How Sleeping “Funny” Causes Nerve Pain
How many of you guys have ever fallen asleep? You got to sleep in at night and then you wake up in the middle of the night and you are suddenly foraging out because you think somebody has broken into your house and they are like, they are trying touch you.
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You have a hand is like sitting like this, but you have no idea whose hand it is. When you really wake up and you realize it’s your own hand, because it’s cotton, it’s falling asleep and it’s like dragging across, or you try to turn over and your whole arm is just, I had this one, I was asleep like this. I woke up, I thought somebody had my hand and it was me and a full dead hand.
Oh, scary. . Or what about when you’re driving and you’re driving for long distance and your fingers start to tingle shaking them out. Like, you’re always like, oh my God, my arms are going numb. This is horrible. Or you feel numbness and tingling in your fingers and you just have no idea why. And you’re like, why is this right? What’s happening to me? Like these three fingers fall asleep or these fingers are hurting and falling asleep.
Which Nerves Cause Problems in My Arms?
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Today we’re going to talk about these three little nerves in our body that make big issues for our arms and hands. Right. Before we get to the fingers, let’s start from the beginning. Cause you know that I liked the anatomy. We’re going to talk about the brachial plexus and where do these nerves actually show up from?
Because we don’t just have nerves that are just hanging out, sitting in the middle of our arm or sitting here. It’s the nerve just doesn’t start and end here. There’s always a nerve line and a nerve pattern that goes all the way up and all the way back down.
They always start from the nerve root, which sits into the vertebrae. Today we’re going to start about, we’re going to talk about the brachial plexus. The brachial plexus is a group of nerves that come from the spinal cord in the neck and they travel down the arm and into the hand, these nerves control the muscles of the shoulder, the elbow, the wrist, and the hand.
The Three Main Nerves In The Arm
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They also provide all the feeling in the arm. A lot of times we don’t even think about the fact that we have nerves that start all the way up here. These nerves are really, really important because they innervate the entire arm, shoulder, wrist, and hand, like we just said, right? The nerves run past the elbow to the wrist and the hand.
There’s three main nerves that we’re going to talk about. You have your median nerve, you have your ulnar nerve and you have your radial. Okay? The median nerve, it passes down the inside of the arm and crosses the front of the elbow. The ulnar nerve passes down the inside of the arm and the radial nerve passes down the backside of the arm and to the outside of the elbow. Now that we know that we have three big nerves that are little nerves, but they make big problems.
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We need to talk about these nerves and where they run, right? Because each nerve has a different pattern. It has a different nerve line. Where the median nerve comes down to the center, the ulnar nerve is actually the one that’s going to affect the little pinky guy and the ring finger a lot of the time. You have the radio, sorry, the ulnar, then you have your radial nerve, sorry. I just told total like brain aneurysm in the middle of like Facebook live.
You have your radial nerve that comes around the back and it comes down and affects these guys. So we have radial ulnar, and median. So, depending on where the pain is and the, where the discomfort is and the numbness and the tingling in your arm and where it lines up in these guys and your little piggies and fingers, these are toes, huh?
The Brachial Plexus, aka The Shoulder Girdle
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Nevermind, whatever. It’s been a day already. It’s only 1230 Anyhow, when they line up into the fingers, that’s where we’re going to know where we’re going with it. Right? There’s your roadmap of where do you want to start looking? So let’s talk about the brachial plexus. The brachial plexus is actually the shoulder girdle, right? We have different flex sides in our body, depending on where the bundle of nerves come out and intervene. It’s a bundle.
So let’s talk about brachial plexus. So we know where it runs, right? We know that it innervates all the way down, providing all the feeling in the arm. Because we have these nerves that run through here, state display, they run there, they come underneath this clavicle, your collarbone, and they run under this big muscle called your pectoralis minor.
What Is Thoracic Outlet Syndrome?
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A lot of times when we’re really way too tight in here and or we have this nice little first rib that tends to get high. What is that all sitting right on top of your rib cage? The rib, the first rib tends to get a little high. What’ll happen is what’s called thoracic outlet syndrome.
This is a group of disorders that occur when the blood vessels or nerves in the space between the collarbone and the first rib, your thoracic outlet. It becomes compressed and, or pec minor gets way too tight and compresses, you have arteries and nerves.
So your hand problem is actually potentially a net problem. Yes, they’re there. It doesn’t mean that is where it starts from, right? It’s a guidepost. It really is. So thoracic outlet syndrome.
If Your Fingers Fall Asleep All The Time…
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If you tend to have it, or there’s a potential that you do have it, these guys will be your guide. These will tend to have a tendency to fall asleep, get numb, get tingling, and it will be your last three fingers in your hand. If you have these three fingers that are falling asleep all the time, or get numb or pins and needles in them, or you’re kind of feeling a little like numbness, that’s these guys. That’s most of the time coming from this area right here.
