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Ask Nadim Al-Mubarak Your Own Question
Nadim Al-Mubarak
Nadim Al-Mubarak,
Category: Medical
Satisfied Customers: 378
Experience:  MD at University Hospital Case Medical Center
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Just looking to see possible cause for my intermittent

Customer Question

just looking to see possible cause for my intermittent tingling. numbness of the last 2 fingers on my right hand, hypersensitivity of forearm. I have a pain on the lower portion of my elbow but I think it is from me poking to find out what was causing the tingling.
JA: What seems to make the symptoms worse or better? Have you noticed any swelling?
Customer: nothing really. I am a sign language interpreter but that does not create a problem. I have shooting pains even when at rest.
JA: Anything else in your medical history you think the doctor should know?
Customer: not really
Submitted: 2 months ago.
Category: Medical
Expert:  Dr Josh replied 2 months ago.


Myself Dr Josh. and I’m happy to help with your question today.

Please provide me the following information so that I can address your concern regarding tingling sensation in last 2 fingers on right hand:

What is your age & gender?

Since how long you have this tingling sensation?

Is there any pain other then tingling in these last 2 fingers of right hand?

Waiting for your reply…

Thank you.

Kind Regards


Expert:  Dr. Thomas, MD replied 2 months ago.


Welcome to just answer.

I am a double board certified US doctor and will be happy to help. Dr. Thomas.

Numbness implies a pinched nerve.

while this could be at the elbow, it is more likely in the cervical spine.

The ulnar distribution.

Lower cervical spine, disc problem.

See a doctor for an exam.

Maybe an MRI.

There is one caution here: If you sense any weakness, this is more of an emergency and I recommend the ER.

If the numbness has gone on for some time, it is also more critical.

OK, so you might have more questions or want to give me more information: Please use reply to expert if you have further questions. Also, please click a positive rating [hopefully excellent [5]—that’s how we are paid, per rating]. If you forgot something, just use reply and come back. I am here

Expert:  Nadim Al-Mubarak replied 2 months ago.

Hello there

I have a different answer for you:

  • First, Numbness does NOT ALWAYS implies pinched nerve, there are more common causes for numbness than that. And, the elbow is unlikely the source.
  • There are many potential reasons for your numbness and they can not be narrowed down without the examination by a good internist or a Neurologist. To name few potential causes, metabolic, electrolytes imbalance, medications, thyroid disease.. etc.
  • We can not recommend tests if we have not have the detailed history and physical examination. Recommending tests, like MRI or any other, is just like shooting in the dark and hoping that we meet the target.
  • My advise is for you to see a Neurologist in your area. You need a detailed history and examination before this can be further tested

Best wishes

Expert:  Dr. Thomas, MD replied 2 months ago.


In the US, Neurologists generally will want a referral from your primary care.

this is because the initial visit will be billed as a consultation.

Most insurance plans will not allow you to go directly to a neurologist and give the neurologist full reimbursement, so the offices will want the referral.

A neurologist is often not the correct doctor.

For example, if this is a pinched nerve, as is most indicated by your description, and orthopedist or physical medicine doctor might be more appropriate.

That is for you and your doctor to sort out. In the US typically, the referral to a specialist is a primary care doctor function. We don't replace your primary care here.

A unilateral numbness in the ulnar distribution would rarely be anything to do with electrolytes, metabolic disease or thyroid disease.

Carpal tunnel is more associated with thyroid disease, and this is not carpal tunnel [wrong distribution]. In addition, it is extremely rare for thyroid disease to cause carpal tunnel.

The other potential causes are more systemic, and would not typically be unilateral.

Find me, Dr. Thomas, anytime.

A double board certified US doctor for correct, up to date, clinically accurate answers.

Expert:  Nadim Al-Mubarak replied 2 months ago.

Your description does not exclusively indicate "pinched nerve". A diagnosis can not be reliably made and should not be made on the basis of the information you provided, NOT without a direct exam. This will unlikely to be any thing serious. A referral form our PCP is not always required, this is not the issue though. Just, check with your family doctor. Best wishes