Complaints of Upper Extremity Numbness and Tingling Relieved With Dry Needling of the Teres Minor and Infraspinatus: A Case Report.

J Orthop Sports Phys Ther. 2017 Mar 03;:1-21

Authors: Lane E, Clewley D, Koppenhaver S

Abstract
Study Design Case report. Background Abnormal sensation, such as numbness or tingling, is traditionally thought to originate from neural compression. There is limited evidence to support reports of abnormal sensation arising from a trigger point. Case Description The patient was a 60-year-old female with primary complaints of right shoulder pain and secondary complaints of neck pain and right upper extremity numbness. Cervical spine neurological examination was unremarkable, and manual examination did not reproduce the patient’s arm numbness or tingling symptoms. Compression of a trigger point in infraspinatus and teres minor reproduced the patient’s primary complaints of shoulder pain. The initial intervention included dry needling (DN), which reproduced her upper extremity numbness. Subsequent treatment included manual therapy and exercise. Outcomes The patient was seen a total of three visits, including the evaluation. Dry needling was utilized in two of her three visits. At discharge, she reported complete resolution of pain and altered sensation. Additionally, her scores on the shortened form of the Disability of the Arm, Shoulder, and Hand, Numerical Pain Rating Score, and Global Rating of Change exceeded the minimal clinically important difference (MCID). These outcomes were maintained at 2- and 12-month follow-up phone calls. Discussion This case report described the examination and use of dry needling in a case where the diagnosis was unclear. Clinicians may consider trigger point referral when examining patients with reports of abnormal sensation, especially when a more common cause cannot be identified. Level of Evidence Therapy, Level 4. J Orthop Sports Phys Ther, Epub 3 Mar 2017. doi:10.2519/jospt.2017.7055.

PMID: 28257619 [PubMed – as supplied by publisher]