Median nerve entrapment now, so you have median nerve entrapment syndrome. That affects movement or sensation in the hand. It’s caused by compression in the median nerve, in the elbow or down into the forearm, which with the forearm and wrist, gives you symptoms in the median nerve distribution.
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You’ll have it that runs all the way through, right? And so it’ll run through this way. A lot of times the median nerve can be trapped in four different locations in the elbow. You have the distal humerus, you have the proximal elbow. Distal means the end of your humerus, the end of your upper arm to the upper part of your elbow, the proximal side of your elbow.
The Pronator Teres And Carpal Tunnel Syndrome
You have that where the two bones meet, which is the elbow joint in and of itself and or this pronator teres muscle, which is the most common cause of median nerve compression. . Pronator teres allows the body or allows the forearm to actually rotate and move down, put your hand on the keyboard or mouse or anything like that. Right. So why is that important for us? The median nerve, because median nerve compression is also carpal tunnel syndrome.
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Carpal tunnel syndrome also called median nerve mark median, nerve compression, right? It is a condition that causes numbness, tingling, or weakness in your hands. What it happens is because of the pressure on your median nerve, which then runs the length of your arm. It goes through a passage of your wrist right here called the carpal tunnel.
You add this little part of your wrist right in here, and you have all of these little bones, carpal bones, and you have this little tunnel, the carpal tunnel and it ends in your hand. The median nerve controls the movement and the feeling of your thumb and the movement of all your fingers, except for your thinking. If you’re having a lot of pain or weakness or numbness or tingling right here, you can still say classy because you still have the pinky, but you may have potentially median nerve compression, which a lot of times gets misdiagnosed as carpal tunnel syndrome.
Misdiagnosed Carpal Tunnel Syndrome
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Carpal tunnel syndrome is one of the most misdiagnosed pathologies that we have. People were, they’re doing this all the time. They’re feeling it down here. This gets irritated, but it might be coming from even all the way up into the next. It could be just a simple strain pattern.
That’s going on way up higher. That’s causing all that pain. If it’s covered or just discovered, not necessarily paying just the numbers anyway. I was very fast, you said two miles an hour. I got things to do. I know we’re going to give you guys assessments on how to assess yourself down the line. Right now we’re going to go through a couple of the other impingements. Some of the symptoms of carpal tunnel burning and tingling and itching or numbness in your phone, thumb index, and middle fingers.
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If you’re adding burning, tingling, numbness, itching, those are things to look forward to right here at shock, like feelings that move into your fingers when you’re like, huh? Oh my God, that got me. Oh my God. Oh, that got me or tingling that moves up your arm. It might be also that you’re normally, you’re noticing your fingers are falling asleep and they become numb at night. If they’re not here and they’re here, this is more of the median nerve, thoracic outlet, median nerve. It’s like a puppet show, thoracic outlet, median nerve.
Okay. So, sometimes you’ll go to sleep and you’ll wake up. Depending on where you’re numb at night, it’s going to give you a pattern as to what’s happening earlier on. You can like stretch, move, shake them out, and it’ll start to feel better. As the wear and tear comes on, and as the compression happens, it will continue.
How Do Nerves Work in the Body?
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It will be like, I don’t, I can’t get rid of it. It’s all day long. As carpal tunnel syndrome gets worse, you may lose grip strength. As things get a little worse, you might lose grip strength because the median nerve can’t work the way it’s used to because it’s not being innervated.
The problem with nerve compression, is that once you compress the nerve, you’re not sending a full signal. It’s like bad Wi-Fi, you guys. When you have good wifi, your computer runs fast. Like you can get things done like this, you start losing the signal. The nerve gets compressed. The wifi goes bad. It’s sketchy, right? It kind of goes and comes, takes longer to get there. It’s a weak, bad lifeline, horribly ruined your full day. Nerve compression is kind of like that.
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The thing with nerve compression is the longer it stays, the weaker it gets. We want to make sure that we are addressing these problems right away. How do we know if we have this? There is a test that you can do you guess you’re like, whoa, she told me one of these fingers and then you’ll end up giving me another finger that we haven’t even really talked about yet.
That’s from one of the customers. It is a different type of median nerve that’s for sure. We’re going to go with Phalen’s test. The Phalen’s test is a way to kind of distinguish this. See if you can distinguish between whether you have it or not. The Phalen’s test put your hands through Robin don’t down your chest and then try to pressure risks together. It’s like this, and I’m starting to get a compression right here.
How Does Phalen’s Test For Carpal Tunnel Work?
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I’m getting more used to the strain pattern for me. Okay. So let me tell you how the Phalen’s test works. I tell not understand you today. The Phalen’s tests, there’s two ways of doing it. The first one you can just hang out and put your hands straight down like this.
