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

Hi, @suzanne2...I've had this painful condition. I started with my chiropractor who did an x-ray, treated it with chiropractic techniques & referred me to an acupuncturist. After 2 treatments of accupunctire, I felt relief & it hasn't bothered me since.

@suzanne2 Hello Suzanne. I have had a few issues that have given me nerve pain with carpal tunnel, thoracic outlet syndrome, and a spine problem with spinal cord compression. I have also done a lot of physical therapy. Sometimes pain can be caused when nerves get compressed and cause pain anywhere along the length of the nerve; sometimes it develops from habits or posture that isn't the best. I can try to help, but to narrow down possible causes it would help to know some more details. Can you tell me more about how this pain began? Was there a trauma or incident that seemed to provoke it? Where specifically do you feel pain? Does any movement or position lessen the pain? Is this a new problem or is it a repeat of something that happened previously?

@cb772 I have contemplated acupuncture so it is interesting that you found relief through it. Amazing you only needed 2 treatments. Totally worth my looking into.

@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.

@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/

@jenniferhunter Thanks so much for the detailed book of information. That is a lot to go over. I do know I have pinched nerves in my neck area from a car accident. That might be my problem. Wished I lived closer to Mayo at times like this. I am teaching kindergarten so I can't just take off and go there now. The doctors around here, well lets just say they leave a lot to be desired. There is the U-M but getting an appointment is not easy anymore! I have a friend who had stomach issues for 3 years and the gastroenterologist kept telling her there was nothing wrong. In other words quit complaining. She developed emergency problems and went to another doctor to find out she has a rare form of intestinal cancer, stage 4. Suddenly the original doc disappeared from the area. No one knows where he went. Now she is fighting for her life.

@suzanne2 Ah, now you know why I was asking for your history. I have been through something similar with a whiplash years ago that with aging caused a disc to herniate and collapse causing cervical stenosis. I didn't have stenosis or arthritis at the nerve roots, but because my disc was collapsed 50%, if I bent my neck to the side, it would contact the nerves at that level and send strong pain down my arm. FYI, thoracic outlet syndrome can be caused by a whiplash injury and seems to be more common among spine patients maybe for that reason, so you should bring up questions about it with your doctors.

Mayo isn't close for me either; it's a 5 hour drive, but it was worth it to get the quality of care that I received there and they get things done right away so you won't spend months waiting for tests and appointments. If I had known how difficult it would be for me to get help locally, and how easy that was when I contacted Mayo, I would have come to Mayo first. I had been turned down by 5 local surgeons who were confused by my symptoms and I had lots of stuff with overlapping symptoms at the same time. You do have to advocate for yourself and seek answers somewhere else if your doctors are not helping or figuring things out. If you do see a neurologist, they could order an MRI and you would get an answer. At that point, if there is a spine issue causing nerve compression, you could send that to Mayo to seek treatment and they will look at the imaging at no charge when they determine if they can help. When you become a patient there, the charges will begin.

You can request that a specific surgeon looks at your imaging like I did. I can help you understand what your reports say. I highly recommend my neurosurgeon at Mayo Rochester, Dr. Jeremy Fogelson. If you do go to Mayo, you'll be sent to a neurologist there and they will examine you and order tests and imaging. They will also use current spine imaging which I had, but they did thoracic and lumbar imaging to have a full picture of my spine. The surgeons like to work with specific neurologists as a team and they do all of that before you see the surgeon so everything is in order for the consult. Here is my patient story about Dr Fogelson.
https://sharing.mayoclinic.org/2019/01/09/using-the-art-of-medicine-to-overcome-fear-of-surgery/