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Dr. Frank
Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 9000
Experience:  Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
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I have had a condition in both arms for over twenty years

Customer Question

I have had a condition in both arms for over twenty years where my arms, from my shoulders to my fingers go to sleep at night.. It has gotten progressively worse the past month, to the point where there is significant pain along with the tingling in both arms and hands. The little finger on my left hand now hitches at the knuckle nearest the nail and I can't seem to find relief. I am seventy five years old and am in good shape, but this is getting to a point where it could be debilitating. My research indicates I may have ulnar nerve entrapment. Do I need to see a doctor, or can I find exercises to relieve the pain? Thank you very much.
Submitted: 1 year ago.
Category: Neurology
Expert:  Nadim Al-Mubarak replied 1 year ago.

Yes, you do need to see a doctor. This is not "ulnar nerve entrapment. The recent worsening symptoms indicate a potentially serious issue of the spine and the nerves that go through it. This will require direct exam by a doctor and some tests, xrays. You may start with your family doctor or a Neurologist. Best wishes

Expert:  Nadim Al-Mubarak replied 1 year ago.

I hope I answered your question. If satisfied, please complete the stars rating. That's how we get compensated for our service. You may still email me with questions on this topic even after you have rated me. Best wishes.

Expert:  Dr. Frank replied 1 year ago.

Hello Welcome to JA. I am an Adult Neurologist and would like to help you with this issue. Neurologically, an Ulnar nerve entrapment is going to give you continual numbness in the pinky and ring finger, and since most of the hand muscles are ulnar innervated, you should note weakness in terms of grip strength. That is not what you describe. What you describe is "ischemic neuropathy" type symptoms, where during sleep, when your heart rate and blood pressure drop, the blood flow to your arms (bilaterally, is it symmetric?) drops. You awaken with ischemic symptoms, pain, numbness, and probably some stiffness to movement initially, until you start warming them up. You have had this a long time, so most likely this is a vascular problem, related to your anatomy. There are a few situations that can do this.

1) TOS, thoracic outlet syndrome. That comes from compression of the subclavian artery as it passes into your arm, it supplies the brachial plexus, the nerves that go into your arm, so as that gets starved for blood as you sleep, you awaken with these symptoms.

Expert:  Dr. Frank replied 1 year ago.

2) You are correct, that you can also have entrapment neuropathies, like your ulnar (cubital tunnel syndrome) or median at the wrist (carpal tunnel syndrome) and then have overlying symptoms when you awaken which is kind of a combination of problem number 1 and your entrapment, but you have to have symptoms during the day.

3) you can have spinal cord problems like syringomyelia, (cervical syrinx) which will give you burning pain in your shoulders, and numbness/weakness in your hands, again worse in the morning, but you should have symptoms during the day.

4) you can have "the metabolic syndrome"

Expert:  Dr. Frank replied 1 year ago.

4) you can have "the metabolic syndrome" of diabetes, hypertension, and/or hypothyroidism, and have a peripheral neuropathy giving you ischemic symptoms as well, so you have this pain more in the morning, so let me know if you have any of those problems. Any other medical diseases? meds you take. Get back to me and we can discuss this further. Dr Frank

Expert:  Dr. Frank replied 1 year ago.

If your hands are cold when you awaken, then you also have to consider vascular conditions like Raynaud's Syndrome, get back to me to discuss this if your hands are cold as well as numb and painful. Dr frank

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