As we’ve mentioned in several blogs over the years, there are many different causes of numbness and tingling in the upper limb. One of the less common reasons for numbness and tingling / pins and needles (or a “pinched nerve”) is thoracic outlet syndrome.
As the nerves leave our neck and course down our arm, they have to pass through a tunnel of bones and muscles called the thoracic outlet. Essentially, this is an area close to the shoulder and neck where the nerves and blood vessels can become easily entrapped. Typically, thoracic outlet causes symptoms of numbness and tingling, pins and needles on the inside of the arm down to the pinky finger. There are various entrapment sites. An “extra” rib can be present in some people (1% of the population) or the nerve can get pinched under muscles. In particular, the scalenes (on the side of our neck) and the pectoral minor (in our chest) are common causes of thoracic outlet syndrome. Usually, these muscular entrapment sites are related to poor posture.
There are various ways to diagnose thoracic outlet syndrome. Astute clinicians should be able to reasonably differentiate this from other causes of a “pinched nerve”. Numbness, tingling, pins and needles can be present in many different conditions and thoracic outlet is only one of them. A good screening tool is the E.A.S.T. test (Roos). In this orthopedic test, the patient will raise their arms as you would to flex your bicep muscles and make fast, strong gripping movements. A person with a true thoracic outlet syndrome would likely notice numbness, tingling, pins and needles in the pinky fingers in a short period of time.
Physiotherapy in Burlington for Thoracic Outlet Syndrome
There are various ways to treat thoracic outlet syndrome. Obviously, if the symptoms are being caused by a cervical rib (extra rib) then our hands are a little tied. If it’s a muscular entrapment there are many options. Our Burlington clinic offers Chiropractic, Physiotherapy, Athletic Therapy and Massage Therapy. Specific techniques include acupuncture, active release technique, graston technique, fascial stretching and in some cases, the use of therapeutic modality (ultrasound / IFC / laser therapy). Postural advice and home exercises are almost always required to correct thoracic outlet syndrome.
Are your experiencing numbness, tingling, pins and needles in your arms? Give us a call! We can help determine the cause and offer you a solution!