, it is very important for the patient to become fully aware of the possibilities before choosing a treatment.
I provide conservative options for carpal tunnel that include aggressive muscle stretching of the tight muscles in the forearm and wrist, in order to restore the muscle to its normal length so that it no longer compresses the nerve, as well as cross frictional massage, nutritional supplementation and ergonomic training. This treatment is effective if tight muscles are the reason of the compression of the median nerve. I also “adjust” the wrist in the case that one of the small bones in the wrist is compressing the median nerve.
The other option is a “release surgery” where the stabilizing tissue in the wrist is cut in order to reduce the pressure on the median nerve in the wrist. This option should only be considered as a last resort. This surgery may provide immediate relief of the strange sensations in the hand, however, if the problem is due to tight muscles and poor ergonomic tendencies, the sensations may return.
As with any problem, I advise any one to consider conservative treatment first before selecting a more invasive treatment.
Dr. Meyers, I am an avid golfer. I would love to take some strokes off
my game. Why is chiropractic so beneficial for pro golfers, such as the case of
Tiger Woods? Brian from Westbrook.
Many athletes, such as golfers, choose chiropractic in order to enhance their performance because chiropractic focuses on the musculoskeletal systems of the body. In other words, we make sure that every muscle, tendon, joint, and bone are optimally functioning. In the case of golfers, if one wants to excel at the game, one must be strong and stable below the hips and quick and flexible above. I as a chiropractic physician, incorporate stretching techniques for tight musculature in the shoulders and hips, core stabilization exercise for balance and injury prevention, strengthening exercise for wrist, elbow and torso musculature and finally spinal adjustments and extremity joint mobilizations to provide flexibility and increased range of motion. All these components are essential and extremely effective for increased golf performance, and are the reasons why many golfers visit a chiropractic physician on a regular basis.
Dr. Meyers, I have recently been suffering from many headaches. I heard
chiropractic helps headaches. Is that true? Jacqueline from
First of all, we must know why you are suffering from a recent onset of headaches. Headaches may either be “secondary” or “primary”. Secondary headaches are those that are the effect of another condition. Secondary headaches have diverse causes, ranging from serious and life threatening conditions such as brain tumors, strokes, meningitis, and subarachnoid hemorrhages to less serious but common conditions such as withdrawal from caffeine and discontinuation of analgesics. Primary headaches are not associated with (caused by) other diseases. Examples of primary headaches are migraine headaches, tension headaches, cervicogenic headaches and cluster headaches. Research shows that chiropractic is effective in cervicogenic and tension headaches.
Cervicogenic headaches are headaches caused by tight muscles and irritated joints in the neck. It can be caused by a trauma to the neck, such as whiplash, effects of long term poor posture, long term repetitive motion of the head or neck that causes muscle spasm, or trigger points. A trigger point is a focal area of spasm in a muscle that refers pain to other areas of the body. Many trigger points that are found in the neck musculature refers pain to many areas of the head. Muscle stretching, massage, cervical stabilization exercise and spinal manipulation (adjustments) are effective in decreasing cervicogenic headache pain.
Tension headaches are the most common type of primary headache; as many as 90% of adults have had or will have tension headaches. Tension headaches are more common among women than men. As the name suggests, tension headaches have a strong relationship to stress. Stress, in turn, may cause the muscles in the neck to stiffen and ultimately spasm and develop trigger points. In the case of the tension headache sufferer, it is mostly important to have the patient alter their lifestyle in order to be removed from stressful situations. Exercise, muscle stretching, and cervical stabilization rehab may also be effective.
