Compression of the nerves or vessels passing between the collarbone and the first rib.
What it is
The neurovascular bundle to the arm passes through a narrow space. An extra cervical rib, a tight scalene muscle, or post-traumatic scarring can compress it.
It is frequently confused with cervical radiculopathy and carpal tunnel syndrome.
How it usually presents
- Arm and hand symptoms worse with the arms raised overhead.
- Numbness typically in the little and ring fingers.
- Aching in the shoulder and side of the neck.
- Hand fatigue with sustained overhead work.
- Colour or temperature change in the hand in vascular forms.
How we treat it
- Nerve conduction testing to exclude the commoner mimics.
- Image-guided scalene block, which is both diagnostic and therapeutic.
- Physical therapy for posture and first-rib mechanics.
- Surgical referral in confirmed vascular cases.
To be assessed, call (314) 310-5577 or request an appointment.
Common questions
Why is this so often missed?
Because it mimics two much commoner conditions, and standard nerve tests can be normal in the neurogenic form.
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Monday–Friday, 8:00 a.m. – 4:00 p.m. Same-day appointments are often available for new accident and injury patients.