← Return to Pinched Nerve in Arm: Where should I go about this?

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@suzanne2

@jenniferhunter My pain is so wide spread it is impossible to narrow it down to one area. My worse area is my right arm and shoulder. I have pain when there has been no activity, ex. waking up with pain traveling up and down from shoulder to wrist, or being kept awake at night. It last for hours.

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Replies to "@jenniferhunter My pain is so wide spread it is impossible to narrow it down to one..."

@suzanne2 Hi Suzanne. You might want to see a neurologist. Their job is to determine the source of your pain or weakness that can come from a trapped nerve or if there is a disease causing nerve issues. You need to know where the problem is to determine what can help. I have experienced a traveling pain that would start at my neck and slowly travel down to my hand and it was caused by thoracic outlet syndrome that was pinching nerves in my neck and shoulder. The treatment for TOS has been physical therapy and myofascial release work to stretch the overly tight fascia that is compressing the muscles and nerves which has helped me a lot.

I have also had spinal cord compression from a bad cervical disc, and that sent pain all over my body.

I've also had carpal tunnel which causes pain at the wrist when you bend it and in the fingers.

Nerves travel through some very small spaces and compression can happen in the wrist (carpal tunnel), where nerves wrap around the bend of the elbow, in the neck as TOS where the brachial plexus nerve bundle passes between of the scalene muscles and then further down where the nerves pass between the collar bone and rib cage, and then under the pec minor muscle, and then there can be an entrapment at the spinal nerve roots if there is a spine problem. The spinal nerve roots are mapped specifically to the body parts. If there are specific fingers that are affected, that might show the nerve path back to the nerve root. If the nerve is trapped anywhere along the path from neck to hand, it causes the same pain, and overlapping symptoms can confuse the diagnosis, and there can be multiple places of nerve entrapments like I had with TOS and carpal tunnel at the same time. I went through carpal tunnel surgery that didn't resolve all the pain I had because they missed the TOS, and that is common because most doctors don't understand TOS. That is why it is important to see a specialist at a place like a teaching multi-disciplinary medical center that treats thoracic outlet syndrome. For TOS, the treatment is usually physical therapy and posture re-education. There are many types of TOS and surgery for some, but the scar tissue from the surgery can make TOS worse. After a few years of physical therapy MFR work, my TOS is much improved.

As you can see, nerve issues can be confusing, and getting proper treatment depends on getting a correct diagnosis. A neurologist will be like a detective to figure it all out. If there are physical issues, MRI imaging can show where problems may be. A physical therapy evaluation may be able to figure some of this out too, but they will ask for results from imaging or the neurologist.

Here is some info on TOS. I would try to rule that out first because it will confuse the other diagnoses like carpal tunnel.
https://www.mayoclinic.org/diseases-conditions/thoracic-outlet-syndrome/symptoms-causes/syc-20353988
https://mskneurology.com/how-truly-treat-thoracic-outlet-syndrome/
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/

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