Teresa’s TCM Clinical Reflections (25)

Elbow Pain and Hand Numbness — Is It a Pinched Nerve in My Hand or Could It Be a Stroke?

By Teresa Shen, BHSc (Acupuncture), ACC Registered Treatment Provider, Registered Chinese Medicine Practitioner (NZ)

“Teresa, my elbow has been very painful lately, and now my hand is going numb too. I searched online and read that it could be a slipped disc in my neck pressing on a nerve, or even compressing my spinal cord. Someone else said hand numbness could be a stroke or a brain tumour. I’m really worried. Could something serious be wrong?”

I often meet patients with similar concerns in my clinic.

I have noticed something interesting. Some patients can cope with shoulder, upper back or elbow pain without becoming too worried. But as soon as they experience numbness in their hand, they become anxious.

They know that numbness may involve the nerves. Once nerves are mentioned, they start thinking about cervical disc problems, spinal cord compression, stroke or even brain tumours. With ChatGPT and Google readily available, reading about these conditions can make their anxiety even worse.

Hand numbness can sometimes be a sign of a serious neurological condition. But it does not automatically mean there is something wrong with the brain or spinal cord.

Let’s First Consider Some Common Causes

When I see patients with these concerns, I usually explain that serious neurological conditions do exist, but we should not immediately assume that hand numbness means a brain tumour or severe spinal cord compression.

There are many more common explanations.

Carpal tunnel syndrome occurs when the median nerve is compressed at the wrist. Cubital tunnel syndrome involves irritation or compression of the ulnar nerve around the elbow. Thoracic outlet syndrome may involve compression or irritation of nerves passing through the neck and shoulder region.

These conditions can cause hand numbness, sometimes together with pain in the elbow, forearm or upper limb.

Some patients notice more numbness at night and feel better after shaking their hand. Others find that keeping their elbow bent for a long time, or leaning on it, makes the numbness worse.

These details help us identify where a nerve may be irritated.

Many peripheral nerve entrapment problems can improve with appropriate diagnosis and treatment. They do not necessarily lead to serious or permanent neurological damage.

How Are Stroke, Brain Tumours and Spinal Cord Compression Different?

I explain to patients that these are important conditions, but they often have other clinical features beyond elbow pain and hand numbness.

A stroke usually begins suddenly. Patients may develop weakness in one arm or leg, facial drooping, difficulty speaking or problems with balance. Even sudden numbness affecting only one side of the body can be a warning sign of stroke.

Symptoms caused by a brain tumour depend on its location. Some patients may experience progressively worsening headaches, weakness, seizures or other neurological changes.

Cervical spinal cord compression may cause numbness in both hands, difficulty with fine finger movements, trouble fastening buttons, unsteady walking, or changes in strength and reflexes.

A cervical disc pressing on a nerve root is not the same as a disc compressing the spinal cord. Even when an MRI shows a disc protrusion, it does not necessarily mean there is serious spinal cord damage.

This is why clinical examination matters. I need to know not only where the patient feels pain or numbness, but also whether there are changes in sensation, muscle strength, reflexes, hand coordination or walking.

If the examination suggests a neurological problem that needs further investigation, the patient should be assessed by a doctor. Depending on the findings, a brain CT, brain MRI or cervical spine MRI may be required.

If someone suddenly develops weakness on one side, facial drooping, difficulty speaking or other suspected stroke symptoms, they should call 111 immediately in New Zealand.

I do not want patients to read about a serious disease online and decide they must have it before anyone has examined them. Living with constant fear and anxiety, sometimes even losing sleep, does not help them understand what is actually happening.

Once We Find the Cause, How Can Elbow Pain and Hand Numbness Be Treated?

Even when a nerve is irritated or compressed, it does not mean there are no treatment options.

In some patients, symptoms are related to muscle tension or local soft tissues irritating a nerve. For example, nerves may be affected around the scalene muscles in the neck, the median nerve may become compressed near the pronator teres muscle in the forearm, or other nerve passages around the shoulder and upper limb may be involved.

These problems can cause pain, numbness and sometimes weakness.

For these patients, I first try to identify where the problem is coming from through clinical examination. Then I consider whether acupuncture, local soft tissue treatment or rehabilitation exercises may be appropriate.

In my clinical practice, I have seen some patients with muscle-related nerve irritation or peripheral nerve symptoms experience improvement in pain and numbness after targeted acupuncture treatment. However, not every nerve entrapment condition is suitable for acupuncture alone.

Some patients have a clear structural cause of nerve compression. Severe carpal tunnel syndrome, cervical degeneration or narrowing of the neural foramina may cause persistent nerve compression. If neurological function continues to deteriorate, some patients may need surgical decompression following specialist assessment.

Even conditions such as stroke, brain tumours or spinal cord compression have established medical treatments, including emergency care, medication, surgery and rehabilitation, depending on the diagnosis.

Once the condition is medically stable, some patients may also consider acupuncture as an additional treatment to help manage certain symptoms or support rehabilitation, when appropriate.

Hand Numbness and Elbow Pain Need Proper Assessment, Not Immediate Fear

I want patients to understand that elbow pain and hand numbness deserve proper examination. We need to identify the cause, but we do not need to assume the worst before we have a diagnosis.

Even when a medical condition is confirmed, the next step is to understand it and choose appropriate treatment, rather than allowing fear to take over everyday life.

Preventing disease is important. But when illness occurs, taking it seriously, obtaining the right diagnosis and choosing appropriate treatment are just as important.

Do not ignore illness, but do not let fear of illness control your life.

Book an Appointment

If you experience recurring elbow pain, hand numbness, neck pain or symptoms radiating into your arm, a clinical assessment may help identify whether the problem involves local muscles, peripheral nerves or the cervical spine.

Teresa can assess whether acupuncture or other conservative treatments may be appropriate, or whether further medical investigation or specialist referral is needed.

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Disclaimer

This article is for general health education and reflects Teresa Shen’s clinical experience. It does not replace individual medical diagnosis, professional advice or necessary medical investigations.

Hand numbness may be associated with peripheral nerve entrapment, cervical radiculopathy, spinal cord disorders or central neurological conditions. New or worsening numbness, weakness, loss of hand coordination or walking difficulties require medical assessment.