“Nothing seems to work,” said MH, a busy working mom and private chef, referring to her neck pain and left shoulder/arm paresthesia*, when she arrived for her acupuncture appointment…
The following case study/article is based on Dr. Dwayne Lee’s treatment of MH, one of his regular clients. Dr. Lee kindly provided the account of his assessment and successful treatment.
When the visit to the urgent care provided no relief, MH arrived to her appointment almost in tears.
“I have not seen her in this much pain in the years that I’ve treated her,” reported Dr. Dwayne. “She cannot sleep and the pain is unremitting. The only thing that seems to provide any relief is to raise her left arm above her head while standing and hold it there.”
Most of the advice and treatment MH sought out was for the cervical spine, specifically in the C5/C6 segments. But all her imaging did not show any lesions or nerve impingements in that area.
The relief from holding the arm up was consistent with the Bakody’s Sign (arm abduction relief).
Deep tissue massage therapy on her posterior neck and shoulder made it worse and prescription medication for pain and inflammation was not helpful.
Upon exam, it seemed clear that MH was suffering from a thoracic outlet impingement in the anterior cervical compartment, although she complained of pain in the posterior shoulder and neck.
“I see this type of patient frequently,” says Dr. Lee. “Pain is reported in a specific area but the root cause is actually elsewhere.”
After a gentle acupuncture treatment, she felt the pain had resolved by the time she left the office. By her second visit, she was able to sleep through the night and had stopped her medication altogether. After 5 visits, she was functioning at work and home and resting well. Certain repetitive motion and posture from work was still plaguing her shoulder but she was now able to incorporate movement therapy to mitigate those issues inherent in her profession.
What is the cause of this fairly common condition?
According to Dr. Lee, “This is especially common in my folks that come in from sedentary office work professions, consistent overhead activity, auto accidents, or even students with heavy backpacks. The key is a proper assessment and diagnosis, in my opinion.”
Unless an acute incident causes sudden trauma and dysfunction, it is usually poor postural patterns that cause and exacerbate the thoracic outlet syndrome, neck pain, and the related upper cross pattern or torsion in the thoracic area.
Accompanying symptoms like headache, TMJ pain/crepitus, chronic joint pain in the elbow/wrist, or the annoying phantom pain near the shoulder blade are very common. As it turns out, MH had almost all of these adjunct symptoms as well. After her treatments, these symptoms went away, indicating that her condition was largely resolved.
To schedule your own assessment and treatment with Dr. Lee, contact us by phone or book online.
Article written by Slava Kolpakov with Dr. Lee’s help.
*Paresthesia = an abnormal sensation, typically tingling or pricking (“pins and needles”), caused chiefly by pressure on or damage to peripheral nerves.