Neck arm chest pains

@wawryk01 I am a Mayo spine surgery patient, and the symptoms you described can possibly be related to a spine problem or TOS. I had a whiplash years ago, and with aging, a disc ruptured, and I developed cervical stenosis and a compressed spinal cord in my neck. My first symptom of a spinal cord compression was a pain in my ankle. Over a few years, those symptoms increased and expanded to pain all over my body. I saw 5 local surgeons who could not connect my symptoms with my spine imaging, and one suggested MS which was completely wrong, but it is what they call a differential diagnosis which is another medical issue that has similar symptoms. I could turn my head and turn the ankle pain on and off, but doctors would not pay attention when I told them this. None of them would help, and after 2 years of searching, I came to Mayo.

I also have thoracic outlet syndrome (TOS) which is literally a pain in the neck. The first symptoms of that was my arm going completely numb while I slept, and it was the arm that I was not laying on. It is a compression of nerves and blood vessels passing from the neck through the chest to the arm, and common compression points are the scalene muscles, between the collar bone and rib cage, and under pectoralis minor as it connects in the arm pit. It has caused pain, tingling, numbness and a heavy feeling to my arms and made my hands turn blue and cold and just the position of my neck can bring on symptoms. TOS is missed most of the time because a lot of doctors don't understand it. They gloss over it in med schools. You can discuss this with the physical therapist or a neurologist. Look for a specialist at a teaching hospital that treats TOS to find a doctor who knows how to treat it. I've been doing physical therapy for TOS including myofascial release for a few years, and during that time, my spine developed stenosis and I needed surgery. TOS also affects the chest and makes muscles tight like living in a straight jacket. My left side is tight from my neck to my pelvis, and it can pull my pelvis out of alignment. It can be caused by bad posture, whiplashes, injuries, and physical build or even an extra rib at the top of the rib cage. Mayo is an excellent place to diagnose TOS, and I came there because I needed a place that understood both TOS and my spine problem. A spine problem can sneak up on you without you knowing it.

If you find yourself without a real diagnosis, you may want to see a neurologist and discuss TOS or spine issues and they may do MRIs of your entire spine. TOS can show on an MRI, and mine showed edema in scalene muscles. At Mayo, they tested this with tiny blood pressure cuffs on my fingers and moved my arms upward to measure the drop in blood pressure when the circulation gets cut off. They also listened to my pulse in my neck, and when I turned my head, the pulse stopped. TOS is positional in how it affects nerves and blood vessels and is often worse on one side. I also had neck muscle spasms contributing to issues. They also do doppler studies and nerve conduction tests.

Here are some links that may be of interest.

https://www.mayoclinic.org/diseases-conditions/thoracic-outlet-syndrome/symptoms-causes/syc-20353988
https://www.mayoclinic.org/diseases-conditions/pinched-nerve/symptoms-causes/syc-20354746
http://www.myofascialrelease.com
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3111492/
https://www.researchgate.net/publication/12917452_Sciatica_Caused_by_Cervical_and_Thoracic_Spinal_Cord_Compression

Here is more about my story.
https://sharing.mayoclinic.org/2019/01/09/using-the-art-of-medicine-to-overcome-fear-of-surgery/

Thanks for the reply. I am only 37 and this is really my first real medical issue. It’s very frustrating to go back and forth and get mutlitple tests with multiple answers or diagnoses. I will definitely ask to see a neurologist about TOS.

@wawryk01 I understand the frustration. Most TOS patients are accused of malingering and are not diagnosed for a number of years. Doctors and their ability to pinpoint our issues as patients are greatly affected by good or bad communications, and if the doctor is willing to listen to and believe the patient's symptoms and how much it was covered in medical school. TOS gets glossed over and doctors think it's rare; it isn't rare, but getting the proper diagnosis is the real problem. My TOS diagnosis came after carpal tunnel surgery that didn't resolve the issues completely and my hand was turning blue. That surgeon just took my pulse and told me I was fine and that his surgery fixed it all. After I had the correct diagnosis that he had missed completely, he wouldn't help me get physical therapy for the TOS and claimed he knew nothing about it... well that was true. You will need to advocate for yourself and seek out knowledgeable professionals. Good luck. Look for a place that treats TOS and you should find some doctors who know about it. Mayo is great for that if it works out for you and would be well worth your time.

Unfortunately I am relying on military doctors. Took them forever to take me seriously about having numb fingers and foot.

@wawryk01 You are going to have to advocate for yourself. Learn as much as you can so you can ask specific questions. If you have TOS, it could be a work related injury with your military service. Usually physical therapy is the best way to treat it. There is surgery for it, but that can make it worse by forming scar tissue that just perpetuates the problem. The surgical success is about 60% as told to me. Good posture is important. I've just read that there is a case of TOS causing a person to pass out because of altered blood flow just by turning their head. At Mayo, my neurologist listened to my pulse on the front of my neck near the collar bone, and heard it stop when I turned my head to the side. You can ask them to do that test. Another test is where they hold your arm to the side with bent elbow and raise it while feeling your pulse and they find a position that stops the pulse. Mayo did a test like that with tiny blood pressure cuffs on my fingers taking measurements. I also had an MRI of the brachial plexus area that showed edema in the scalene muscles that are at the side of the neck. People with a longer neck are more disposed to this problem because the collar bones are lower (so the neck looks longer), so there is less room under them where the nerves pass between the collar bone and rib cage.

Here is a website for a physical therapy training & rehab that explains a lot about TOS. He also has a facebook page and discusses his findings on there. He has several articles related to rehabbing that you might find interesting. https://trainingandrehabilitation.com/how-truly-treat-thoracic-outlet-syndrome/

I hope you'll check back in later and let us know about your progress.