Joe A Shaw PA-C - 5/17/2008

Question
For about a year, I've noticed every two to three months (maybe less frequently) my left arm gets numb, with the numbness running down my little and ring finger.  This only happens at night when sleeping.  My neck has always felt "stiff" or like a muscular tightness when this happens as well.  I realized it is after lifting ten pound dumbells for some other activity the prior day or so.  It doesn't happen every time, but I have put together it is after some activity.  Usually I take several Advil and everything is fine.  Last week, I had to carry a heavier carry-on bag/purse for a family emergency on a plane, slept very cramped, etc., and it is back nightly.  Can anything else besides a bulging disc be causing this? During the day, things seem fine, other than the residual stiff neck kind of feeling.
I am thinking of seeing either an orthopedic surgeon or neurologist, but unsure of which.  Any ideas/thoughts appreciated.

Answer
Theresa,
It does sound like some kind of neck or disc problem. You may have DDD degenerative disc disease, which is common problem...kind of a fancy word for arthritis of the spine. Here the vertebrae can collapse onto one another causing nerve compression problems. This is more common in whites >45 yrs old. It could be a bulging disc..but bulging is not uncommon either as 50% of 50 yr olds that are ASYMPTOMATIC..ie no symptoms..will have bulging discs.So your Dr should not rush to a conclusion that this is what is causing your pain unless there is clear evidence on the MRI at that specific location C7 C8 of cervical on the left side. Finally you could have a ruptured disc at this location..but that usually does not come and go. Personally I would see an ortho spine surgeon, but a neurologist would also be fine...either way you will probably need EMG test and xrays,MRI. And ultimately advise PT and NSAIDs with surgery as last  resort if at all.

http://www.carpal-tunnel-symptoms.com/EMG-test-for-carpal-tunnel-syndrome.html