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Possible T4 Syndrome/Consistent Left UE Distal Arm/Hand Numbness Case

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[#341]

Hello fellow IDN providers: So I have a more complex case that I would like your input on in terms of possible root cause as well as treatment options for this patient. He is a 38 y.o. male who presents with occasional neck and upper back pain (in between his Left Scapula and Thoracic Spine at the T3-T5 levels) and Left UE numbness/tingling as well only in his left forearm and left hand. He only has the Left UE symptoms when he is in a slumped posture and when he places pressure/weight through his left ulnar side of his forearm which will create an "achiness" and then will cause numbness in his left pinky finger, then his ring finger, and then in his other digits until the entire left hand becomes numb. When he sits with proper posture and ergonomics, then his symptoms improve. I have dry needled cervical spine as well as his thoracic spine, dorsal scapular and suprascapular neurotrigger points, pec major and minor (thinking more TOS involvement), as well as his ulnar, median, and radial nerve pathways. He subjectively reports that he feels 70-80% better since the start of skilled PT with the incorporation of dry needling, trigger point releases, postural correction exercises, and ulnar nerve glides. But I, of course, still want to get to the "root cause" and want to get 100% elimination of symptoms. He has only had 6 sessions of skilled PT thus far and is compliant with HEP. He is fully active with consistent workouts at the gym and does not have any functional limitations. Any advice would be greatly appreciated. 


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