Most readers of this journal describe a neck that hurts in the neck. Some describe something stranger: fingers that tingle when they look down at a phone, a hand that feels clumsy on the steering wheel, an ache that starts at the base of the neck and runs over the shoulder blade and down the arm. They often do not connect it to the neck at all. They think they slept on the arm wrong.
This entry does not diagnose arm symptoms. It explains why the neck is worth mentioning when the arm is the complaint, draws the line between tonight and this week, and describes what to tell the person who examines you.
Why an arm can report a neck problem
The nerves that serve the shoulders, arms and hands leave the spinal cord in the neck, exiting between the vertebrae on each side. Along the way they pass close to the joints, discs, and muscles that a crash can strain. Irritation near the point where a nerve leaves the neck can be felt far from the neck, in the part of the arm or hand that nerve supplies. That is why a clinician examining a neck after a crash often asks about the arms, and why Missouri Injury Clinic lists numbness or tingling in the extremities among the auto injury problems it treats.
Plenty of arm tingling has nothing to do with the neck. Wrists, elbows, and circulation have their own explanations, and a crash can injure those directly too. Sorting that out is the exam's job.
Tonight: the emergency room
Go to an emergency room now, or call 911, for any of these:
- Weakness or numbness on one side of the body, especially with trouble speaking, a drooping face, or confusion.
- Weakness or numbness in both arms, or in the arms and the legs.
- Weakness that is getting worse by the hour.
- Trouble walking, or legs that feel unsteady, along with the arm symptoms.
- A loss of bowel or bladder control.
- Severe neck pain after a high-speed crash or a rollover, particularly with numbness anywhere.
The journal's standing line applies as always: chest pain, a sudden severe headache, weakness or numbness on one side, trouble speaking, a loss of bowel or bladder control, or a head injury with vomiting or worsening confusion is an emergency room trip right now, not a call to a clinic. Chest pain with arm pain, in particular, is never a neck question first.
This week: the exam
Arm symptoms that are steady rather than worsening, that come and go with neck position, and that appear alongside an ordinary stiff neck after a crash, belong in an exam this week rather than a wait-and-see month. Readers describe things like:
- Pins and needles in a few fingers when looking down or turning the head.
- An ache from the neck over the top of the shoulder blade and into the upper arm.
- A hand that feels clumsy or weak when buttoning, typing, or gripping a mug.
- Tingling that wakes them at night and eases after moving the arm.
If any of those starts to worsen, or a symptom from the emergency list appears, the plan changes to tonight.
What to write down before the visit
Arm symptoms are easy to describe vaguely and hard to describe usefully. These five notes help:
- Which fingers. Thumb and index finger, the middle finger, or the ring and little finger. Be specific; it tells an examiner a great deal.
- Which side, or both.
- What brings it on. Looking down, turning to one side, reaching overhead, driving, lying on that arm.
- What eases it. Changing position, shaking the hand out, resting the arm on your head.
- Grip. Any dropped cups, keys, or pens since the crash, with dates.
Add the first day you noticed it. Arm symptoms can appear on the same delayed schedule this journal describes in Entry 03.
What the exam checks
Without speaking for any particular clinician, a first visit after a crash that includes arm symptoms generally covers the neck's movement in each direction and a neurological screen of the arms: reflexes at the elbow and wrist, strength in specific muscles, and sensation in different areas of the arm and hand. Findings are compared side to side and written down with a date. If the findings call for imaging or a referral to a different specialty, a straight answer about that is part of the visit. Entry 07 covers the practical side of getting there.
The one action
Call the office you can reach this week, say it was a car crash, give the date, and say that your arm or hand has been involved. Missouri Injury Clinic's Hazelwood office is at 14 Village Square Shop Ctr, (314) 627-1411, open Monday through Thursday 9am to 6pm and Friday 9am to 12pm. Every office closes daily from 12 to 2. The clinic says it reserves same-day appointment times daily for car accident injuries.