Hands get numb while sleeping
Fifty-six year old woman. Complains of numbness in hands when sleeping, more in little finger and ring finger. Hands become very numb at night, disturbing sleep. Patient has to wake up all night and change position, shake and stretch her hands. This condition lasts about six months.
Objective examination: neurodynamic tests of the median and ulnar nerves are sharply positive (more on the left side), the nerves are painful when palpating, Tinnell's symptom is positive, palpation of the scalene muscles is very painful, mobility of the first rib is limited (elevated, more on the left side). Past medical history: had surgery less than a year ago to remove a malignant tumor of the left breast, frequent respiratory tract illnesses with a severe cough.
Diagnosis: thoracic outlet syndrome, tunnel compression ischemic brachial plexus neuropathy with emphasis on the ulnar nerve, functional joint blocks of the first ribs, scalene muscle dysfunction.
Treatment: muscle energy technique and rhythmic mobilization of the first rib (both left and right), myofascial release of the cervical fascia, mobilization in movement of the cervicothoracic junction, proximal and distal gliding techniques for the ulnar and median nerve (clinical neurodynamics).
☛ Neurodynamic techniques - comprehensive and systematized therapy
The result: reduction of symptoms after the first sessions, improvement of sleep quality. After ten times the patient's condition improved greatly, frequency and severity of numbness episodes were reduced. The patient was given extensive recommendations on therapeutic exercises aimed at: neurodynamic sliding of nerves, restoration of mobility of the first ribs, normalization of the scalene muscles, neck fascia, improvement of posture, B-group vitamins, folic acid were prescribed. Patient's diligent fulfillment of all recommendations played an important role in the success of treatment.
Numbness when sleeping. Conclusions.
This is one of many examples of ineffectiveness of the attempts to solve the biomechanical problem chemically. Before our meeting the patient had already undergone multiple consultations of different specialists (including different neurologists), took courses of different medications, but without any significant effect. Also, the case is an illustration of the integrity of the body and the complexity of the interconnections within it. Surgery, adhesions, immobilization changed the mechanics of fascias, joints, muscles, the accompanying chemotherapy greatly weakened the body, disrupted metabolic processes. All this layered on overloaded scalene muscles, coughing for a long time, impaired posture (upper crossed syndrome) and led to symptoms far from the site of the problem - numbness when sleeping.
Osteopath, sports medicine doctor
15 years of experience in osteopathy and manual therapy. Read more...
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