Middle Shoulder Blade Pain Referring into Arm & Hand

Pins & Needles into the hand coupled random achy pain into the shoulder blade and along the arm are symptoms of nerve compression. However, the problem does not always originate in the neck or cervical spine as it is known as. These particular symptoms can in fact come from nerve irritation in the upper thoracic spine which located between the shoulder blades, a condition that is known as T4 syndrome. This week I will discuss a common case of a person with middle shoulder blade pain and pins & needles into the hand.

Signs & Symptoms of a Patient with middle shoulder blade pain & Pins & Needles into the hand

  • Ongoing Pins & Needles into all of the fingers of the left or right hand

  • Has gradually worsened in nature over a number of months

  • Extreme soreness in the mid shoulder blade region along the spine when touched

  • Sharp Pain into the right elbow when the T5 vertebrae between upper shoulder blades is compressed by the Physical therapist

  • Forward bending of the neck causes sharp pain into shoulder referring to the wrist

  • Pins & Needles into the hand aggravated by combing of the hair or any overhead activity

  • Pins & Needles and sharp pain was relieved by vigorously ‘shaking out the hand’

So what’s causing the shoulder blade pain & pins & needles into the hand?

In this example because of the extreme local tenderness at the T5 vertebrae between the shoulder blades, the thoracic spine can be considered as the origin of this condition. The autonomic nerves which partly originate from the thoracic spine, transmit nerve impulses from the brain and spinal cord to the organs of the body. Irritation of these nerve roots between T3-T7 vertebra is classified as a T4 syndrome, a condition that can bring about Pins & needles into the hand.

Management & Treatment

When the Physical Therapist examines his/her findings, they must identify the correct tools for treatment. When treating a patient with these symptoms I have found great benefit from using graded manual traction following cervical rotation to the painfree side of the neck. Manual centralising mobilising is helpful also in later stages for relief of middle scapula pain. Throughout the treatment process, symptoms of neck pain when bending, pins & needles in hand when placed behind head and elbow pain when compressing T5 vertebrae are continually assessed for improvement.

Tomás Ryan is a Registered Physical Therapist with The Irish Association of Physical Therapy (MIAPT) and is based in Thurles.

Contact Number: 0504 26672

Email your queries to: info@tipp-phyiscaltherapy.ie

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Physiotherapy & Injury Rehabilitation Clinic in Tipperary

0504 26672


The Surgery, Fianna Road, Thurles


Riverside Medical Centre, 7 Upper

Irishtown, Clonmel

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Receipts are provided after each treatment for tax or health insurance companies.