What you’re going to do is you’re going to bend the wrist. If you have compression going on in here, and neurocompression after about 67 seconds, you’ll have numbness and tingling in these fingers.
The other way is what Mike was showing you, where you bend and you press it together. And that compression will impinge that nerve. If there is a positive numbness and tingling, it becomes a positive for a Phalen’s test. That means your median nerve is compressed. That just means that we got to figure out how to get rid of wherever that nerve compression gets.
Tinel Sign Test: What It Is And How To Do It
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It means you have nerve compression of the median nerve media nerve. There’s another thing that you can do. That’s a special test for carpal tunnel and it’s called the Tinel test. Test is a clinical test that is designed to detect irritated nerves. What you’re going to do is if you have a partner, you’re going to have them grab onto your wrist. You’re going to hold it.
You’re just going to attack the area of the median nerve. Lightly tapping over the median nerve,what’s going to happen is if you have irritation, it’s gonna light it up like fireworks on 4th of July.
And it’s going to be really painful. It’s going to send the little shock waves and send the little tingling. What it’s going to do is it’s going to give you right over the area that like, aha, Hey, it’s a positive test.
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So it’s Tinel’s test. If you think you have it, tap on it. If it comes up and lights up, that’s an indication that you’ve got something going on. It just is going to give you a positive assessment. That’s what we’re looking for right now. We’ll tell you where, how, where to move into, on how to get rid of it down the lines.
Listen, now we’ve done the media nerve, but remember carpal tunnel, the biggest issue with carpal tunnel is that median nerve and the median nerve entrapment most commonly is where the pronator teres is.
It’s all of the stuff that we do all day long, drive computers, text on the phone, FaceTime, zoom mouse. I don’t even know what else, play the piano, screw a light bulb in and out. I don’t know what else ever else.
Pronator Teres Syndrome
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Pronator teres syndrome is a compression of the median nerve at the elbow. It’s rare compared to the compression at the wrist, but it actually is not as rare as you think it shows up a lot. It’s more common. The more that we get into the technology age, a lot more common cause we’re using these guys a lot more.
Well, I find out if you’re going to have any of these positive tests, you’d come up with that thrown in your chair. Is that protein of terraces involved? Pretty much so. How do we do a probative Terry syndrome test to see if we’re positive with it?
What you’re going to do is you’re going to take the person’s elbow grasping at 90 degrees. The elbow is bent at 90 degrees of flexion and there. Mike’s going to stabilize my hand with one side and then he’s going to perform a movement where I have to resist.
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I’m going to have Julie turn her hand down on the whole arm, forearm down towards the ground. And I’m resisting that motion. I’m rotating this way as she’s tried to rotate. It’s kind of like a funky handshake. What you’re doing is in resistance, I’m moving this way and he’s, he’s resisting the road, rotating the opposite way.
Tests For Diagnosing Nerve Pain
So, and if that lights up, then it’s giving you a positive test for pro-military syndrome, which is really common. Then that shows you, Hey, guess what? It could be up here. Not necessarily down there so that we’ve gone through the median nerve. We’ve gone through the carpal tunnel.
We’ve gone through pronator teres. We’ve gone through brachial, plexus and thoracic outlet syndrome. Now we’re going to move nerves moving and we’re going into, so could you say it’s like the kinks in the guard, be quiet. Stop. Beat me to my own punch mark.
Ulnar Nerve Entrapment
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Now we’re going to go into ulnar nerve entrapment. Remember the ulnar nerve is out here guys.
All our nerves are when there’s too much pressure is put on the nerve in the elbow by it’s either your bones, your tendons, your muscles, your cartilage, and it becomes inflamed or swollen. It’s also known as cubital tunnel syndrome, carpal tunnel, cubital tunnel, carpal tunnel, cubital tunnel. It moves out to the outside. This can start a pinched nerve can start all over the place, right?
It can start in several places throughout. It can be the joints. It can be into the muscle. It can be into the tendon until the ligament, when a pinched nerve is in your elbow, it can leave your arm and hand feeling sore and numb.
The Ulnar Nerve
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The ulnar nerve. It runs the length of your arm, right? It helps control the muscles in the forum and the hand sensations affecting your ring finger and your little finger also traveled through the ulnar nerve. These dudes right here. It is the most vulnerable point in the elbow, the ulnar.
This is your funny bone or come in contact with that funny bone, which is not very funny when you hit it. And it always says you bang. It sends a tingling down, no fun. The other thing with the older nerve you guys is, if you’re sitting on your elbows for a long period of time, you’re sitting like this for a long period of time.
If you’re leaning on your elbows for a long period of time, if you’re catching your ulnar nerve and the older nerve also can move. The older nerve can actually slip out of place because it’s really superficial and actually move in.
