Q. How to rule out neck pain and numbness?

Answered by
Dr. Akshay Kumar Saxena
and medically reviewed by Dr. Sneha Kannan

Hi doctor,

A physiotherapist did some manipulation with my neck and since then when I fall asleep at night, my arms, hands, upper back (area just below the neck) and brain feels weird as if blood supply is cut. This happens several times during the night while I am sleeping and these symptoms go away when I sit for 5-10 minutes. Because of this, I am unable to sleep properly. I want to get Doppler ultrasound of arteries and veins. Please suggest which Doppler ultrasound I should get to rule out the possibility of any obstruction in arteries or veins caused by several jerks, trauma to my neck and rest of the spine that might be causing problem with blood circulation. My whole spine MRI screening shows disc protrusion at L4/5 and L5/S1. Cervical area does not show any significant change. Please help.

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Dr. Akshay Kumar Saxena

MBBS., DNB (ORTHOPAEDICS)., DIP SICOT ( BELGIUM)., MNAMS., SPINE FELLOWSHIP,AARHUS UNIVERSITY,DENMARK
Orthopedics And Traumatology Spine Surgery

Hello,

Welcome to icliniq.com.

You have mentioned pain and numbness in your upper limbs after manipulation was done by a physical therapist. You have also mentioned both upper limb involvement which is actually a surprise because normal spinal manipulations should not actually lead to this especially if your cervical spine MRI is fine.

To actually find out a cause for both your upper limb symptoms, a detailed neurological examination of both your upper limbs including assessment of motor power, sensory examination and evaluation of deep tendon reflexes, nerve conduction studies and CT angiogram of carotid and vertebral vessels can be done.

There is an entity called as thoracic outlet syndrome which can actually lead to your upper limb symptoms, but bilateral involvement is not very common. Can you kindly send me the above mentioned details along with the investigations done by you till now? I can see and advise you accordingly. Also send me your blood investigations done recently as well.


Treatment plan:

Will be based upon the investigation and clinical details as provided.

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