Question
About 6 weeks ago I began to experience left sided neck pain that felt like a burning pain with no hx of injury. Over the next few weeks the burning went from my neck into the upper back and down the arm to the fingers(the thumb and index finger only). This pain did not respond to Ibuprofen or other OTC pain relievers.Heat and massage(self)seemed to work the best. The pain persists and now I can actually bring the pain on by positiioning my head a certain way. There are days that I have no pain at all. Where do I start with this? I mentioned it to my PCP on a visit recently and he said to give it time. In the past year I have changed employment and sit at a computer 8 hours a day with headphones on. I am asking my employer to have the ergonomic expert assess my work station. Any suggestions. My health hx is pretty unremarkable.

Answer
Dear Cindy,

The problems you have reported, numbness and tingling into the hands, are commonly derived from dysfunction in the neck.  With the additional information that head positioning makes these symptoms re-appear, I am confident that you have nerve root encroachment in the neck, which causes inflammation and sometimes compression of the nerve.  

Specifically the encroachment is affecting the nerve roots that combine to form the median nerve into the arm and hand...it supplies motor and sensory information to and from the hand (thumb and first two fingers).  This nerve is comprised of fibers mainly from the C7 nerve root concerning its motor function, and the sensory distribution to the area is from C6.

These types of problems are usually caused by either disk degeneration, disk bulges, or osteoarthritis (bone spurs), which are encroaching upon the holes of the vertebra where the nerves exit the spine.  It is common in the lower neck due to previous trauma, acute injury, or chronic postural and ergonomic issues that create abnormal movement patterns and degeneration.  With your job descriptions of desk work and with poor ergonomics and posture so rampant in this country, this is the likely scenario.

I would recommend that you seek out the care of a chiropractic physician, medical doctors really don't treat these issues...just meds and wait and seek approach, then maybe physical therapy.  Chiropractic physicians on the other hand treat these issues every day, and with great success.  The chiropractor should take a complete history, perform orthopedic and neurological tests and take x-rays to look at the structure of the spine.  This will determine if an MRI needs to be performed.  I would also recommend that you seek out the care of a chiropractor who is certified in structural rehabilitation of the spine.  This is the only true way to correct the structure when dysfunctional.  It is likely that you neck curve is decreased, your head is pushed forward, or the curve may be reversed.  To find a doctor who is certified in structural rehab, check out www.idealspine.com. To better understand how the structure can be problematic, here are a few quotes for you to appreciate:

揊or every inch of forward head posture, it can increase the weight of the head on the spine by an additional 10 pounds.?Kapandji, Physiology of Joints, Vol 3.

揕oss of the cervical curve stretches the spinal cord 5-7 cm and causes Disease.? Dr. Alf Breig, Neurosurgeon (Nobel Prize Recipient)

揊orward head posture leads to long term muscle strain, disc herniations, arthritis and pinched nerves.? The Mayo Clinic, Nov. 3rd, 2000

?0% of the stimulation and nutrition to the brain is generated by the movement of the spine?Dr. Roger Sperry, (Nobel Prize Recipient for Brain Research)

Additionally, Dr. Sperry demonstrated that 90% of the energy output of the brain is used in relating the physical body to gravity.  Only 10% has to do with thinking, metabolism, and healing, so when you have forward head posture your brain will rob energy from your thinking, metabolism, and immune function to deal with abnormal gravity/posture relationships and processing.

Additionally Cindy, I am going to attach below an article I have written on the ergonomics of work postures, and what you can do about them yourself. If the link is not clickable, just copy and paste it into your browser, and it should take you to the blog on my website.

http://suncoasthealthcare.net/blog/2006/12/training-for-stability-of-neck-and.ht...

Good luck, and feel free to write back if you need.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net