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As soon as you lay your hand down, this happens to me a lot. Actually. Soon as I lay my hand down, I was like, oh, oh. With the ulnar nerve, what happens is you can have stuff like doing it because it makes me a better therapist. The other thing too is you can actually do overuse syndrome and catch that older nerve is also where your bursa is hanging out.
So bursitis inflammation of your bursa sac. If you remember, we’ve talked about that little fluid-filled SAC that hangs out to help with friction. If it’s inflamed, it’ll get inflamed and that’ll compress onto the ulnar. So there’s a lot of things. Bone spurs, arthritis.
Weakness In Your Hands – What It Means
We can have a lot of stuff going on with the symptoms of an ulnar. Ulnar nerve entrapment, the biggest thing is weakness in your hands. You may feel like, oh, I can’t really do a lot with these guys.
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I don’t have a lot of movement. If you start to have weakness in your hand, it could be coming from your own window. This brings up a really good, a good point. It always in your fingers and your hand because it’s running into your fingers in your hand, right?
Having all these issues, is it really where it is? . Most likely not. If it’s more than likely coming from way upstream is where the compression starting and it’s ending up down there and I just jumped on your line.
So I’m going to say it again. So it’s actually not even my line. I wish I could take credit for it. James is amazing in this. He always says, which I really love, this line is when you are, when you’re watering your garden and you have a kink in your hose, is it usually, let’s just say the same.
Nerve Pain: A Kink In The Hose
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There’s several peaks, right? That’s just one circle. Go ahead. Okay. Thanks. You have a kink in your hose and you’re watering this garden and you really want to take care of your garden, but you notice that the kink in your hose is not allowing the water to actually spray. It’s just riffing.
Do you just figure out that it’s just the kink by the nozzle or could it potentially be other kinks going up into the hose that you will have to go start from the faucet? If you start from the faucet where the water comes out, then you may notice there were a lot of kinks in the hose before you just get to the nozzle. Boom. That’s how it’s supposed to be set. That was pretty good. You guys all jumped on it, try to make it your own. It’s not even mine. It’s James.
23:33
So James, thank you for that. I’m sorry that you got some others that travel when you were looking at those kids, where’s our best place to start at the very end and work our way back this way or go back to the house.
No, it’s at the faucet always start where then the nerves are coming out in the nerve root. You here’s the thing you guys with nerve impingement, even though you’re feeling it in here, this is the end of the line. I always call it end of the Bart one. So I’m from the bay area. It was always the end of the Bart line where the train stopped and had to reverse course.
This is the end of your life. If you’re having, if you’re having weakness or you’re having tingling on here, you want to make sure that you go all the way and start from the beginning all the way down and go to the end and then work your way down.
24:27
Because just because you have the three nerves here, your radial, your ulnar, and your median nerve, it can be coming from your PA tech minor being too tight. It can be coming from your first real. I’m just saying the biggest thing is that first registration elevated up.
It could be coming from a joint fixation in your neck, which could be compressing into the nerve. It can be coming from a nerve entrapment from the muscle structure. It can be coming from old scar tissue that pulls on it.
A lot of anxiety is happening these days, right? Because of all of the emotions that are going on and we tend to sit like this and everything’s all tightened up easy way to do it. It could be coming from sitting and playing video games on your elbows the entire time.
Before Surgery, Test
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There’s a lot that could be from this. My suggestion: we’ll get surgery right away. No, no. I think you should do the test. Do the test that we’ve given you, tell me how you feel. If they come up positive, what that’s giving you as a positive aha. Of like, wow, I got her and entrapment, what do I do next? Follow the line all the way up.
Have, have somebody take a look at your neck, go to see a doctor and have them give you a referral, right. And get a good assessment. If you do a good assessment, they’re going to be able to help you on all of this. What will happen is once the doctor gives you an assessment, there’ll be able to work on the area and move it right back down the chain. Hopefully they’ll be able to clear you of anything that you have.
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So, and you don’t want to sip your coffee out of, oh gosh. It would be awful. It would be awful. So you guys, I hope that helped. I’m sorry that it was so disjointed today that this directive got what I said, we’ll play our words, but I will be back.
Nerve Entrapment Doesn’t Always Mean Surgery
This is what happens when I leave my hair down to talk, I lose all control of my body. Anyway, at the end of the day only you guys can fix you. So really pay attention. Don’t think that every time we have a nerve entrapment, it means surgery. It doesn’t mean the end of the line.
It means the start of what can we do? The more that you focus on you’ll be better off for it. So I hope you guys enjoyed it. If anybody has elbow pain, has nerve pain, has finger pain has weakness in their hands.
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Please show them the video. Hopefully that can give them help. And we can help them. If not, we’ll see you next week. Same time, same channel. Hopefully a little less, a little less spunkiness next time. I hope you guys are having a great day.