Sharp Burning Pain into the thumb & Forearm due to Neck restriction
Many people can develop a sharp or occasional burning pain into the thumb and forearm after doing manual work overhead such as ceiling painting etc. These symptoms can persist for weeks with no improvement with the patient thinking that the cause of the problem is in the hand or arm. However, this may not be the case and here is a common example of the thumb and forearm pain being caused by restrictions of the nerve root in the neck.
Nerves extending from the Neck to the Hand
Shoulder Pain Signs & Symptoms
Sharp & Occasional burning pain into the lower arm and thumb
Forearm & thumb pain is aggravated by turning the head, looking upwards to the ceiling, Driving, reading the newspaper, studying.
Gets temporary relief by lying down on a bed or sofa
Can be very painful getting out of bed at morning time and when trying to sleep at night
The cause of the problem is often an episode of painting a ceiling for a prolonged period or heavy fall when playing sport
Examination findings of Neck
Pain into the thumb and forearm is relieved by bending to chin to chest. However stiffness is noted in the neck when turning the head, there commonly is no noted pain the neck region. Bending the head backwards, .i.e. looking upwards and turning the head to the painful arm side aggravated the pain further. Thorough examination of the cervical spine (neck) will reveal tenderness when graded Posterior- Anterior pressure is applied to the left C5/C6 facet joint. The facet joint or hinge joint may be restricted thus narrowing the angle at which the nerve exits theC5/C6 foramen of the vertebra. The nerve root forms the radial nerve once it passes through the shoulder and supplies sensitivity and muscle control to the thumb and muscles of the forearm.
Treatment & Management
The cause of the nerve pain in this case is nerve root irritation in the cervical spine vertebra (the neck) on the left side between the C5 and C6 vertebra. A restriction or tightness will be present between both vertebras and is further exaggerated when bending the neck backwards or sideways to the side of painful symptoms. This serves to narrow the space from which the nerve root comes through causing irritation of the nerve; this problem is often termed nerve mechano-sensitivity, which described an over-reactive response of the nerve to posture and cervical movement. Treatment for this condition would focus on graded mobilisations to restricted C5/6 vertebra to help encourage further movement and free up further space for the nerve to root to thread through.
Tomás Ryan is a Registered Physical Therapist with The Irish Association of Physical Therapy (MIAPT) and is based in Thurles & Clonmel
Contact Number: 0504 26672
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