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Pinched Nerve or Thoracic Outlet?

Numbness/Tingling and fatigue/heaviness in the arms?

We have been stuck doing desk work at our dinner tables since COVID and it hasn't exactly been the best positioning!  Yet, even at our desks, we could be more mindful of our positioning! 


Nerves.

Per the picture above, you can see that the nerves exit the spine of the neck and extend down the arm to the hand.  You can also see the areas of nerve bundles at the collar bone and in the axillary region (armpit).  A cervical disc herniation can pinch the nerve at the spine and cause numbness and tingling down the arm.  Additionally, tight neck muscles (aka scalenes) and/or tight pecs can pinch the nerve bundles and cause similar pain/nerve symptoms.

How do you know which is which? Apart from imaging, there are a couple of telling signs. Cervical traction can ease a pinched nerve at the spine, but tends to aggravate pinched nerves from thoracic outlet because it pulls on the neck muscles already impinging on the nerves. Less definitive, neck retraction is a motion that elongates the cervical spine and 'gives space' to the nerves that exit the spine. For pinched nerves at the cervical spine, this is a great self-intervention for relief; for thoracic outlet, it's 50/50 relief dependiing on how tight your scalenes are!


If it is thoracic outlet and your nerves are more trapped at your pecs, this is a great intervention to help ease the pressure.


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