Neck and Thumb Pain: A Doctor’s Personal Story
Are neck and thumb pain connected? Can a nerve in your neck cause hand arthritis? In the early summer, I had a pinched nerve in my neck and shortly thereafter, on the hand that was getting numb, evidence of early arthritis appeared in that thumb joint. Believe it or not, these two things are quite connected.
I like to say that our medical care system is “poisoned by Netter”. This is the name of a great anatomic artist from the 40s through the 90s. Netter made the incredible complexity of the human body very simple. All physicians working today have used his images to study anatomy or used those of artists following in his footsteps. The upside of Netter diagrams is that one system of the body at a time can be explained beautifully. The downside is that this philosophical movement of compartmentalizing the body (of which Netter was only a part) lead to our modern system of hyper-specialization. For example, if you have a hand issue, you see a hand surgeon. His knowledge of the rest of the body outside the hand drops off steeply, so it’s very unlikely he would ever examine your neck. If you have a neck problem you see the spine surgeon, who would never examine your hand in any detail. In fact, our modern medical care system in this regard reminds me of a bunch of blind men examining an elephant. The guy at the front believes it’s a fire hose, the guy at the leg thinks it’s a tree trunk, and the guy at the back thinks he has a rope (tail). This is the opposite of the Orthopedics 2.0 philosophy that we teach. You can’t do a great job in orthopedic care unless you’re as comfortable examining the neck as the thumb. Let me explain using myself as the example.
Before my neck went bad in the early summer, my right thumb was going numb when I played football with my son. When the neck went bad and I had severe nerve pain into the shoulder and down the arm I also acquired a bump on my thumb (shown above). If you look at it, it’s a small little thing, but it hurts if I press on it. Are the two things-my neck and the thumb bump-connected? You bethca!
What happened? As the nerve in my neck nerve got worse, it caused bad chemicals to get dumped into certain joints in my hand. These chemicals can feed the fire of a degenerative cascade and chew up cartilage. In addition, the muscles that drive this joint that are powered by the nerve also began to misfire. While my neck and nerve are dramatically better because of various Regenexx procedures, I noticed this last phenomenon a few nights ago. With my neck in a strange position, my hand began to go a little numb and my thumb locked up momentarily. This happened because the muscles on one side of the joint fired differently than the other, leading to more wear and tear on that joint. So the bump is early arthritis from my neck.
As discussed above, the concept that my neck could have caused this thumb bump is completely foreign to most physicians. Much of this is caused by our hyper-specialization. For example, that system would have two different doctors responsible for my neck and my thumb. The same concept of neck-upper extremity problems also happens with tennis or golfer’s elbow, shoulder problems, and carpal tunnel. However, since doctors almost never make this connection between the neck and these diagnoses, patients have also learned not to connect the dots.
The upshot? The body is one big machine. We use terms like neck and thumb simply for convenience, but the implication is that they are separate machines. They are not. The neck, shoulder, elbow, wrist, and hand are one finely tuned machine. What happens in one part of that kinetic chain impacts the others! So if you have neck issues and your shoulder or elbow or hand has problems, the first place to look for the cause is usually the neck!