Charles Lascano, MD, CAQSM, DABFM.
Sports Medicine Physician. Sanitas Medical Centers.
Many times, we have symptoms that are not originating from where we are really feeling them. This article describes common scenarios of symptoms located at the upper or lower extremities, which do not originate from where we feel them, and explains where the symptoms are most likely to be coming from.
Scenario # 1: Upper arm pain, which is triggered by overhead activities and is less with arm rest. The most likely origin is a shoulder problem because many tendons from the shoulder attach to the upper arm bone. Therefore, conditions like shoulder tendon problems can manifest as upper arm pain, with or without associated shoulder pain.
Scenario # 2: Pain, numbness, tingling, or muscle weakness that travels into the posterior part of the shoulder, upper arm, forearm, or hand. Symptoms can affect one or the two upper extremities at the same time. The most likely origin is the neck due to a pinched nerve root at the cervical spine, even without the presence of neck pain.
Scenario # 3: Pain at the medial border of the elbow and forearm that radiates to the ring and pinky fingers, commonly with associated numbness and/or tingling of the ring and/or pinky fingers. The most likely cause is cubital tunnel syndrome which is due to a pinched nerve in the elbow.
Scenario # 4: Numbness, tingling, burning, and pain—primarily in the thumb and index, middle, and ring fingers that travel up the forearm toward the shoulder, and appear mainly at bedtime. The most likely cause is carpal tunnel syndrome which is due to a pinched nerve in the wrist.
Scenario # 5: Uncomfortable pressure, squeezing, fullness, or pain of the left arm, which can be also present in the neck and/or chest area. When this scenario is present it is very important to think about an ongoing heart attack as the first possibility and 911 must be called immediately.
Scenario # 6: Pain, numbness, tingling, or muscle weakness that travels into the buttocks, hip, groin, thigh, leg, or foot. Symptoms can affect one or the two lower extremities at the same time. The most likely origin is the low back due to a pinched nerve root at the lumbar spine even without the presence of back pain.